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PurposeThis study models the effects of the COVID-19 pandemic on the performance of the private health-care sector in the Middle East and North Africa (MENA) countries. This paper aims to address the economic, societal and sustainability of the health-care sector.Design/methodology/approachData were collected from Bloomberg and the sample consists of 534 firm-year observations from 55 firms listed over 2010–2020. The authors apply panel data and control for the country and governance effects.FindingsThe authors found heterogeneous results regarding the three sub-sectors. The pandemic has a negative effect on the accounting and market performances of the "Pharmaceutical companies” and an insignificant impact on "Healthcare Management and Facilities Services.” Moreover, the impact of COVID-19 on health-care firms' performance depends on the country's economic classification and the degree of regulatory and governance frameworks.Research limitations/implicationsFurther studies may consider a larger sample and other regions. It is recommended to address the health-care sector's challenges to invest in new technologies such as "digital twin” and predictive and personalized medicine. It is worth testing model development theory and its effects on speeding up and designing models to ensure the proper functioning and developing mathematics to determine uncertainties in patient data and model predictions.Originality/valueTo the best of the authors' knowledge, this paper is novel as it is unique in modeling the impact of COVID-19 on the health-care public companies in the MENA region. The findings pinpoint firms' and countries' heterogeneous impacts on financial and market performances.
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PurposeThe empirical analysis dealt in this paper emphasizes on the impact of military expenditures on out of pocket (OOP) healthcare payments. A sizeable body of defence economics literature has investigated the trade-off between military and public health expenditure, by testing the crowding-out or growth-stimulating hypothesis;does military expenditure scaling up crowd-out or promote governmental resources for social and welfare programs, including also state health financing?Design/methodology/approachIn this study, panel data from 2000 to 2018 for 129 countries is used to examine the impact of military expenditure on OOP healthcare payments. The dataset of countries is categorized into four income-groups based on World Bank's income-group classification. Dynamic panel data methodology is applied to meet study objectives.FindingsThe findings of this study indicate that military expenditure positively affects OOP payments in all the selected groups of countries, strongly supporting in this way the crowding-out hypothesis whereby increased military expenditure reduces the public financing on health. Study econometric results are robust since different and alternative changes in specifications and samples are applied in our analysis.Practical implicationsUnder the economic downturn backdrop for several economies in the previous decade and on the foreground of a potential limited governmental fiscal space related to the Covid-19 pandemic adverse economic effects, this study provides evidence that policy-makers have to adjust their government policy initiatives and prioritize Universal Health Coverage objectives. Consequently, the findings of this study reflect the necessity of governments as far as possible to moderate military expenditures and increase public financing on health in order to strengthen health care systems efficiency against households OOP spending for necessary healthcare utilization.Originality/valueDespite the fact that a sizeable body of defence economics literature has extensively examined the impact of military spending on total and public health expenditures, nevertheless to the best of our knowledge there is no empirical evidence of any direct effect of national defence spending on the main private financing component of health systems globally;the OOP healthcare payments.
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Este artículo es el resultado de un estudio de las propuestas de política pública presentados en el Congreso de Costa Rica para amortiguar o revertir los efectos socioeconómicos y de salud provocados por la pandemia del Covid-19. De todas las propuestas presentadas en los primeros seis meses de la declaratoria de emergencia ocasionada por el virus, en el año 2020, más de la mitad (194 en total) intentan mitigar uno o varios de los efectos de tal enfermedad infecciosa. Aún en la multiplicidad de protección a sectores específicos que se tratan de salvaguardar (33), hay una marcada tendencia en la regulación financiera-fiscal y de actuación en torno a la reactivación productiva. Pese a esto, una parte sustancial de las políticas planteadas para convertirse en leyes, no tienen un sustento financiero para ejecutarlas.Alternate :This article is the result of a study of the public policy proposals presented in the Costa Rican Congress to cushion or reverse the socioeconomic and health effects caused by the Covid-19 pandemic. Of all the proposals presented in the first six months of the emergency declaration caused by the virus, in the year 2020, more than half (194 total) try to mitigate one or more of the effects of such an infectious disease. Even in the multiplicity of protection for specific sectors that are sought to be safeguarded (33), there is a marked trend in financial-fiscal regulation and action around productive reactivation. Despite this, a substantial part of the policies proposed to become laws do not have financial support to execute them.
