Dynamic Price Application to Prevent Financial Losses to Hospitals Based on Machine Learning Algorithms.

Hospitals that are considered non-profit take into consideration not to make any losses other than seeking profit. A model that ensures that hospital price policies are variable due to hospital revenues depending on patients with appointments is presented in this study. A dynamic pricing approach is presented to prevent patients who have an appointment but do not show up to the hospital from causing financial loss to the hospital. The research leverages three distinct machine learning (ML) algorithms, namely Random Forest (RF), Gradient Boosting (GB), and AdaBoost (AB), to analyze the appointment status of 1073 patients across nine different departments in a hospital. A mathematical formula has been developed to apply the penalty fee to evaluate the reappointment situations of the same patients in the first 100 days and the gaps in the appointment system, considering the estimated patient appointment statuses. Average penalty cost rates were calculated based on the ML algorithms used to determine the penalty costs patients will face if they do not show up, such as 22.87% for RF, 19.47% for GB, and 14.28% for AB. As a result, this study provides essential criteria that can help hospital management better understand the potential financial impact of patients missing appointments and can be considered when choosing between these algorithms.

The Effect of the Comprehensive Reform of Agricultural Water Prices on Farmers' Planting Structure in the Oasis-Desert Transition Zone-A Case Study of the Heihe River Basin.

The comprehensive reform of agricultural water prices is an important policy for promoting the high-quality sustainable development of agriculture and ensuring national water security. In this study, based on farmer survey data from different water price policy implementation areas in the oasis-desert transition zone of the Heihe River Basin (HRB), crops are divided into high-water-consuming crops and low-water-consuming crops based on the average water consumption per hm2. The content of this study consists of two main parts: first, the study explores the response of farmers to different agricultural water price policies by comparing the impact of uniform water price and tiered water price policies on their planting structure. Second, it studies the areas where the tiered water price policy is implemented to verify the impact of price signals on farmers' production decisions. The results show that, compared with the uniform water price policy, the implementation of the tiered water price policy will significantly reduce the proportion of high-water-consuming crops planted when other conditions remain unchanged. Under the tiered water price policy, the increase in water prices will reduce the proportion of farmers planting high-water-consuming crops, but the difference is not significant. This result reveals that when the opportunity cost of irrigation water increases, farmers will increase the proportion of low-water-consuming crops. The findings also indicate that a higher educational level, improved land inflow, the number of crop types, and satisfaction with the current subsidy policy will help increase the proportion of low-water-consuming crops. However, an increase in the family-cultivated land area will reduce the area of low-water-consuming crops.

The impact of conventional cost-effectiveness analysis on pricing dynamics in the market of new medicines: a proposed countervailing approach.

BACKGROUND: Countries using cost effectiveness ratio as a decision tool for price and reimbursement decisions still witness accelerating price increases. The objective of this paper is to propose a change in the application of the incremental cost effectiveness ratio as a criterion for price policy. RESEARCH DESIGN: We develop a model that sets a price for marginal effectiveness equal to the marginal willingness to pay, but it reimburses average effectiveness according to the size of increased QALY gain. RESULTS: This new formula also allows to split the economic value of drug between patients and the industry and creates a reward to invest into QALY gains. We show some empirical data of the new prices derived from the application of the new formula, as well as the implications in terms of the consumer and manufacturer´s surplus based on two potential scenarios of the incentives generated by this new formulation. DISCUSSION: We propose that small increases in life expectancy be priced differently from substantial as a way of containing the price dynamics. CONCLUSIONS: A change in the application of the ICER threshold will help to reduce the price pressure on public budgets.

Does the Price Support Policy Drive a Balanced Distribution of Profits in the Chinese Dairy Supply Chain? Implications for Supplier and Consumer Psychology.

