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  • Friedman, Jed  (6)
  • Das, Jishnu  (5)
  • Washington, D.C : The World Bank  (10)
  • Health, Nutrition and Population  (10)
  • 1
    Sprache: Englisch
    Seiten: 1 Online-Ressource (27 pages)
    Paralleltitel: Erscheint auch als Decerf, Benoit Lives, Livelihoods, and Learning: A Global Perspective on the Well-Being Impacts of the COVID-19 Pandemic
    Schlagwort(e): Communicable Diseases ; Covid ; Education ; Health and Poverty ; Health, Nutrition and Population ; Learning ; Mortality ; Poverty ; School Health ; Welfare
    Kurzfassung: This study compares the magnitude of national level losses that the COVID-19 pandemic inflicted across three critical dimensions: loss of life, loss of income, and loss of learning. The well-being consequences of excess mortality are expressed in years of life lost, while those of income losses and school closures are expressed in additional years spent in poverty (as measured by national poverty lines), either currently or in the future. While 2020-21 witnessed a global drop in life expectancy and the largest one-year increase in global poverty in many decades, widespread school closures may cause almost twice as large an increase in future poverty. The estimates of well-being loss for the average global citizen include a loss of almost three weeks of life (19 days), an additional two and half weeks spent in poverty in 2020 and 2021 (17 days), and the possibility of an additional month of life in poverty in the future due to school closures (31 days). Well-being losses are not equitably distributed across countries. The typical high-income country suffered more total years of life lost than additional years in poverty, while the opposite holds for the typical low- or middle-income country. Aggregating total losses requires the valuation of a year of life lost vis-a-vis an additional year spent in poverty. If a year of life lost is valued at five or fewer additional years spent in poverty, low-income countries suffered greater total well-being loss than high-income countries. For a wide range of valuations, the greatest well-being losses fell on upper-middle-income countries and countries in the Latin America region. This set of countries suffered the largest mortality costs as well as large losses in learning and sharp increases in poverty
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  • 2
    Sprache: Englisch
    Seiten: 1 Online-Ressource (58 pages)
    Paralleltitel: Erscheint auch als Das, Jishnu The Prices in the Crises: What we are Learning from Twenty Years of Health Insurance in Low- and Middle-Income Countries
    Schlagwort(e): Gesundheitspolitik ; Krankenversicherung ; Gesetzliche Krankenversicherung ; Gesundheitsreform ; Gesundheitswesen ; Gesundheitsversorgung ; Gesundheitskosten ; Gesundheitsfinanzierung ; Adverse Selektion ; Entwicklungsländer ; Adverse Selection ; Health Care Provider Behavior ; Health Care Quality ; Health Insurance ; Health Insurance Utilization ; Health Ministries ; Health Policy and Management ; Health, Nutrition and Population ; Medical Insurance Premiums ; Moral Hazard
    Kurzfassung: Governments in many low- and middle-income countries are developing health insurance products as a complement to tax-funded, subsidized provision of health care through publicly operated facilities. This paper discusses two rationales for this transition. First, health insurance would boost fiscal revenues for health care, as post-treatment out-of-pocket payments to providers would be replaced by pre-treatment insurance premia to health ministries. Second, increased patient choice and carefully designed physician reimbursements would increase quality in the health care sector. This essay shows that, at best, these objectives have only been partially met. Despite evidence that health insurance has provided financial protection, consumers are not willing to pay for unsubsidized premia. Health outcomes have not improved despite an increase in utilization. The authors argue that this is not because there was no room to improve the quality of care but because behavioral responses among health care providers have systematically undermined the objectives of these insurance schemes
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  • 3
    Sprache: Englisch
    Seiten: 1 Online-Ressource (38 pages)
    Paralleltitel: Erscheint auch als Wilkinson, Thomas A Framework for the Economic Evaluation of Digital Health Interventions
    Schlagwort(e): Digital Health Intervention ; Economic Evaluation ; Health Intervention Investment ; Health System Decision Making ; Health Systems Development and Reform ; Health, Nutrition and Population ; Low Income Country Health Interventions ; Middle Income Country Health Interventions
    Kurzfassung: Numerous digital health interventions have been piloted in response to the health care challenges low- and middle-income countries face. Because the opportunity cost of investing in digital health interventions can be large, countries must make choices about which interventions to scale up. To make good investment decisions about digital health interventions, there is a need to define and establish their value, and to use economic evaluation to make informed decisions, however DHIs present methodological challenges for economic evaluation. To address these challenges, this paper first creates a 'gap map' of digitalevidence which reveals a dearth of economic evaluation evidence about digital health interventions; this lack can limit decisions on policy, programming, and appropriate scale-up of digital health interventions. To advance work in this field, this paper then