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We examine the net benefits of social distancing to slow the spread of COVID-19 in USA. Social distancing saves lives but imposes large costs on society due to reduced economic activity. We use epidemiological and economic forecasting to perform a rapid benefit–cost analysis of controlling the COVID-19 outbreak. Assuming that social distancing measures can substantially reduce contacts among individuals, we find net benefits of about $5.2 trillion in our benchmark case. We examine the magnitude of the critical parameters that might imply negative net benefits, including the value of statistical life and the discount rate. A key unknown factor is the speed of economic recovery with and without social distancing measures in place. A series of robustness checks also highlight the key role of the value of mortality risk reductions and discounting in the analysis and point to a need for effective economic stimulus when the outbreak has passed.
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This paper analyses determinants of household savings in a model based on an extension of the disequilibrium savings theory. These extensions follow from the life-cycle, permanent-income and Ricardian-equivalence theories. Based on panel data of 20 countries from the period 2000–2020, fixed-effect least squares estimation procedures are used. The analysis provides evidence that negative interest rates lead to a statistically and economic significant increase in savings. This implies that stimulating household consumption with a monetary policy of negative interest rates is counter-productive. The positive effect of income uncertainty and lagged saving rates gets smaller for negative interest rates, weakening the support for the disequilibrium-savings theory. Larger government deficits increase savings even more when rates are negative, strengthening the Ricardian equivalence effect. The effect of negative interest on the predictions of the life-cycle and permanent-income theories is mixed.
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Despite the challenges, remittances frequently remain a primary source of economic support for those left behind, as well as for national development of post-conflict countries. [...]situations in the wake of recent conflicts are known for heightened remittance flows.3 As a large share of the remittance flows in conflict settings occurs through informal channels, the importance of remittances in these economies has often been underestimated. A focus on broader settings that can provide security, justice, and economic sustenance to individuals and communities affected by the crisis has been reflected in the human security approach6 to post-conflict7 development.8 Remittances can be central to fighting poverty—by diversifying household income sources, providing capital for productive investment and facilitating local markets, and funding education, health, and other social expenses.9 Remittances can contribute to post-conflict recovery in the long term. "20 Horst has shown that among the Somali diaspora in Norway, most political engagements do not occur through state institutions but take place on sub-national levels, including individual and group money transfers and certain humanitarian initiatives.21 Somali diaspora members mediate with clan leaders and elders who can contribute to reconciliation processes through customary mechanisms such as compensatory payments, but as noted above, such involvement can also sustain continued warfare.22 While the role of diaspora in post-conflict reconstruction efforts can be significant, diaspora can also remain an "under-utilized resource" whose strong emotional connection to their home country is offset by unstable institutional environments.23 Weak formal institutions and regulatory frameworks may offer little systematic support for entrepreneurship development, which is constrained by high transaction and compliance costs. Informal institutions and cultural attitudes remain important in the post-conflict assimilation of returning migrants who bring with them beliefs and understandings from their countries of settlement, resulting in hybrid norms and institutions.24 Many forcibly displaced and returning migrants may also lack properly transferable professional skills.25 The transfer of social and political remittances does not always signify "diffusion of democracy"—the effects of returning migrants to democratization depend on their experience of political mobilization as migrant workers, as well as on the status of democratic values in the political order of the host country, among other factors.26 Changing perspectives on conflict-affected remittances Remittances became central in the migration scholarship only in the 1990s, when the analytical focus shifted from migration as a result of [End Page 44] decision-making of rational individuals towards a more nuanced view of the role of households, social networks, and community in migration processes.
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Am J Manag Care. 2021;27(3):137-139. https://doi.org/10.37765/ajmc.2021.88612 _____ Low-value services—services that provide insufficient clinical benefit relative to cost—are increasingly recognized as a major problem in the US health care system. The pandemic's unprecedented impact on the US health care system, and society writ large, offers an opportunity to reshape the conversation and incentives around low-value services after the immediate crisis subsides. [...]although recent initiatives have raised awareness of low-value care among clinicians, knowledge gaps remain, and researchers and advocates have not effectively communicated the scope or salience of the problem to patients. Currently, many measures are derived from claims data alone, which may be insufficient for nuanced determinations of low-value care. [...]most existing measures focus on encouraging the delivery of underused services, whereas relatively few measures explicitly target overuse or capture the harm precipitated by low-value care.