Evaluating the price policy of raw milk is of great significance to the sustainable development of an industry supply chain. In this context, our study used the multi-period difference-in-difference method to systematically examine the impact of the policy implementation on product price and profit distribution in the supply chain. The results showed the following: (1) the price of raw milk in the implementation area of the price support policy is 13.54% higher than that of the unimplemented area; (2) the effect of price increase in the western region (15.5%) is higher than that in the eastern region (13%), and the central region (10.73%); (3) furthermore, the purchase price guidance policy of raw milk drives price increase or price suppression in the links of the supply chain to promote a balanced distribution of profits among the participants in the chain. These conclusions all have good stability and have reference significance for further improving and adjusting the price support policy of raw milk to realize the sustainable development of the Chinese dairy industry. This will enhance the production confidence of Chinese raw milk producers and improve Chinese consumers' expectations and consumer psychology regarding domestic dairy products.

Do companies in the pharmaceutical supply chain earn excess returns?

Rising drug spending has led to increased calls to curtail drug costs. However, it is unclear where to target policy solutions. We estimated excess returns (the extent to which a firm's profits are higher than expected given the risk associated with their investments) for manufacturers and middlemen in the pharmaceutical supply chain to determine who is making excessive profits. Excess returns were calculated as the difference between return on invested capital and the expected returns given risk, which is known as the weighted average cost of capital. We compared excess returns for manufacturers and middlemen to the average for S&P 500 companies. We find that both manufacturers and middlemen have higher excess returns in 2013-2018 compared with the S&P 500. However, if we treat research and development (R&D) as an investment rather than an expense, we find that excess returns for pharmaceutical manufacturers are lower than the S&P 500 (1.7% vs. 3.6%), but biotech manufacturers (9.6%), wholesalers (8.1%), and insurers/PBM/retailers (5.9%) continue to have significantly higher excess returns compared to the S&P 500. Our findings suggest public policies that promote competition in all areas of the pharmaceutical supply chain are important avenues for curtailing drug spending.

Achieving sustainable soil and water protection: The perspective of agricultural water price regulation on environmental protection.

With the development of Chinese economy, more and more attention has been paid to environmental protection, the implementation of water price policy affects economic and environmental changes in China. This paper analyzes the impact of water price policy on agricultural land use and the scale of water pollution discharge in 240 cities in China between 2001 and 2017, by including data from China Urban Statistical Yearbook and China Land & Resources Almanac. The theoretical analysis of this study indicates that the optimal scale of pollution depends on the local initial endowment, economic investment capital and the marginal cost of environmental pollution caused by government's economic activities. Furtherly, the economic activities have a worsening impact on environmental pollution, but when the government implements environmental protection and water price policy measures in response to environmental pollution caused by economic activities, it has a significant impact on the decline in the scale of pollution. The government has promoted the pollution suppression model in the formulation of water prices, which has internalized the external cost of pollution in economic activities and can effectively reduce the scale of agricultural water pollution discharge.

Drug price, dosage and safety: Real-world evidence of oral hypoglycemic agents.

OBJECTIVES: Drug price reduction is one of the major policies to restrain pharmaceutical expenses worldwide. This study explores whether there is a relationship between drug price and clinical quality using real-world data. METHODS: Patients with newly-diagnosed type 2 diabetes receiving metformin or sulfonylureas during 2001 and 2010 were identified using the claim database of the Taiwan universal health insurance system. Propensity score matching was performed to obtain comparable subjects for analysis. Pharmaceutical products were categorized as brand-name agents (BD), highpriced generics (HP) or low-priced generics (LP). Indicators of clinical quality were defined as the dosage of cumulative oral hypoglycemic agents (OHA), exposure to other pharmacological classes of OHA, hospitalization or urgent visit for hypoglycemia or hyperglycemia, insulin utilization and diagnosis of diabetic complications within 1 year after diagnosis. RESULTS: A total of 40,152 study subjects were identified. A generalized linear mix model showed that HP and BD users received similar OHA dosages with comparable clinical outcomes. By contrast, LP users had similar outcomes to BD users but received a 39% greater OHA dosage. A marginally higher risk of poor glycemic control in LP users was also observed. CONCLUSIONS: Drug price is related to indicators of clinical quality. Clinicians and health authorities should monitor the utilization, effectiveness and clinical safety indicators of generic drugs, especially those with remarkably low prices.

Price elasticity of illegal versus legal cannabis: a behavioral economic substitutability analysis.

