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AHPP sponsors special journal issue on health service provider incentives

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AHPP sponsors special journal issue on health service provider incentives

The Director of the Asia Health Policy Program, Karen Eggleston, served as guest editor of the International Journal of Healthcare Finance and Economics for the June 2009 issue. The eight papers of that issue evaluate different provider payment methods in comparative international perspective, with authors from Hungary, China, Thailand, the US, Switzerland, and Canada. These contributions illustrate how the array of incentives facing providers shapes their interpersonal, clinical, administrative, and investment decisions in ways that profoundly impact the performance of health care systems.

The collection leads off with a study by János Kornai, one of the most prominent scholars of socialism and post-socialist transition, and the originator of the concept of the soft budget constraint. Kornai’s paper examines the political economy of why soft budget constraints appear to be especially prevalent among health care providers, compared to other sectors of the economy.

Two other papers in the issue take up the challenge of empirically identifying the extent of soft budget constraints among hospitals and their impact on safety net services, quality of care, and efficiency, in the United States (Shen and Eggleston) and – even more preliminarily – in China (Eggleston and colleagues, AHPP working paper #8).

The impact of adopting National Health Insurance (NHI) and policies separating prescribing from dispensing are the subject of Kang-Hung Chang’s article entitled “The healer or the druggist: Effects of two health care policies in Taiwan on elderly patients’ choice between physician and pharmacist services” (AHPP working paper #5).

In “Does your health care depend on how your insurer pays providers? Variation in utilization and outcomes in Thailand” (AHPP working paper #4), Sanita Hirunrassamee of Chulalongkorn University and Sauwakon Ratanawijitrasin of Mahidol University study the impact of multiple provider payment methods in Thailand, providing striking evidence consistent with standard predictions of how payment incentives shape provider behavior. For example, patients whose insurers paid on a capitated or case basis (the 30 Baht and social security schemes) were less likely to receive new drugs than those for whom the insurer paid on a fee-for-service basis (civil servants). Patients with lung cancer were less likely to receive an MRI or a CT scan if payment involved supply-side cost sharing, compared to otherwise similar patients under fee-for-service. (This article is open access.)

The fourth paper in this special issue is entitled “Allocation of control rights and cooperation efficiency in public-private partnerships: Theory and evidence from the Chinese pharmaceutical industry” (AHPP working paper #6). Zhe Zhang and her colleagues use a survey of 140 pharmaceutical firms in China to explore the relationships between firms’ control rights within public-private partnerships and the firms’ investments.

Hai Fang, Hong Liu, and John A. Rizzo delve into another question of health service delivery design and accompanying supply-side incentives: requiring primary physician gatekeepers to monitor patient access to specialty care (AHPP working paper #2).

Direct comparisons of payment incentives in two or more countries are rare. In “An economic analysis of payment for health care services: The United States and Switzerland compared,” Peter Zweifel and Ming Tai-Seale compare the nationwide uniform fee schedule for ambulatory medical services in Switzerland with the resource-based relative value scale in the United States.

Several of the papers featured in this special issue were presented at the conference “Provider Payment Incentives in the Asia-Pacific” convened November 7-8, 2008 at the China Center for Economic Research (CCER) at Peking University in Beijing. That conference was sponsored by the Asia Health Policy Program of the Shorenstein Asia-Pacific Research Center at Stanford University and CCER, with organizing team members from Stanford University, Peking University, and Seoul National University.

As Eggleston notes in the guest editorial to the special issue, AHPP and the other scholars associated with the issue “hope that these papers will contribute to more intellectual effort on how provider payment reforms, carefully designed and rigorously evaluated, can improve ‘value for money’ in health care.”

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Religion and Secularization in Europe?

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  • “Religious Divisions After the Reformation: A Spur to Secularization?”
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    John Efron (UC Berkeley)
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    John Bowen (Washington University, Saint Louis)
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    Tim Byrnes (Colgate University)
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Co-sponsored by the Stanford Department of Religious Studies, the Taube Center for Jewish Studies, the Mediterranean Studies Forum, the Department of History, the Stanford Humanities Center,and the Forum on Contemporary Europe.

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Mediterranean Film Series: "Inch'Allah Dimanche"

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Three internationally recognized films will be screened at Stanford University in April and May 2009. The screenings begin at 7:00 pm in Cubberley Auditorium located at the School of Education Building. Co-sponsored by the Mediterranean Studies Forum, the Forum on Contemporary Forum and the Department of Iberian and Latin American Cultures, the screenings are free and open to the public.