develops an economic evaluation framework that can be used when determining the economic value of digital health interventions. Such a standardized approach, alongside guidance to assist the conduct and use of economic evidence, can improve decision making and investments in DHI under constrained health budgets. The resulting digital health intervention economic evaluation framework consists of 5 steps: (1) determine the context, (2) determine the intervention type, (3) establish the level of complexity, (4) set the analytic principles, and (5) represent the value proposition. Users of the framework should attempt to adhere to its steps and principles, but where this is not feasible or appropriate, they should provide justification for the methodological choice. The framework should facilitate methodological transparency, thereby improving the overall usefulness of economic evaluations of digital health interventions
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  • 4
    Sprache: Englisch
    Seiten: 1 Online-Ressource (65 pages)
    Paralleltitel: Erscheint auch als Bedoya, Guadalupe Randomized Regulation: The Impact of Minimum Quality Standards on Health Markets
    Schlagwort(e): Gesundheitswesen ; Gesundheitsreform ; Patienten ; Gesundheitsversorgung ; Produktqualität ; Epidemie ; Regulierung ; Experiment ; Kenia ; Health Care Market ; Health Care Utilizaton ; Health, Nutrition and Population ; Informal Sector ; Patient Safety Standards ; Public Health ; Regulatory Enforcement
    Kurzfassung: This paper presents results from the first randomization of a regulatory reform in the health sector. The reform established minimum quality standards for patient safety, an issue that has become increasingly salient following the Ebola and COVID-19 epidemics. In the experiment, all 1,348 health facilities in three Kenyan counties were classified into 273 markets, and the markets were then randomly allocated to treatment and control groups. Government inspectors visited health facilities and, depending on the results of their inspection, recommended closure or a timeline for improvements. The intervention increased compliance with patient safety measures in both public and private facilities (more so in the latter) and reallocated patients from private to public facilities without increasing out-of-pocket payments or decreasing facility use. In treated markets, improvements were equally marked throughout the quality distribution, consistent with a simple model of vertical differentiation in oligopolies. This paper thus establishes the use of experimental techniques to study regulatory reforms and, in doing so, shows that minimum standards can improve quality across the board without adversely affecting utilization
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  • 5
    Sprache: Englisch
    Seiten: 1 Online-Ressource (71 pages)
    Paralleltitel: Erscheint auch als Print Version: Neelsen, Sven Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis
    Schlagwort(e): Child Health ; Conditional Cash Transfers ; Early Child and Children's Health ; Financial Incentive ; Health Economics and Finance ; Health, Nutrition and Population ; Maternal Health ; Meta-Analysis ; Performance-Based Financing ; Reproductive Health ; Vouchers
    Kurzfassung: Financial incentives for health providers and households are increasingly used to improve reproductive, maternal, and child health service coverage in low- and middle-income countries. This study provides a quantitative synthesis of their effectiveness. A systematic review was conducted of the effects of performance-based financing, voucher, and conditional cash transfer programs on six reproductive, maternal, and child health service indicators, with eligible evidence coming from randomized controlled trials and studies using double-difference, instrumental variables, and regression discontinuity designs. Four literature searches were conducted between September 2016 and March 2021 using seven academic databases, Google Scholar, development agency and think tank websites, and previous systematic reviews. Random effects meta-analysis was used to obtain mean effect sizes. From 58 eligible references 212 impact estimates were extracted, which were synthesized into 130 program-specific effect sizes. Financial incentives increase coverage of all considered reproductive, maternal, and child health indicators, but mean effects sizes are of modest magnitude. Effect size heterogeneity is typically low to moderate, and there is no indication that study bias risk, baseline indicator levels, or a combination of provider- and household-level incentives impact effect sizes. There is, however, weak evidence that mean effect sizes are somewhat smaller for performance-based financing than for voucher and conditional cash transfer programs, and that the increase in income, rather than the incentive itself, drives coverage improvements. Financial incentives improve reproductive, maternal, and child health service coverage. If future research confirms the preliminary finding that performance-based financing has smaller effects, voucher and conditional cash transfer programs are the preferred policy option among incentive interventions to achieve higher reproductive, maternal, and child health service coverage. The relative effectiveness and efficiency of incentives compared with unconditional increases of provider and household incomes, however, need to be studied further
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  • 6
    Online-Ressource
    Online-Ressource
    Washington, D.C : The World Bank
    Sprache: Englisch
    Seiten: Online-Ressource (1 online resource (38 p.))