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The Taskforce aims include: 'improving patient access to general practice and GP-led multidisciplinary teams, making primary care more affordable, improving prevention, and reducing pressure on hospitals',3 and these data suggest that increasing general practice funding to support the Taskforce's aims is consistent with community expectations. The use of market researchers to rapidly access data is innovative and highlights the value of consumer input into health policy decision making, reinforcing the need for sharing of routinely collected data to better understand allocation of health system expenditure. Authors Michael Wright MBBS, MSc, PhD (UTS), GAICD, FRACGP, Research Fellow, Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW;Clinical Associate Professor, Sydney University Medical School, University of Sydney, Sydney, NSW Roald Versteeg BBusMan, Chief Policy Officer, The Royal Australian College of General Practitioners, East Melbourne, Vic (at time of submission) References 1.
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The uncertainty that the COVID-19 pandemic has brought demonstrates that income redistribution and traditional debt relief mechanisms are insufficient to meet public spending needs, mitigate external debt, and comply with the UN's Sustainable Development Goals (SDGs), which aim to reduce multilateral debt to sustainable levels. Also, West African countries have focused their attention on the long-term fight against poverty and inequality and strengthening their social programs, especially in primary health care and macroeconomic stability. However, for more than a decade, the developing and least developed countries of West Africa have faced rapidly weakening macroeconomic conditions, combining several interrelated crises such as the sharp decline in oil prices, volatile financial markets and tourism disruptions, a global recession, the crisis of climate change, and shortages of food and energy, along with the economic contraction of COVID-19. Data from these countries show that health spending increases economic growth, minimizes infant mortality rates, and reduces debt. Furthermore, increasing government spending efficiency reduces the total debt and improves the health sector, in particular.
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PurposeThis paper explores medical tourism development challenges in the United Arab Emirates (UAE) pre- and during Covid-19. Medical tourism is becoming a dynamic, rapid growth area and an engine of economic development.Design/methodology/approachIn-depth interviews were conducted with medical tourism professionals. Fourteen medical tourism stakeholders were interviewed from 1 January to 31 January 2020. Qualitative thematic analysis was applied on medical tourism challenges before and during the pandemic.FindingsThe major themes indicated concerns for medical tourism in the UAE and they included higher medical services costs and a shortage of highly qualified medical expertise. The emerging themes related to the challenges of coping with Covid-19 and strategies to attract medical tourists.Originality/valueThis study contributes towards (1) the theory of medical tourism, (2) the related limited prior published work on this topic relating to the UAE and (3) the importance of medical tourism in today's tourism industry. Additionally, there are theoretical and practical implications for medical tourism stakeholders in terms of attracting inbound medical tourists to the UAE from other countries during the Covid-19 crisis and in the post-pandemic situation.
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How has public healthcare spending prepared countries for tackling the COVID-19 pandemic? Arguably, spending is the primary policy tool of governments for providing effective health. We argue that the effectiveness of spending for reducing COVID deaths is conditional on the existence of healthcare equity and lower political corruption because the health sector is particularly susceptible to political spending. Our results, obtained using ordinary least squares and two-stage least squares estimations, suggest that higher spending targeted at reducing inequitable access to health has reduced COVID deaths. Consistent with the findings of others, our results indirectly suggest that health spending is necessary, but not sufficient unless accompanied by good governance and equitable access. Equitable health systems ease the effects of COVID presumably because they allow states to reach and treat people more effectively. Spending aimed at increasing health system capacity by increasing access thus seems a sound strategy for fighting the spread of disease, ultimately benefiting us all.