BACKGROUND AND AIMS: The evolving legal status of cannabis world-wide necessitates evidence-based regulatory policies to minimize risks associated with cannabis misuse. A prominent concern is the impact legalization may have on the illegal cannabis market, including whether illegal cannabis will serve as a substitute for legal cannabis. Empirical data on this issue are virtually non-existent. This study used behavioral economics to investigate substitutability of legal and illegal cannabis in legalized catchment areas in the United States. DESIGN: A substitution-based marijuana purchase task assessed estimated cannabis consumption from concurrently available legal (a dispensary) and illegal (a dealer) sources. Prices of the two options were reciprocally either held constant ($10/gram) or escalated ($0-$60/gram). SETTING: US states with legalized recreational cannabis. PARTICIPANTS: Adult cannabis users who were at least 21 years old (n = 724; mean age = 34.13; 52% female; 74% Caucasian) were recruited using online crowdsourcing. MEASUREMENTS: Mean consumption values were used in demand curve modeling to generate indices of price sensitivity and elasticity. Differences in demand indices were compared using extra sums-of-squares F-tests. FINDINGS: Both legal and illegal fixed-price cannabis options had significant positive cross-price elasticities (Ps < 0.001), indicating that higher prices motivate substitution irrespective of legality. However, the presence of a legal alternative had a substantially greater effect on consumption and elasticity of illegal cannabis (∆elasticity  = 0.0019; F(1,37)  = 160, P < 0.0001) than the presence of an illegal alternative on demand for legal cannabis (∆elasticity  = 0.0002; F(1,37)  = 48, P < 0.0001), indicating asymmetric substitution. Demand for legal cannabis was significantly greater than for illegal cannabis (P < 0.0001). CONCLUSIONS: Cannabis users treat legal cannabis as a superior commodity compared with illegal cannabis and exhibit asymmetric substitutability favoring legal product. Cannabis price policies that include somewhat higher consumer costs for legal cannabis relative to contraband (but not excessively higher costs) would not be expected to incentivize and expand the illegal market.

Price and distribution policies in healthcare marketing in Romania.

There is a principle similar to the theory of exchange in the marketing of health services, meaning that what is delivered to the target market (i.e. the beneficiaries) must be equal to or greater than what is to be received (i.e. the price). The price level in the marketing mix is influenced by how the consumer perceives the respective medical service and is quantified in the profit and the turnover of the organization respectively. The cost of the medical act as a whole is the value of all the tangible and intangible variables associated with it, and the planning, distribution and promotion of the product must be taken into account in the price setting.

Impact of Increased Tobacco Price on Adult Smoking Rate in South Korea / 보건행정학회지

BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.

Impact of Increased Tobacco Price on Adult Smoking Rate in South Korea / 보건행정학회지

BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.

Analysis of high-value medical supplies price setting policy under the disease fee payment system reform in China: A case of Endoscopic Retrograde Cholangio-Pancreatography (ECRP) / 中国卫生政策研究

This paper analyzes the ERCP price setting policy and its impact on the patient''s cost and it puts forward possible price setting policy recommendations, according to the current situation of the disease payment system reform and promotion prospects of ERCP.ERCP belongs to the low-price high-value medical supplies, but hospitalization expenses data of 9 types of diseases show that consumables accounted for 35.81~48.25%.The main factor hindering widely the application of ERCP lies in high-ratio self-payment and high medical cost, in other words, as the ERCP supplies are not included in the scope of medical insurance payments, the current rate of patients with high surgical expenses, medical costs are expensive.As per the analysis of this paper, the following are the policy recommendations to put forward 1)Paying attention to historical settlement data and scientific formulation of disease charges;2)Considering different treatment methods and allocate appropriate disease payment standards;3)Standardize operation code to ensure the information quality of accurate disease expenses calculation.

