Health care spending growth: how different is the United States from the rest of the OECD?
ABSTRACT This paper compares the long-term (1970-2002) rates of real growth in health spending per capita in the United States and a group of high-income countries in the Organization for Economic Cooperation and Development (OECD). Real health spending growth is decomposed into population aging, overall economic growth, and excess growth. Although rates of aging and overall economic growth were similar, annual excess growth was much higher in the United States (2.0 percent) versus the OECD countries studied (1.1 percent). That difference, which is of an economically important magnitude, suggests that country-specific institutional factors might contribute to long-term health spending trends.
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ABSTRACT: Countries have reached universal health coverage by different paths and with varying health systems. Nonetheless, the trajectory toward universal health coverage regularly has three common features. The first is a political process driven by a variety of social forces to create public programmes or regulations that expand access to care, improve equity, and pool financial risks. The second is a growth in incomes and a concomitant rise in health spending, which buys more health services for more people. The third is an increase in the share of health spending that is pooled rather than paid out-of-pocket by households. This pooled share is sometimes mobilised as taxes and channelled through governments that provide or subsidise care--in other cases it is mobilised in the form of contributions to mandatory insurance schemes. The predominance of pooled spending is a necessary condition (but not sufficient) for achieving universal health coverage. This paper describes common patterns in countries that have successfully provided universal access to health care and considers how economic growth, demographics, technology, politics, and health spending have intersected to bring about this major development in public health.The Lancet 09/2012; 380(9845):924-32. · 39.21 Impact Factor
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ABSTRACT: Smart environments help to increase the auton- omy and quality of life of people with special needs (PwSN) through adapted assistive services. In conjunction with context awareness and service delivery mechanisms, it is possible to dynamically deliver services to users by taking into account contextual information, e.g., user’s locations, devices’ states, current activities. However, implementing such systems in actual smart spaces is not trivial. The micro and macro context awareness model helps in defining layers on which contextual information are processed as close as possible from their sources (micro), without losing the ben- efits of information processing at a systemic level (macro). This paper describes the micro and macro context aware- ness model and its uses in the implementation of a service provision system for smart environments. Transparency and intelligibility are important factors in context awarenessHealth and Technology. 01/2013;
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ABSTRACT: 報告番号: ; 学位授与日: 2010-03-24 ; 学位の種別: 課程博士 ; 学位の種類: 博士（医学） ; 学位記番号: 甲3435 Background: Out-of-pocket health expenditure has become the primary source of health financingin China. Its share in the total health expenditure increased to 49 percent from 20 percent with apeak at 60 percent since 1978 to 2006. To estimate the determinants of individual out-of-pockethealth expenditure in China, we conducted this study.//Methods: We used a sub-sample of adults aged eighteen and over from 2004 China Health andNutrition Survey data. Heckman selection model was conducted to control for potential sampleselection bias.//Results: 24.6 percent of the sampled population (n=9,860) reported recent health problems; amongthem, 80.7 percent utilized health care. The median out-of-pocket health expenditure was 55Renminbi (7 Renminbi = US$ 1). Poor health status, perceived quite serious illness and age over 65have the highest coefficients at 3.345, 2.024 and 1.172, respectively. Income elasticity is positive at0.18. Urban residents and individuals with chronic diseases, with health insurance, from a highereducated-head household, or reside in the middle or eastern region pay more for health care.//Conclusion: Need, predisposing and enabling factors work together to determine out-of-pockethealth expenditure. Appropriate medical relief policies focusing on the population with highfinancial burden need to be considered01/2011;