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ABSTRACTWith the widespread ownership and usage of mobile devices combined with the subsequent challenges usage poses on relationships, this research examines how people negotiate time spent on mobile devices (smartphones and/or tablets) accomplishing professional tasks. Participants in this study were the users of the mobile device within a full-time managerial level position. Diverse organizational representation included, but not limited to health care, engineering, public relations, finance, education, and distribution management industries. Using qualitative methods and semi-structured interviews, data analysis unveiled what negotiation means when using mobile devices in any capacity for professional reasons within the domestic (familial) sphere. Management-level organizational members share how parameters (sometimes called boundaries or borders) are both in and out of their control when using mobile devices to communicate professionally. Within their control was the users' ability to engage or disengage, while also challenged with situations out of their control due to organizational directives. This research re-conceptualizes the concepts of Clark's (2000) Work/Family Border Theory. While this data was gathered prior to Covid19, understanding this balance has current and future relevancy from an academic and applied perspective.
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The home health-care industry is under growing pressure to deliver services more effectively to meet the increasing demand from care recipients, particularly the elderly population. It is estimated that U.S. home health-care expenditures will rise from US[Formula Omitted]108.8 billion in 2019 to US$186.8 billion in 2027 [1] . A simultaneous ongoing shortage of physicians, registered nurses, certified nursing assistants, and social workers has created a major service delivery gap in the home health-care industry, especially in rural areas where timely access to quality health-care services is very limited [2] . The recent COVID-19 pandemic exacerbated this problem as it isolated many care recipients from their caregivers or friends.
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Gaps in global social policies are receiving greater attention amid ongoing and looming global crises. Intersectionality between crisis, including the ongoing COVID-19 pandemic and armed conflict in Ukraine, intensify already heightened inflation rates and worsening clkimate crises. As a result, social policies are being implemented in response to the cost-of-living increases that are severely impacting more than 1.2 billion people. This issue of the GSP Digest focuses on cost-of-living increases amid these crises. Imminent public health crises and armed conflicts have impacted nearly all policy areas of international actors and their social aspects.
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Chronic psychotic disorders are severe and disabling mental disorders associated with poor psychiatric and medical outcomes, and among the most costly mental disorders to treat. Understanding trends in aggregate health care expenditures over time, and respective drivers, can provide relevant insights for decision makers, namely around appropriate allocation of scarce resources within the health care sector. Using administrative health care times series data from Ontario, this analysis examined trends in aggregate public health care expenditures and activity from 2012 to 2019 among all individuals with a diagnosis of a chronic psychotic disorder. Total aggregate health care expenditures for individuals with a chronic psychotic disorder in Ontario increased at a moderate rate over this time period, in line with the growth of the number of people diagnosed, and thus not likely driven by unit costs or resource use. Psychiatric hospitalizations made up the largest share of health care expenditures (~30%). Nonetheless, among all health services, expenditures of acute medical hospitalizations, outpatient prescription drugs and home care saw the largest growth over time. Mean/per capita health care expenditures were greater for females, and increased with age as well as with the presence of comorbidities/chronic conditions. In particular, mean/per capita health care expenditures increased steadily with the number of comorbidities and were highest for individuals with 5 or more comorbidities and those with congestive heart failure, highlighting the ever-increasing importance of addressing physical health conditions among this patient population. These findings will have important implications for decision makers, namely around the appropriate allocation of health care resources for patients with chronic psychotic disorders. Future research should continue to monitor health care expenditures for individuals with chronic psychotic disorders as well as extend this analysis beyond 2019 to understand how the COVID-19 pandemic, and resulting lockdowns, has impacted aggregate health care expenditures and outcomes for patients living with chronic psychotic disorders.
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This article describes the public health impact of Alzheimer's disease, including prevalence and incidence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report examines the patient journey from awareness of cognitive changes to potential treatment with drugs that change the underlying biology of Alzheimer's. An estimated 6.7 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, and Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated by the COVID-19 pandemic in 2020 and 2021. More than 11 million family members and other unpaid caregivers provided an estimated 18 billion hours of care to people with Alzheimer's or other dementias in 2022. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $339.5 billion in 2022. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the paid health care workforce are involved in diagnosing, treating and caring for people with dementia. In recent years, however, a shortage of such workers has developed in the United States. This shortage - brought about, in part, by COVID-19 - has occurred at a time when more members of the dementia care workforce are needed. Therefore, programs will be needed to attract workers and better train health care teams. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2023 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $345 billion. The Special Report examines whether there will be sufficient numbers of physician specialists to provide Alzheimer's care and treatment now that two drugs are available that change the underlying biology of Alzheimer's disease.