Analysis of the Changes of Burden Factor Loading for Chronic Disease Inpatients before and after the Im-plementation of Zero Price Policy by Establishing Structure Equation Model / 中国药房

OBJECTIVE:To construct the structure equation model for the burden of chronic disease inpatients in primary hos-pital before and after the implementation of zero price policy,and analyze the changes of burden factor loading. METHODS:6 pri-mary hospitals were randomly selected in Danyang,Jiangsu province. The data of hospitalization expenses for chronic diseases(hy-pertension,diabetes,bronchitis)were collected before and after the implementation of zero price policy. Using drug cost,nursing fees,inspection fees and treatment fees as independent variables,hospitalization burden as latent variable,SPSS and AMOS 24.0 software were adopted to establish the model. RESULTS:The burden factor loading of inpatients changed greatly before and after the implementation of zero price policy. χ2=24.586,χ2/df=1.446, RMSEA=0.019,GFI=0.995,AGFI=0.989,CFI=0.988,NFI=0.963 manifested good model fitting. Factor loading of drug cost increased greatly,indicating the burden of inpatients was reduced after the implementation of zero price policy. Factor loading of inspection fees and treatment fees increased significantly,the charac-terization effects of them to the burden of inpatients were enhanced. Factor loading of nursing fees was the lowest,and it had the weakest effects on the burden of inpatients,of which the government should enhance the regulation. CONCLUSIONS:Established model has good reliability and validity. It can reflect the change of burden factor loading of inpatients before and after the implemen-tation of zero price policy.

Empirical Analysis on Price Policy Compensation Status in 4 Years after the Drug Zero Profit Policy / 中国卫生经济

Objective:Retrospective analysis was conducted on the status of drug profit decreasing and pricing compensation profits increasing after the implementation of drug zero profit policy.The ratio of pricing policy compensation in place and the reform effects were evaluated to provide references for poliey making on implementing drug zero profit policy.Methods:The total usage of western medicine and Chinese patent medicine,the item of medical charging costs and item times before and after the implementation of drug zero profit,the decreasing of drug profits by outpatient and inpatient and the increasing of medical items were selected from hospital information system from 2013 to 2016.Results:From 2013 to 2016,the price of compensation policy in place rates were 94.59％,89.51％,95.18％,95.64％;4 year total compensation policy in place rate was 93.67％;outpatient compensation mainly by inspecting fee (75.22％),the cost of treatment (11.18％),surgery (5.91％);hospital compensation mainly surgical fees,nursing fees (36.40％)(19.09％),(19.08％) medical expenses and treatment expenses (13.53％);a good compensation effect of price policy.Conclusion:The compensation of price policy was in accordance with the expectation of reform,and the sharing of information with the competent department of price could help to establish a scientific and reasonable price compensation policy.It needed to further promote the reform of drug and comsumable usage control.

Empirical Analysis on Price Policy Compensation Status in 4 Years after the Drug Zero Profit Policy / 中国卫生经济

Objective:Retrospective analysis was conducted on the status of drug profit decreasing and pricing compensation profits increasing after the implementation of drug zero profit policy.The ratio of pricing policy compensation in place and the reform effects were evaluated to provide references for poliey making on implementing drug zero profit policy.Methods:The total usage of western medicine and Chinese patent medicine,the item of medical charging costs and item times before and after the implementation of drug zero profit,the decreasing of drug profits by outpatient and inpatient and the increasing of medical items were selected from hospital information system from 2013 to 2016.Results:From 2013 to 2016,the price of compensation policy in place rates were 94.59％,89.51％,95.18％,95.64％;4 year total compensation policy in place rate was 93.67％;outpatient compensation mainly by inspecting fee (75.22％),the cost of treatment (11.18％),surgery (5.91％);hospital compensation mainly surgical fees,nursing fees (36.40％)(19.09％),(19.08％) medical expenses and treatment expenses (13.53％);a good compensation effect of price policy.Conclusion:The compensation of price policy was in accordance with the expectation of reform,and the sharing of information with the competent department of price could help to establish a scientific and reasonable price compensation policy.It needed to further promote the reform of drug and comsumable usage control.

Price elasticity of on- and off-premises demand for alcoholic drinks: A Tobit analysis.

