In recent years, for-profit (FP) firms have replaced nonprofit (NP) organizations as the most prevalent form of health maintenance organization (HMO). In this paper, we provide empirical evidence on the pricing practices of both organizational forms. We theorize that nonprofit HMOs derive utility from conduct that increases their marginal cost above the minimum level. They exhibit this conduct ...

BACKGROUND Cambodia has been reconstructing its economy and health sector since the end of conflict in the 1990s. There have been gains in life expectancy and increased health expenditure, but Cambodia still lags behind neighbours One factor which may contribute is the efficiency of public health services. This article aims to understand variations in efficiency and the extent to which changes ...

The challenges imposed by healthcare reform are having an effect on the respiratory care landscape similar to the effect the tsunami had on the landscape of Japan; long established standards of care and traditional care delivery services cannot survive in such a financially challenging environment and are rapidly being assessed and modified to accommodate our new understanding of quality and ef...

BACKGROUND Although health care reforms may improve efficiency at the macro level, less is known regarding their effects on the utilization of health care personnel. Following the 2002 Norwegian hospital reform, we studied the productivity of the physician workforce and the effect of personnel mix on this measure in all nineteen Norwegian hospitals from 2001 to 2013. METHODS We used panel ana...

In the absence of a perfect risk adjustment scheme, cost sharing can reduce risk selection in community-rated health insurance markets. However, cost sharing also reduces incentives for efficiency. In this paper, we develop a model in which insurers determine the cost efficiency of health care. They have incentives for risk selection because there are two risk types which differ in their expect...

BACKGROUND Macroeconomic growth in China enables significant progress in health care and public health. It faces difficult choices regarding access, quality and affordability, while dealing with the increasing burden of chronic diseases. Policymakers are pressured to make complex decisions while implementing health strategies. This study shows how this process could be structured and reports th...

background: the iranian healthcare system is primarily an insurance based system. this structure has an important influence on the efficiency and equity of the provision of healthcare in iran. this paper reviews the history of the iranian healthcare system and the impact of the iranian health insurance system on healthcare performance based on the results of interviews with key opinion leaders ...

In the health systems literature one can see discussions about the trade off between the equity achievable by the system and its efficiency. Essentially it is argued that as greater health equity is achieved, so the level of efficiency will diminish. This argument is borrowed from economics literature on market efficiency. In the application of the economic argument to health, however, serious ...