    Ausgabe: Online-Ausg. World Bank E-Library Archive
    Paralleltitel: Das, Jishnu The Quality of Medical Advice In Low-Income Countries
    Schlagwort(e): Clinics ; Health Monitoring and Evaluation ; Health Systems Development and Reform ; Health outcomes ; Health, Nutrition and Population ; Intervention ; Medicines ; Nutrition ; Patient ; Patients ; Primary Health Care ; Vaccination ; Workers ; Clinics ; Health Monitoring and Evaluation ; Health Systems Development and Reform ; Health outcomes ; Health, Nutrition and Population ; Intervention ; Medicines ; Nutrition ; Patient ; Patients ; Primary Health Care ; Vaccination ; Workers ; Clinics ; Health Monitoring and Evaluation ; Health Systems Development and Reform ; Health outcomes ; Health, Nutrition and Population ; Intervention ; Medicines ; Nutrition ; Patient ; Patients ; Primary Health Care ; Vaccination ; Workers
    Kurzfassung: This paper provides an overview of recent work on quality measurement of medical care and its correlates in four low and middle-income countries-India, Indonesia, Tanzania, and Paraguay. The authors describe two methods-testing doctors and watching doctors-that are relatively easy to implement and yield important insights about the nature of medical care in these countries. The paper discusses the properties of these measures, their correlates, and how they may be used to evaluate policy changes. Finally, the authors outline an agenda for further research and measurement
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 7
    Sprache: Englisch
    Seiten: Online-Ressource (1 online resource (29 p.))
    Ausgabe: Online-Ausg. World Bank E-Library Archive
    Paralleltitel: Das, Jishnu Mental Health Patterns And Consequences
    Schlagwort(e): Anxiety ; Depression ; Health Monitoring and Evaluation ; Health care ; Health indicators ; Health outcomes ; Health, Nutrition and Population ; Mental ; Mental Health ; Mental illness ; Morbidity ; Public health ; Anxiety ; Depression ; Health Monitoring and Evaluation ; Health care ; Health indicators ; Health outcomes ; Health, Nutrition and Population ; Mental ; Mental Health ; Mental illness ; Morbidity ; Public health ; Anxiety ; Depression ; Health Monitoring and Evaluation ; Health care ; Health indicators ; Health outcomes ; Health, Nutrition and Population ; Mental ; Mental Health ; Mental illness ; Morbidity ; Public health
    Kurzfassung: The social and economic consequences of poor mental health in the developing world are presumed to be significant, yet are largely under-researched. The authors argue that mental health modules can be meaningfully added to multi-purpose household surveys in developing countries, and used to investigate this relationship. Data from nationally representative surveys in Bosnia and Herzegovina, Indonesia, and Mexico, along with special surveys from India and Tonga, show similar patterns of association between mental health and socioeconomic characteristics across countries. Individuals who are older, female, widowed, and report poor physical health are more likely to report worse mental health outcomes. Individuals living with others with poor mental health are also significantly more likely to report worse mental health themselves. In contrast, there is little observed relationship between mental health and poverty or education, common measures of socio-economic status. The results instead suggest that economic and multi-dimensional shocks such as illness or crisis can have a greater impact on mental health than overall levels of poverty. This may have important implications for social protection policy. The authors also find significant associations between poor mental health and lowered labor force participation (especially for women) and higher frequency visits to health centers, suggesting that poor mental health can have significant economic consequences for households and the health system. Finally, the paper discusses how measures of mental health are distinct from general subjective welfare measures such as happiness and indicate useful directions of future research
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 8
    Online-Ressource
    Online-Ressource
    Washington, D.C : The World Bank
    Sprache: Englisch
    Seiten: Online-Ressource (1 online resource (47 p.))
    Ausgabe: Online-Ausg. World Bank E-Library Archive
    Paralleltitel: Baird, Sarah Infant Mortality Over The Business Cycle In The Developing World
    Schlagwort(e): Developing Countries ; Expenditures ; Health Monitoring and Evaluation ; Health, Nutrition and Population ; Insurance ; Long-term resource ; Natural Disaster ; Population Policies ; Private investors ; Public investment ; Risk Management ; Safety Net ; Tax ; Developing Countries ; Expenditures ; Health Monitoring and Evaluation ; Health, Nutrition and Population ; Insurance ; Long-term resource ; Natural Disaster ; Population Policies ; Private investors ; Public investment ; Risk Management ; Safety Net ; Tax ; Developing Countries ; Expenditures ; Health Monitoring and Evaluation ; Health, Nutrition and Population ; Insurance ; Long-term resource ; Natural Disaster ; Population Policies ; Private investors ; Public investment ; Risk Management ; Safety Net ; Tax
    Kurzfassung: The diffusion of cost-effective life saving technologies has reduced infant mortality in much of the developing world. Income gains may also play a direct, protective role in ensuring child survival, although the empirical findings to date on this issue have been mixed. This paper assembles data from Demographic and Health Surveys (DHS) in 59 countries to analyze the relationship between changes in per capita GDP and infant mortality. The authors show that there is a strong, negative association between changes in per capita GDP and infant mortality- in a first-differenced specification the implied elasticity of infant mortality with respect to per capita GDP is approximately -0.56. In addition to this central result, two findings are noteworthy. First, although there is some evidence of changes in the composition of women giving birth during economic upturns and downturns, the observed changes in infant mortality are not a result of mothers with protective characteristics timing fertility to correspond with the business cycle. Second, the association between infant mortality and per capita GDP is particularly pronounced for periods of large contractions in GDP, suggesting the inability of developing country households or health systems (or both) to smooth resources. Simple back-of-the-envelope calculations using the estimates suggest that there may have been more than 1 million "excess" deaths in the developing world since 1980 as a result of large, negative contractions in per capita GDP
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 9
    Sprache: Englisch
    Seiten: Online-Ressource (1 online resource (27 p.))
