Assessing the effectiveness of health care cost containment measures: evidence from the market for rehabilitation care

Ziebarth, Nicolas R.

doi:10.1007/s10754-013-9138-1

Cited by 15 publications

(9 citation statements)

References 63 publications

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“…A comprehensive review of the German health insurance system and the related literature is beyond the scope of this paper. For this, the reader is referred to Jürges (), Hullegie and Klein (), Ziebarth ( and ) and Schmitz and Ziebarth (), as well as the references therein.…”

Section: Related Literaturementioning

confidence: 99%

Skewed, Persistent and High before Death: Medical Spending in Germany

2016

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We use claims panel data from a big German private health insurer to provide detailed individual‐level evidence on medical spending between 2005 and 2011. This includes evidence on the distribution of medical spending, the dependence of medical spending on age and other demographic characteristics, its persistence, and how medical spending evolves in the years before death. Our main findings are that health care spending more than doubles between ages 50 and 80 and that spending is very concentrated: the top 10 per cent of all spenders are responsible for 53 per cent of all medical spending in a given year. There is a 50 per cent probability that individual expenditures lie in the same quintile of the distribution after five years, for both very‐high‐ and very‐low‐cost individuals. Medical spending in the year of death is six times higher for the deceased than for everybody else in that year and accounts for 7.9 per cent of lifetime spending. Females use more office‐based care and have higher spending at younger ages, whereas males have higher spending at older ages, particularly for hospital care, and die younger. The presentation of these empirical facts is framed by an institutional discussion of the German health care system, a comparison between publicly‐ and privately‐insured individuals, and a discussion of medical spending trends in aggregate‐level data.

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Section: Related Literaturementioning

confidence: 99%

Skewed, Persistent and High before Death: Medical Spending in Germany

2016

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“…anticonvulsants), and more limited evidence that increased cost-sharing for doctor visits and drugs was associated with increased hospitalisations, even in the short-term. However, looking at more general cost-sharing, the RAND HIE, Anderson et al (2012), Ziebarth (2014), Kaestner and Lo Sasso (2015) and Puig-Junoy et al (2016) found no evidence for such offset effects.…”

Section: Previous Evidencementioning

confidence: 93%

Public Healthcare Entitlements and Healthcare Utilisation among the Older Population in Ireland

Nolan

2016

Health Economics

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The use of direct out-of-pocket payments to finance general practitioner (GP) care by the majority of the population in Ireland is unusual in a European context. Currently, approximately 40% of the population have means-tested access to free GP care, while the remainder must pay the full out-of-pocket cost. In this paper, we use data from The Irish Longitudinal Study on Ageing (TILDA) to examine the impact of the current system of public healthcare entitlements on GP utilisation among the older population. Using difference-in-difference propensity score matching methods, we find significant effects of changes in public healthcare entitlements on GP utilisation (i.e. introducing user fees reduces utilisation, while removing them increases utilisation). There is limited evidence of offset effects on other types of healthcare utilisation. The results have direct implications for current Irish health policy, and add to the international literature on the effects of insurance on healthcare utilisation. Copyright © 2016 John Wiley & Sons, Ltd.

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“…In 2011, 1.9 million rehabilitation therapies were prescribed and a total of C8.9 billion are annually spent (cf. Ziebarth, 2010bZiebarth, , 2014. This commitment to rehabilitation while workers are receiving temporary earning replacement as part of their sickness benefits may have played a role in curbing growth in the WDP program.…”

Section: Why Has the German Experience Been So Different?mentioning

confidence: 99%

Protecting working-age people with disabilities: experiences of four industrialized nations

Burkhauser

Daly

Ziebarth

2016

J Labour Market Res

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Although industrialized nations have long provided public protection to working-age individuals with disabilities, the form has changed over time. The impetus for change has been multi-faceted: rapid growth in program costs; greater awareness that people with impairments are able and willing to work; and increased recognition that protecting the economic security of people with disabilities might best be done by keeping them in the labor market. Here we describe the evolution of disability programs in four countries: Germany, the Netherlands, Sweden, and the United States. We show how growth in the receipt of publically provided disability benefits has fluctuated over time and discuss how policy choices played a role. Based on our descriptive comparative analysis we summarize shared experiences that potentially benefit policymakers in all countries.

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Assessing the effectiveness of health care cost containment measures: evidence from the market for rehabilitation care

Cited by 15 publications

References 63 publications

Skewed, Persistent and High before Death: Medical Spending in Germany

Skewed, Persistent and High before Death: Medical Spending in Germany

Public Healthcare Entitlements and Healthcare Utilisation among the Older Population in Ireland

Protecting working-age people with disabilities: experiences of four industrialized nations

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