John A. Nyman

The value of health insurance: the access motive

Why do people purchase health insurance? Many economists would answer that it permits purchasers to avoid risk of financial loss. This note suggests that health insurance is also demanded because it represents a mechanism for gaining access to health care that would otherwise be unaffordable. For example, although a US

Profit Incentives and Technical Efficiency in the Production of Nursing Home Care

300,000 procedure is unaffordable to a person with US

The economics of moral hazard revisited

50,000 in net worth, access is possible through insurance because the annual premium is only a fraction of the procedures cost. The value of insurance for coverage of unaffordable care is derived from the value of the medical care that insurance makes accessible.

Excess Costs and Utilization Associated with Methicillin Resistance for Patients with Staphylococcus aureus Infection

In recent years, nursing home care expenditures have approached one percent of GNP. Their growth is a major contributor to the escalating costs of health care. In this article, the authors analyze a sample of nursing homes from Wisconsin to determine the characteristics of the efficiently operated nursing homes. Data envelopment analysis is used to calculate efficiency scores for the various nursing homes in the sample. The authors then use regression analysis to investigate the determinants of efficiency, holding constant the characteristics of the output. They find that for-profit firms have significantly higher efficiency scores. Copyright 1989 by MIT Press.

Prospective and `cost-plus' medicaid reimbursement, excess medicaid demand, and the quality of nursing home care

Paulys (1968) [Pauly, M., 1968. The economics of moral hazard, Comment, American Economic Review 58, 531-537.] analysis of the welfare loss from insurance assumes that medical care consumption is not determined by income, but recent studies suggest it is. This study argues that (1) Paulys analysis overstates the welfare loss because it includes the effect of income on consumption, (2) the relevant income effect is derived from income transfer from the healthy to the ill that occur when the probability of illness is less than 1, and (3) the welfare loss can be considered the transaction cost of insurance.

Universal bone densitometry screening combined with alendronate therapy for those diagnosed with osteoporosis is highly cost-effective for elderly women

OBJECTIVE To determine differences in healthcare costs between cases of methicillin-susceptible Staphylococcus aureus (MSSA) infection and methicillin-resistant S. aureus (MRSA) infection in adults. DESIGN Retrospective study of all cases of S. aureus infection. SETTING Department of Veterans Affairs hospital and associated clinics. PATIENTS There were 390 patients with MSSA infections and 335 patients with MRSA infections. METHODS We used medical records, accounting systems, and interviews to identify services rendered and costs for Minneapolis Veterans Affairs Medical Center patients with S. aureus infection with onset during the period from January 1, 2004, through June 30, 2006. We used regression analysis to adjust for patient characteristics. RESULTS Median 6-month unadjusted costs for patients infected with MRSA were

Improving the Quality of Nursing Home Outcomes: Are Adequacy- or Incentive-oriented Policies More Effective?

34,657, compared with

Quality-of-Life Weights for the US Population Self-Reported Health Status and Priority Health Conditions, by Demographic Characteristics

15,923 for patients infected with MSSA. Patients with MRSA infection had more comorbidities than patients with MSSA infection (mean Charlson index 4.3 vs 3.2; P < .001). For patients with Charlson indices of 3 or less, mean adjusted 6-month costs derived from multivariate analysis were

The costs of recurrent syncope of unknown origin in elderly patients

51,252 (95% CI,

Measuring the direct healthcare costs of a fall injury event

46,041-