    Ausgabe: Online-Ausg. World Bank E-Library Archive
    Paralleltitel: Friedman, Jed Psychological Health Before, During, And After An Economic Crisis
    Schlagwort(e): Anxiety ; Depression ; Families ; Health Care ; Health Monitoring and Evaluation ; Health Research ; Health, Nutrition and Population ; Mental ; Mental Health ; Mental Illness ; Screening ; Workers ; Anxiety ; Depression ; Families ; Health Care ; Health Monitoring and Evaluation ; Health Research ; Health, Nutrition and Population ; Mental ; Mental Health ; Mental Illness ; Screening ; Workers ; Anxiety ; Depression ; Families ; Health Care ; Health Monitoring and Evaluation ; Health Research ; Health, Nutrition and Population ; Mental ; Mental Health ; Mental Illness ; Screening ; Workers
    Kurzfassung: The 1997 Indonesian financial crisis resulted in severe economic dislocation and political upheaval, and the detrimental consequences for economic welfare, physical health, and child education have been previously established in numerous studies. We also find the crisis adversely impacted population psychological well-being. We document substantial increases in several different dimensions of psychological distress among male and female adults across the entire age distribution over the crisis period. In addition, the imprint of the crisis can be seen in the differential impacts of the crisis on low education groups, the rural landless, and residents in those provinces that were hit hardest by the crisis. Elevated levels of psychological distress persist even after indicators of economic well-being such as household consumption had returned to pre-crisis levels suggesting long-term deleterious effects of the crisis on the psychological well-being of the Indonesian population
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 10
    Online-Ressource
    Online-Ressource
    Washington, D.C : The World Bank
    Sprache: Englisch
    Seiten: Online-Ressource (1 online resource (20 p.))
    Ausgabe: Online-Ausg. World Bank E-Library Archive
    Paralleltitel: Das, Jishnu Patient Satisfaction, Doctor Effort, And Interview Location
    Schlagwort(e): Aged ; Clinics ; Gender ; Gender and Health ; General Practice ; Health ; Health Care ; Health Monitoring and Evaluation ; Health Outcomes ; Health Services ; Health Systems Development and Reform ; Health, Nutrition and Population ; Hospitals ; Interview ; Knowledge ; Measurement ; Medicines ; Nursing ; Observation ; Aged ; Clinics ; Gender ; Gender and Health ; General Practice ; Health ; Health Care ; Health Monitoring and Evaluation ; Health Outcomes ; Health Services ; Health Systems Development and Reform ; Health, Nutrition and Population ; Hospitals ; Interview ; Knowledge ; Measurement ; Medicines ; Nursing ; Observation ; Aged ; Clinics ; Gender ; Gender and Health ; General Practice ; Health ; Health Care ; Health Monitoring and Evaluation ; Health Outcomes ; Health Services ; Health Systems Development and Reform ; Health, Nutrition and Population ; Hospitals ; Interview ; Knowledge ; Measurement ; Medicines ; Nursing ; Observation
    Kurzfassung: To examine the relationship between patient satisfaction and doctor performance, the authors observed 2,271 interactions between 292 doctors and their patients in 98 clinics and hospitals in Paraguay and conducted an exit-survey with the same patients as they left the clinic. For a subsample of 64 facilities they also interviewed patients who visited the facility within the last week. There are three patterns in the data: (1) Patient satisfaction is positively correlated with doctor effort, measured as a combination of time spent, questions asked, and examinations performed after controlling for observed doctor and patient characteristics; (2) However, accounting for unobserved doctor characteristics dramatically reduces the level of significance and size of correlation between effort and satisfaction, showing that much of the positive relationship is driven by these unobserved doctor-specific factors; and (3) Reported satisfaction is significantly lower for patients interviewed at home compared with those interviewed at the clinic. This leads the authors to conclude that even if patient satisfaction reflects some aspects of the doctor's performance, unobserved heterogeneity combined with survey biases limit the widespread applicability of patient satisfaction as an indicator of doctor performance
    URL: Volltext  (Deutschlandweit zugänglich)
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