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Alzheimer Disease , COVID-19 , Humans , Aged , United States/epidemiology , Alzheimer Disease/epidemiology , Alzheimer Disease/therapy , Alzheimer Disease/diagnosis , Pandemics , Health Care Costs , COVID-19/epidemiology , Medicare , Caregivers/psychologyABSTRACT
We assess the ability of Ethiopia's flagship social protection program, the Productive Safety Net Program (PSNP), to mitigate the adverse impacts of the COVID-19 pandemic on food and nutrition security of households, mothers, and children. We use both prepandemic in-person household survey data and a postpandemic phone survey. Employing a household fixed effects difference-in-differences approach, we find that household food insecurity increased by 11.7 percentage points and the size of the food gap increased by 0.47 months in the aftermath of the onset of the pandemic. Participation in the PSNP offsets virtually almost all of this adverse change;the likelihood of becoming food insecure increased by only 2.4 percentage points for PSNP households, and the food gap increased by only 0.13 months. The protective role of the PSNP was greater for poorer households and those living in remote areas. Results are robust to definitions of PSNP participation, different estimators, and how we account for the nonrandomness of mobile phone ownership. Furthermore, PSNP households were less likely to reduce expenditures on health and education by 7.7 percentage points and were less likely to reduce expenditures on agricultural inputs by 13 percentage points.
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In the United States, the threat of COVID-19 as a public health problem was impossible to separate from the financial threat. From the start, the virus's circulation through human bodies intermingled with all the ways human lives had been defined by neoliberalism's economizing rationality. To unpack the convergence of the pandemic with neoliberal rationality, this article examines the financial advisory discourse produced by credit and fintech companies at the start of the pandemic, focusing on Equifax, Experian, and Mint. This messaging was replete with expressions of care, along with promises of institutional assistance. However, reading further it became clear the companies offered mostly financial self-help advice. The immediate turn to this type of messaging suggested how much the financial system depended on a collective continuation of the individual's sense of moral responsibility for financial self-management and creditworthiness, and especially diligent debt-payment.Alternate :Aux États-Unis la menace de la COVID-19 comme problème de santé publique était indissociable de la menace financière. Dès le début de la pandémie, la circulation du virus dans les corps humains s'est interposée avec toutes les façons dont les vies humaines ont été définies par la rationalité économisante du néolibéralisme. Pour éclaircir la convergence de la pandémie avec la rationalité néolibérale, le présent article examine les messages d'avis financiers produits par les entreprises de crédit et de technologie financière pendant la pandémie, notamment Equifax, Experian et Mint. Ces messages étaient emplis d'expression de soutien, avec des promesses d'aide institutionnelle. Cependant, une lecture plus attentive permet de voir que ces entreprises ont surtout offert des conseils visant l'auto-assistance financière. Le recours immédiat à ce type de message indique le degré auquel le système financier dépend sur la continuation collective du sens de responsabilité morale des personnes pour gérer eux-mêmes leurs finances et leur capacité de crédit, et particulièrement pour continuer à payer leurs dettes.
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While social isolation and loneliness affect individuals of all ages and backgrounds, older adults can be affected disproportionately, and are much more likely to suffer from health complications and related healthcare expenses. The COVID-19 pandemic has highlighted and heightened the severity of social isolation and loneliness, especially for people aging at home, in long-term care facilities, and in nursing homes. This article explores meaningful interventions for older adults, including some that look outside the traditional healthcare sector and in the technology, housing, transportation, and nutrition fields.
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NHS leaders have told governments what UK and Welsh funding priorities should be in future budgets as fears grow some Welsh NHS organizations will not break even this financial year. According to a new paper by the Welsh NHS Confederation, government needs to review the long-term funding model for health and social care because without further investment, patient experience and quality of care will suffer. NHS leaders say funding priorities should include the ongoing costs of Covid-19, recovery of care services, the backlog in elective care and the maintenance of NHS estates -- including reducing carbon emissions. The rising cost of healthcare was blamed on Covid-19, a growing and ageing population, developments in medical technology, increases in energy prices, pay and price inflation, pharmaceutical developments, and recruitment and retention challenges, while both demand on, and expectations of, the NHS continue to increase.