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Studi sulla Sanità integrativa e sulla Bilateralità - Assistenza sanitaria integrativa: scenari futuri e possibili sinergie con il sistema sanitario nazionale

Authors:
Michele Faioli at Università Cattolica del Sacro Cuore
Michele Faioli
Anna Maria Murante at Sant'Anna School of Advanced Studies
Anna Maria Murante
Francesca Pennucci at Sant'Anna School of Advanced Studies
Francesca Pennucci
Sabina Nuti at Sant'Anna School of Advanced Studies
Sabina Nuti
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Il presente lavoro di ricerca si propone di analizzare gli scenari futuri di azione dei Fondi Sanitari Integrativi (Fsi), tenendo conto sia dell’opinione dei diversi portatori di interesse, sia dei cittadini italiani; intende altresì valutare, dato il quadro normativo italiano, possibili ambiti di sinergia con il Sistema Sanitario Nazionale (Ssn), con l’obiettivo di individuare strategie di incremento del valore aggiunto complessivamente prodotto con le risorse della collettività.
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Declining amenable mortality: A reflection of health care systems?
Article
Full-text available
  • Nov 2017
  • BMC HEALTH SERV RES
Background Some studies have analyzed the association of health care systems variables, such as health service resources or expenditures, with amenable mortality, but the association of types of health care systems with the decline of amenable mortality has yet to be studied. The present study examines whether specific health care system types are associated with different time trend declines in amenable mortality from 2000 to 2014 in 22 European OECD countries. MethodsA time trend analysis was performed. Using Nolte and McKee’s list, age-standardized amenable mortality rates (SDRs) were calculated as the annual number of deaths over the population aged 0–74 years per 100,000 inhabitants. We classified health care systems according to a deductively generated classification by Böhm. This classification identifies three dimensions that are not entirely independent of each other but follow a clear order: the regulation dimension is first, followed by the financing dimension and finally service provision. We performed a hierarchical semi-log polynomial regression analysis on the annual SDRs to determine whether specific health care systems were associated with different SDR trajectories over time. ResultsThe results showed a clear decline in SDRs in all 22 health care systems between 2000 and 2014 although at different annual changes (slopes). Regression analysis showed that there was a significant difference among the slopes according to provision dimension. Health care systems with a private provision exhibited a slowdown in the decline of amenable mortality over time. It therefore seems that ownership is the most relevant dimension in determining a different pattern of decline in mortality. Conclusions All countries experienced decreases in amenable mortality between 2000 and 2014; this decline seems to be partially a reflection of health care systems, especially when affected by the provision dimension. If the private ownership is maintained or promoted by health systems, these findings might be considered when thinking about regulation policies to control factors that might influence health care performance.
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Enrolee outcomes after health insurance plan terminations: a diagnosis of default effects
Article
  • Jan 2018
Behavioural economic research has established that defaults, one form of nudge, powerfully influence choices. In most policy contexts, all individuals receive the same nudge. We present a model that analyses the optimal universal nudge for a situation in which individuals differ in their preferences and hence should make different choices and may incur a cost for resisting a nudge. Our empirical focus is on terminated choosers (TCs), individuals whose prior choices become no longer available. Specifically, we examine the power of defaults on individuals who had enrolled in Medicare Advantage plans with drug coverage and whose plans were then discontinued. Currently, if these TCs fail to actively choose another Medicare Advantage plan, they are defaulted into traditional fee-for-service Medicare (TM) without drug coverage. Overall, the rate of transition of TCs into TM is low, implying that original preferences and status quo bias overpower the default. Increasing numbers of Americans are choosing plans in health insurance exchange settings such as Medicare, the Affordable Care Act and private exchanges. Plan exits and large numbers of TCs are inevitable, along with other forms of turmoil. Any guidance and defaults provided for TCs should factor in their past revealed preferences.
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