BACKGROUND: Understanding how price policies will affect alcohol consumption requires estimates of the impact of price on consumption among different types of drinkers and across different consumption settings. This study aims to estimate how changes in price could affect alcohol demand across different beverages, different settings (on-premise, e.g., bars, restaurants and off-premise, e.g., liquor stores, supermarkets), and different levels of drinking and income. METHODS: Tobit analysis is employed to estimate own- and cross-price elasticities of alcohol demand among 11 subcategories of beverage based on beverage type and on- or off-premise supply, using cross-sectional data from the Australian arm of the International Alcohol Control Survey 2013. Further elasticity estimates were derived for sub-groups of drinkers based on their drinking and income levels. RESULTS: The results suggest that demand for nearly every subcategory of alcohol significantly responds to its own price change, except for on-premise spirits and ready-to-drink spirits. The estimated demand for off-premise beverages is more strongly affected by own price changes than the same beverages in on-premise settings. Demand for off-premise regular beer and off-premise cask wine is more price responsive than demand for other beverages. Harmful drinkers and lower income groups appear more price responsive than moderate drinkers and higher income groups. CONCLUSION: Our findings suggest that alcohol price policies, such as increasing alcohol taxes or introducing a minimum unit price, can reduce alcohol demand. Price appears to be particularly effective for reducing consumption and as well as alcohol-related harm among harmful drinkers and lower income drinkers.

Evaluation on the difference between levels of medical services price and policy implications in Sichuan province / 中国卫生政策研究

This paper designed an index for the differences in medical service prices and this index therein named the Hospital Price Difference Index ( HPDI) which is used as a quantitative tool for evaluation. During evalua-tion, the paper measured the levels of prices and the factors of influence in 18 public hospitals listed in the Sichuan Province. The results showed that the effect of regulating the levels of prices was reasonable and effective, but was sig-nificantly affected by the internal and external factors. The internal factors have been found to be the medical and clini-cal technologies, and the grade and scale acted as external ones. This paper suggested that the price department should pay more attention on the levels of prices, and hence made a reasonable reform project for the prices by taking the scale of adjustment of prices into account.

The opposite thought and advice for the price policy of centralized purchasing in national essential drugs / 药学实践杂志

Objective To analysis the major problems and the causes in the process of centralized purchasing of national essen -tial drugs, and to give some effective solutions according to the price problems for ensuring the quality and regular supply of national es -sential drugs , decrease patients burden effectively and safeguard the medication safety of patients .Methods The implementation of cen-tralized purchasing of national essential drugs was investigated , the problems which were major and outstanding were analyzed to find out the internal causes and the effective solutions were given .Results The progression of centralized purchasing of national essential drugs was successfully in general .The implementation of the principle of winning of the bidding with the lowest bid price lead to excessive low price, which caused some problems such as lower quality or bad supplied of some national essential drugs .Conclusion The price policy of centralized purchasing of national essential drugs should not be instituted based on the lower price , more winning of biddings .It needed more scientific and overall perspective thoughts .It maybe solve the problems mentioned above by winning of the bidding with the lowest bid price in the interval average price , appropriately loosing the control of difference rate with the results of decreasing the drug price , avoiding cut-throat competition, ensuring the quality and supply of drugs , lightening the patients′burden, releasing the problem of high cost of getting medical treatment .

Publicación de revistas electrónicas: economía de su producción, distribución y uso

Se analizan aspectos económicos de la actividad de publicación de revistas académicas y científicas, a partir de los costos de producción y de la revisión de los datos disponibles al respecto. Se establece una comparación entre la producción de revistas impresas en papel y en formato electrónico. Se discuten las políticas de precios de suscripción y se ofrece una guía para establecer un punto de equilibrio que ayude a las bibliotecas a optar entre suscribirse a las revistas y obtener copias de artículos mediante los servicios de préstamo interbibliotecario y de envío de documentos.

This paper analyses economic aspects of the scientific scholarly journal publishing, based on production costs and use data. It compares the production of traditional journals with electronic journals, discussing price policies for subscriptions and providing a guide to assess breakeven points, helping libraries to face the option of subscribing to journals or obtaining separate copies through intelibrary borrowing or document delivery.