Brian Yule

Aggregate health care expenditures and national income: is health care a luxury good?

It is well known that a strong relationship exists between national expenditures on health care and national income. This has been used to suggest that health care is a luxury good, and that factors such as the type of health care delivery system in a country are of little importance in determining expenditure levels. This paper argues that these implications rely upon the application of microeconomic analysis to macroeconomic data, and that this is not appropriate. As well as raising questions about the inferences drawn from previous studies, new empirical evidence is presented which casts some doubts on previous findings. International comparisons are based on Purchasing Power Parity rather than exchange rate conversions, underlining the importance of prices as well as quantities in the relationship, and leading to the conclusion that the aggregate data show health care to be, if anything, a necessity rather than a luxury good.

The demand for dental care: an assessment.

This paper reviews the existing literature on the demand for dental care and assesses its implications for the U.K., where such analysis has been lacking to date. The characteristics of the U.K. dental system are briefly outlined, and some observations on the theory of the demand for dental care are made. The main part of the paper consists of a review of empirical work, most of which is North American or Scandinavian. It is concluded that there is as yet no consensus on several empirical matters of major importance. Areas for future research, both in the U.K. and more widely, are presented.

DO PHYSICIANS' PERCEPTIONS OF DRUG COSTS INFLUENCE THEIR PRESCRIBING?

SummaryThis study examines general practitioner (GP) attitudes towards and knowledge of prescribing costs, and the influence of these 2 factors in the doctor’s demand for drugs. The main emphasis of the study is on the influence of perceived cost of drugs on prescribing habits.A postal questionnaire was sent to all 273 GPprincipals in the Grampian region of Scotland. This questionnaire assessed GPs’ attitudes and knowledge with respect to prescribing costs. Information was also collected on the prescribing habits of 176 of these GPs. This information was linked to look at the influence GPs’ knowledge of drug costs has on their actual prescribing behaviour. Three drug groups were studied: ulcer—healing drugs, pain—killers and penicillins.The results showed that although most GPs agreed that costs should be borne in mind when prescribing medicines, their actual knowledge of drug costs was often inaccurate. Furthermore, for certain therapeutic groups, prescribing habits are influenced by GPs’ perceptions of drug costs. This implies that GPs are not as averse to considering costs as is often assumed, and that giving GPs better information about drug costs might promote more rational prescribing.

The economics and evaluation of dental care and treatment

This paper is concerned with economic evaluation in dentistry. The potential for such evaluation is great, but has not been fully realised to date. A number of issues which are common to the existing literature are discussed, and particular attention is paid to the question of measuring dental health in economic appraisal. Directions for future research are presented. The paper concludes that the future for economic evaluation in dentistry is favourable and that there is a need for greater collaboration between economic and dental researchers in this area.

The way to economic prescribing

Concern about the size of the NHS drugs bill in the UK has resulted in three main policy initiatives by government: regular increases in prescription charges, the introduction of restrictions on the range of prescribable drugs, and the implementation of prescribing budgets. This paper argues that such policies, whilst reducing the NHS drugs bill, have given little consideration to the efficiency of prescribing. Other policy options are considered which may reduce the NHS drugs bill in ways more consistent with efficient prescribing.