The three films, Gitmek: My Marlon and Brando (2008, Turkey/Iraq/Iran), Carol's Journey (2002, Spain/US), and Inch' allah Dimanche (2001, Algeria/France), address the issues of love and friendship across national borders. Each makes use of diverse cinematographic techniques and multiple languages in providing a critical reflection on different cultures, societies and political systems located in the Mediterranean Basin.

Inch' allah Dimanche will be screened on Wednesday, May 27th 2009. The film tells the passionate story of an Algerian immigrant woman struggling against old world traditions. Zouina leaves her homeland with her three children to join her husband in France, where he has been living for the past 10 years. In a land and culture foreign to her, she struggles against her mother-in-law's tyrannical hand and her husband's distrustful bitterness. The film received awards from Marrakech, Toronto, Bordeaux, and Amiens International Film Festival.

For a printable film schedule, visit: http://www.stanford.edu/group/mediterranean/film%20series%2009.pdf

Jointly sponsored by the Forum on Contemporary Europe, Mediterranean Studies Forum, and Department of Iberian and Latin American Cultures.

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Mediterranean Film Series: "Carol's Journey"

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Three internationally recognized films will be screened at Stanford University in April and May 2009. The screenings begin at 7:00 pm in Cubberley Auditorium located at the School of Education Building. Co-sponsored by the Mediterranean Studies Forum, the Forum on Contemporary Forum and the Department of Iberian and Latin American Cultures, the screenings are free and open to the public.

The three films, Gitmek: My Marlon and Brando (2008, Turkey/Iraq/Iran), Carol's Journey (2002, Spain/US), and Inch' allah Dimanche (2001, Algeria/France), address the issues of love and friendship across national borders. Each makes use of diverse cinematographic techniques and multiple languages in providing a critical reflection on different cultures, societies and political systems located in the Mediterranean Basin.

Carol's Journey will be screened on May 6th 2009. The film describes the Spanish Civil War through the eyes of a 12-year-old. Uprooted from her home in New York, Carol travels to her mother's native village in Spain. Separated from her adored father, she struggles to adjust to her new life. Through her relationships with her grandfather, a teacher and a local boy, she gains a perspective on her situation in a nation divided. The film won the special mention at Berlin International Film Festival.

For a printable film schedule, visit: http://www.stanford.edu/group/mediterranean/film%20series%2009.pdf

Jointly sponsored by the Forum on Contemporary Europe, Mediterranean Studies Forum, and Department of Iberian and Latin American Cultures.


Cubberley Auditorium
Stanford University
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Conferences

Mediterranean Film Series: "Gitmek: My Marlon and Brando"

-

Three internationally recognized films will be screened at Stanford University in April and May 2009. The screenings begin at 7:00 pm in Cubberley Auditorium located at the School of Education Building. Co-sponsored by the Mediterranean Studies Forum, the Forum on Contemporary Forum and the Department of Iberian and Latin American Cultures, the screenings are free and open to the public.

The three films, Gitmek: My Marlon and Brando (2008, Turkey/Iraq/Iran), Carol's Journey (2002, Spain/US), and Inch' allah Dimanche (2001, Algeria/France), address the issues of love and friendship across national borders. Each makes use of diverse cinematographic techniques and multiple languages in providing a critical reflection on different cultures, societies and political systems located in the Mediterranean Basin.

Gitmek will be screened on Wednesday, April 29th 2009. It narrates the love story between Ayca, a Turkish actress, and Hama Ali, an Iraqi Kurdish actor, at the onset of the 2003 invasion of Iraq. Ayca travels from Istanbul to the Iraqi border via Iran so that she can re-unite with her beloved. The journey takes her through breathtaking landscapes, strange encounters and terrifying times. The film received recognition and awards from Tribeca, Tokyo Sarajevo, Istanbul, Kerala, Jerusalem and Yerevan International Film Festival.

For a printable film schedule, visit: http://www.stanford.edu/group/mediterranean/film%20series%2009.pdf

Jointly sponsored by the Forum on Contemporary Europe, Mediterranean Studies Forum, and Department of Iberian and Latin American Cultures.

Cubberley Auditorium
Stanford University

Conferences
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