Decomposing the Determinants of Health Care Expenditure: The Case of Spain

Cantarero, David; Peñas, Santiago Lago

doi:10.2139/ssrn.1406474

Cited by 7 publications

(4 citation statements)

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“…These differences may be explained, in part, by financial and organizational differences in health systems. In 2005, health care expenditure measured in PPP (Purchasing Power Parity) per capita was $2,225 in Spain, $3,326 in Canada and $6,401 in the USA [36]. …”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of early detection of breast cancer in Catalonia (Spain)

et al. 2011

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BackgroundBreast cancer (BC) causes more deaths than any other cancer among women in Catalonia. Early detection has contributed to the observed decline in BC mortality. However, there is debate on the optimal screening strategy. We performed an economic evaluation of 20 screening strategies taking into account the cost over time of screening and subsequent medical costs, including diagnostic confirmation, initial treatment, follow-up and advanced care.MethodsWe used a probabilistic model to estimate the effect and costs over time of each scenario. The effect was measured as years of life (YL), quality-adjusted life years (QALY), and lives extended (LE). Costs of screening and treatment were obtained from the Early Detection Program and hospital databases of the IMAS-Hospital del Mar in Barcelona. The incremental cost-effectiveness ratio (ICER) was used to compare the relative costs and outcomes of different scenarios.ResultsStrategies that start at ages 40 or 45 and end at 69 predominate when the effect is measured as YL or QALYs. Biennial strategies 50-69, 45-69 or annual 45-69, 40-69 and 40-74 were selected as cost-effective for both effect measures (YL or QALYs). The ICER increases considerably when moving from biennial to annual scenarios. Moving from no screening to biennial 50-69 years represented an ICER of 4,469€ per QALY.ConclusionsA reduced number of screening strategies have been selected for consideration by researchers, decision makers and policy planners. Mathematical models are useful to assess the impact and costs of BC screening in a specific geographical area.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of early detection of breast cancer in Catalonia (Spain)

et al. 2011

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“…More recent studies include Cullen et al () on health, Rettenmaier & Wang (), Doyle (), Panopoulou & Pantelidis (), Sheiner () on health expenditures and O'Connor et al (), Fuchs () and Fuchs et al () on the utilization of medical services. The most recent studies from Europe are Reich et al () for Switzerland and Cantarero Prieto & Lago‐Penas () for Spain (both on health expenditures), Gusmano et al () on access to health care and Bojke et al () on regional variation in productivity in the British National Health Service. Skinner () provides a detailed introduction to the topic and the literature and discusses several other studies which are not mentioned here.…”

Section: Introductionmentioning

confidence: 99%

Determinants of Regional Variation in Health Expenditures in Germany

Göpffarth

Kopetsch²,

Schmitz

2015

Health Economics

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Health care expenditure in Germany shows clear regional differences. Such geographic variations are often seen as an indicator for inefficiency. With its homogeneous health care system, low co-payments and uniform prices, Germany is a particularly suited example to analyse regional variations. We use data for the year 2011 on expenditure, utilization of health services and state of health in Germany's statutory health insurance system. This data, which originate from a variety of administrative sources and cover about 90% of the population, are enriched with a wealth of socio-economic variables, data on pollutants, prices and individual preferences. State of health and demography explains 55% of the differences as measured by the standard deviation while all control variables account for a total of 72% of the differences at county level. With other measures of variation, we can account for an even greater proportion. A higher proportion of variation than usually supposed can thus be explained. Whilst this study cannot quantify inefficiencies, our results contradict the thesis that regional variations reflect inefficiency. Copyright © 2015 John Wiley & Sons, Ltd.

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“…This institutional context has been taken into account in the analysis of the determinants of regional health expenditure in Spain. We can cite the papers of Cantarero [17] Costa-Font and Rico [18] Costa-Font and Pons-Novell [15] Costa-Font and Moscone [19] Cantarero and Lago-Peñas [20] Lauridsen et al, [21] and Cantarero and Lago-Peñas [22]. The main conclusion that emerges from these papers is the influence of institutional and political factors, as well as some degree of spatial interdependence between neighboring regions.…”

Section: Public Health Expenditure In Spainmentioning

confidence: 99%