This PhD thesis focuses on health economics, encompassing economic evaluation of healthcare treatments and interventions, health data management, and implications of health policies, particularly within the public sector. The study addresses macroeconomic and public accounting aspects, delving into the functioning of healthcare systems and individual and social determinants of health-related topics. A pivotal concern within health economics involves hospital performance regarding cost containment and adherence to regulatory norms, especially amid significant reforms in payment systems and management objectives. The introduction of financial incentives and performance objectives in the 1980s aimed to foster efficient management and resource allocation. However, these mechanisms inadvertently introduced challenges such as patient selection biases (creaming and dumping) and a potential reduction in service quality due to moral hazard on the supply side. In recent years, the focus on data management has intensified, with Health Data Management (HDM) playing a crucial role in organizing and integrating digital health data. It includes electronic medical records, health and administrative data processed by governments, and a growing body of literature addressing healthcare disparities among ethnic and racial groups and variations based on sex and age. Another emerging area of interest in health economics is the study of informal caregiving, where individuals, often family or friends, provide care without economic compensation. This caregiving is associated with both physical and mental health effects and is distributed unevenly in society, influenced by gender and socioeconomic factors. The causal impact of caregiving remains challenging to estimate, adding to the growing curiosity among health economists. In the face of these facts, we have chosen to focus our research activities on issues of economic evaluation of health systems in terms of, e.g. hospital performance, the management of health and administrative data provided by the public administration, through the use of statistical software, and the study of a public policy aimed at social protection for persons in need of long-term care, to observe and measure the impact on the quality of life of caregivers and family well-being. This thesis addresses these critical issues through three essays. The first essay focuses on the economic evaluation methodologies of healthcare treatments, providing a comprehensive review of techniques such as Budget Impact Analysis (BIA). The aim is to elucidate the advantages and disadvantages of these methodologies, offer practical recommendations for healthcare professionals, and outline avenues for future research. The second essay demonstrates the application of data management skills using Stata software, widely employed in academic research and by private companies for data analysis. It summarizes research conducted during a visiting PhD at the Centre for Research in Health and Economics of the University Pompeu Fabra Barcelona, specifically managing administrative data from the "Muestra Continua de Vidas Laborales" provided by the Spanish government's Seguridad Social from 2005 to 2016. The third essay explores the impact of the Ley de Dependencia, a public policy introduced in 2007 and repealed in 2012, on the quality of life of caregivers, gender inequality, the sexual division of the labour market, and family well-being. This research contributes valuable insights into the consequences of social protection policies for individuals needing long-term care. In conclusion, this thesis contributes significantly to the theoretical and empirical aspects of health economics by addressing critical issues related to hospital performance, data management, and the impact of public policies on caregivers and family well-being. The multidimensional approach employed in these essays provides a comprehensive understanding of the complex dynamics within the healthcare sector, offering practical implications for policymakers and researchers alike.
Essay in health economics / Scrocco, Antonio. - (2023). [10.14274/scrocco-antonio_phd2023]
Essay in health economics
SCROCCO, ANTONIO
2023-01-01
Abstract
This PhD thesis focuses on health economics, encompassing economic evaluation of healthcare treatments and interventions, health data management, and implications of health policies, particularly within the public sector. The study addresses macroeconomic and public accounting aspects, delving into the functioning of healthcare systems and individual and social determinants of health-related topics. A pivotal concern within health economics involves hospital performance regarding cost containment and adherence to regulatory norms, especially amid significant reforms in payment systems and management objectives. The introduction of financial incentives and performance objectives in the 1980s aimed to foster efficient management and resource allocation. However, these mechanisms inadvertently introduced challenges such as patient selection biases (creaming and dumping) and a potential reduction in service quality due to moral hazard on the supply side. In recent years, the focus on data management has intensified, with Health Data Management (HDM) playing a crucial role in organizing and integrating digital health data. It includes electronic medical records, health and administrative data processed by governments, and a growing body of literature addressing healthcare disparities among ethnic and racial groups and variations based on sex and age. Another emerging area of interest in health economics is the study of informal caregiving, where individuals, often family or friends, provide care without economic compensation. This caregiving is associated with both physical and mental health effects and is distributed unevenly in society, influenced by gender and socioeconomic factors. The causal impact of caregiving remains challenging to estimate, adding to the growing curiosity among health economists. In the face of these facts, we have chosen to focus our research activities on issues of economic evaluation of health systems in terms of, e.g. hospital performance, the management of health and administrative data provided by the public administration, through the use of statistical software, and the study of a public policy aimed at social protection for persons in need of long-term care, to observe and measure the impact on the quality of life of caregivers and family well-being. This thesis addresses these critical issues through three essays. The first essay focuses on the economic evaluation methodologies of healthcare treatments, providing a comprehensive review of techniques such as Budget Impact Analysis (BIA). The aim is to elucidate the advantages and disadvantages of these methodologies, offer practical recommendations for healthcare professionals, and outline avenues for future research. The second essay demonstrates the application of data management skills using Stata software, widely employed in academic research and by private companies for data analysis. It summarizes research conducted during a visiting PhD at the Centre for Research in Health and Economics of the University Pompeu Fabra Barcelona, specifically managing administrative data from the "Muestra Continua de Vidas Laborales" provided by the Spanish government's Seguridad Social from 2005 to 2016. The third essay explores the impact of the Ley de Dependencia, a public policy introduced in 2007 and repealed in 2012, on the quality of life of caregivers, gender inequality, the sexual division of the labour market, and family well-being. This research contributes valuable insights into the consequences of social protection policies for individuals needing long-term care. In conclusion, this thesis contributes significantly to the theoretical and empirical aspects of health economics by addressing critical issues related to hospital performance, data management, and the impact of public policies on caregivers and family well-being. The multidimensional approach employed in these essays provides a comprehensive understanding of the complex dynamics within the healthcare sector, offering practical implications for policymakers and researchers alike.File | Dimensione | Formato | |
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