Toward a National Health Care Survey

Toward a National Health Care Survey
Author: National Research Council
Publisher: National Academies Press
Total Pages: 203
Release: 1992-02-01
Genre: Medical
ISBN: 0309046920

The nation's health care system has changed dramatically and the country is debating further significant changes. Comprehensive information is needed to guide policymakers in understanding and evaluating the current problems and in formulating federal health care policy. This book contains an evaluation of the plan developed by the National Center for Health Statistics for restructuring its existing provider surveys. It identifies current and future data needed by researchers and policymakers to assess the effect of changes in financing, organization, and delivery of health care on access, quality, costs, and outcomes of care and determines the extent to which the design and content of the proposed survey can meet these data needs. The book goes beyond a simple review and recommends a design framework to develop a coordinated and integrated data system to gather information about people and their illness over time and to link this information to costs and health care outcomes.

Ghana National Health Insurance Scheme

Ghana National Health Insurance Scheme
Author: Huihui Wang
Publisher: World Bank Publications
Total Pages: 101
Release: 2017-08-14
Genre: Business & Economics
ISBN: 1464811180

Ghana National Health Insurance Scheme (NHIS) was established in 2003 as a major vehicle to achieve the country’s commitment of Universal Health Coverage. The government has earmarked value-added tax to finance NHIS in addition to deduction from Social Security Trust (SSNIT) and premium payment. However, the scheme has been running under deficit since 2009 due to expansion of coverage, increase in service use, and surge in expenditure. Consequently, Ghana National Health Insurance Authority (NHIA) had to reduce investment fund, borrow loans and delay claims reimbursement to providers in order to fill the gap. This study aimed to provide policy recommendations on how to improve efficiency and financial sustainability of NHIS based on health sector expenditure and NHIS claims expenditure review. The analysis started with an overall health sector expenditure review, zoomed into NHIS claims expenditure in Volta region as a miniature for the scheme, and followed by identifictation of factors affecting level and efficiency of expenditure. This study is the first attempt to undertake systematic in-depth analysis of NHIS claims expenditure. Based on the study findings, it is recommended that NHIS establish a stronger expenditure control system in place for long-term sustainability. The majority of NHIS claims expenditure is for outpatient consultations, district hospitals and above, certain member groups (e.g., informal group, members with more than five visits in a year). These distribution patterns are closely related to NHIS design features that encourages expenditure surge. For example, year-round open registration boosted adverse selection during enrollment, essentially fee-for-service provider mechanisms incentivized oversupply but not better quality and cost-effectiveness, and zero patient cost-sharing by patients reduced prudence in seeking care and caused overuse. Moreover, NHIA is not equipped to control expenditure or monitor effect of cost-containment policies. The claims processing system is mostly manual and does not collect information on service delivery and results. No mechanisms exist to monitor and correct providers’ abonormal behaviors, as well as engage NHIS members for and engaging members for information verification, case management and prevention.

Care Without Coverage

Care Without Coverage
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 213
Release: 2002-06-20
Genre: Medical
ISBN: 0309083435

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Measuring What We Spend

Measuring What We Spend
Author: National Research Council
Publisher: National Academies Press
Total Pages: 217
Release: 2013-02-15
Genre: Political Science
ISBN: 0309265789

The Consumer Expenditure (CE) surveys are the only source of information on the complete range of consumers' expenditures and incomes in the United States, as well as the characteristics of those consumers. The CE consists of two separate surveys: (1) a national sample of households interviewed five times at three-month intervals; and (2) a separate national sample of households that complete two consecutive one-week expenditure diaries. For more than 40 years, these surveys, the responsibility of the Bureau of Labor Statistics (BLS), have been the principal source of knowledge about changing patterns of consumer spending in the U.S. population. In February 2009, BLS initiated the Gemini Project, the aim of which is to redesign the CE surveys to improve data quality through a verifiable reduction in measurement error with a particular focus on underreporting. The Gemini Project initiated a series of information-gathering meetings, conference sessions, forums, and workshops to identify appropriate strategies for improving CE data quality. As part of this effort, BLS requested the National Research Council's Committee on National Statistics (CNSTAT) to convene an expert panel to build on the Gemini Project by conducting further investigations and proposing redesign options for the CE surveys. The charge to the Panel on Redesigning the BLS Consumer Expenditure Surveys includes reviewing the output of a Gemini-convened data user needs forum and methods workshop and convening its own household survey producers workshop to obtain further input. In addition, the panel was tasked to commission options from contractors for consideration in recommending possible redesigns. The panel was further asked by BLS to create potential redesigns that would put a greater emphasis on proactive data collection to improve the measurement of consumer expenditures. Measuring What We Spend summarizes the deliberations and activities of the panel, discusses the conclusions about the uses of the CE surveys and why a redesign is needed, as well as recommendations for the future.

Improving the Measurement of Consumer Expenditures

Improving the Measurement of Consumer Expenditures
Author: Christopher D. Carroll
Publisher: University of Chicago Press
Total Pages: 517
Release: 2015-06-16
Genre: Business & Economics
ISBN: 022612665X

Robust and reliable measures of consumer expenditures are essential for analyzing aggregate economic activity and for measuring differences in household circumstances. Many countries, including the United States, are embarking on ambitious projects to redesign surveys of consumer expenditures, with the goal of better capturing economic heterogeneity. This is an appropriate time to examine the way consumer expenditures are currently measured, and the challenges and opportunities that alternative approaches might present. Improving the Measurement of Consumer Expenditures begins with a comprehensive review of current methodologies for collecting consumer expenditure data. Subsequent chapters highlight the range of different objectives that expenditure surveys may satisfy, compare the data available from consumer expenditure surveys with that available from other sources, and describe how the United States’s current survey practices compare with those in other nations.

Accounting for Health and Health Care

Accounting for Health and Health Care
Author: National Research Council
Publisher: National Academies Press
Total Pages: 239
Release: 2011-01-05
Genre: Medical
ISBN: 0309186846

It has become trite to observe that increases in health care costs have become unsustainable. How best for policy to address these increases, however, depends in part on the degree to which they represent increases in the real quantity of medical services as opposed to increased unit prices of existing services. And an even more fundamental question is the degree to which the increased spending actually has purchased improved health. Accounting for Health and Health Care addresses both these issues. The government agencies responsible for measuring unit prices for medical services have taken steps in recent years that have greatly improved the accuracy of those measures. Nonetheless, this book has several recommendations aimed at further improving the price indices.