Towards an economic model of the Dutch health care sector

Folmer, Kees; Stevens, Johnny; Tulder, Frank van; Westerhout, Ed

doi:10.1002/(sici)1099-1050(199707)6:4<351::aid-hec274>3.0.co;2-5

Cited by 7 publications

(1 citation statement)

References 4 publications

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“…To be useful for the analysis of patient payment policies, the model of consumer demand for out-patient physician services could take into account the exiting empirical analyses (e.g., [70,71]). However, it should also seek to integrate the level of informal patient payments (where relevant) and the behavior of health care providers.…”

Section: Discussionmentioning

confidence: 99%

Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature

Skriabikova

Pavlova

Groot

2010

IJERPH

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This paper reviews the existing empirical micro-level models of demand for out-patient physician services where the size of patient payment is included either directly as an independent variable (when a flat-rate co-payment fee) or indirectly as a level of deductibles and/or co-insurance defined by the insurance coverage. The paper also discusses the relevance of these models for the assessment of patient payment policies. For this purpose, a systematic literature review is carried out. In total, 46 relevant publications were identified. These publications are classified into categories based on their general approach to demand modeling, specifications of data collection, data analysis, and main empirical findings. The analysis indicates a rising research interest in the empirical micro-level models of demand for out-patient physician services that incorporate the size of patient payment. Overall, the size of patient payments, consumer socio-economic and demographic features, and quality of services provided emerge as important determinants of demand for out-patient physician services. However, there is a great variety in the modeling approaches and inconsistencies in the findings regarding the impact of price on demand for out-patient physician services. Hitherto, the empirical research fails to offer policy-makers a clear strategy on how to develop a country-specific model of demand for out-patient physician services suitable for the assessment of patient payment policies in their countries. In particular, theoretically important factors, such as provider behavior, consumer attitudes, experience and culture, and informal patient payments, are not considered. Although we recognize that it is difficult to measure these factors and to incorporate them in the demand models, it is apparent that there is a gap in research for the construction of effective patient payment schemes.

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Section: Discussionmentioning

confidence: 99%

Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature

Skriabikova

Pavlova

Groot

2010

IJERPH

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A model for the Dutch pharmaceutical market

Canton

Westerhout

1999

Health Econ.

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This paper develops a general-equilibrium model for the Dutch pharmaceutical market. The model derives the behaviour of patients, pharmacists, drug producers and parallel-importers from microeconomic principles and recognizes the interactions between the various actors. The latter is important since the general-equilibrium effects are sometimes at odds with intuition from a partial-equilibrium approach. A calibrated version of the model is used to evaluate the effects of various policy experiments on the bill for pharmaceutical care in the Netherlands. These experiments include an incentive policy to encourage cost-conscious drug distribution, an increase of copayments for pharmaceutical care, a reduction of trade barriers for parallel-importers, and market entry by producers of generic substitutes.

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Financing medical specialist services in The Netherlands: Welfare implications of imperfect agency

Folmer

Westerhout

2008

Economic Modelling

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From 1995 onward the financing scheme for specialist care in the Netherlands has moved from a fee-for-service scheme to a lump-sum budget scheme. This paper analyses the economic and welfare effects of this policy change. The paper adopts a model that integrates demand and supply considerations and recognizes the potential roles of moral hazard and supplier-induced demand. The model is fully numerical, being estimated and calibrated upon data for the Dutch health care sector. The paper finds that the shift in financing regime has been welfare-reducing. The policy change induced medical specialists to lower the supply of health services which was already too low from a welfare point of view. This conclusion is robust to significant changes in major parameter values.

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Towards an economic model of the Dutch health care sector

Cited by 7 publications

References 4 publications

Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature

Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature

A model for the Dutch pharmaceutical market

Financing medical specialist services in The Netherlands: Welfare implications of imperfect agency

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