Biography:

Afentoula Mavrodi is a Ph.D. Candidate at the Department of Business Administration, University of Macedonia, Greece. She holds a M.Sc. in International Health Management with Distinction from Imperial College London. She has worked as a consulting analyst in London and as a freelance consultant in both public and private sector healthcare institutions in Greece. For her Ph.D. research she holds a scholarship from Onassis Foundation.

Abstract:

This study aimed at examining the test-retest reliability of an instrument developed to:

a) elicit a monetary value on a quality-adjusted life-year (QALY) using the Willingness-to-Pay (WTP) approach, within the Contingent Valuation Method (CVM); and b) capture general population’s motives regarding value assignment. Validation of this instrument constitutes part of a PhD research for which the candidate holds a scholarship from Onassis Foundation.

WTP was elicited in two ways (iterative closed-ended bidding system/open-ended question). Participants’ motives were assessed through 3 and 4 follow-up statements designed for those willing to pay for the hypothetical treatment and those not willing to pay (protest bidders), respectively.

The study was conducted in Thessaloniki, Greece, during October/November 2018. A randomly selected sample responded via telephone interviews on two occasions over a period of 4 weeks (n=97). Differences between the two points in time were evaluated using the Wilcoxon signed ranked test. Test-retest reliability was assessed using the intra-class correlation coefficient.

WTP estimates showed no statistically significant differences between the two points in time (p>0.05). Test-retest reliability was acceptable and very good for WTP and WTP per QALY estimates, respectively (ICC values of 0.67 (95% CI: 0.51, 0.78) and 0.85 (0.73, 0.91), respectively). Analysis revealed high reliability for all three motivation statements with coefficients ranging from 0.84 (0.67, 0.92) to 0.89 (0.89, 0.96). 3 out of 4 statements formulated exclusively for protest bidders showed acceptable/very good reliability (ICC values ranging from 0.84 (0.67, 0.92) to 0.89 (0.78, 0.95)). After excluding outliers, ICC for WTP estimates was improved at 0.93 (0.88, 0.96).

Biography:

Plummer started at Penn State in 2016 after a 25-year entrepreneurial career. During that time, he started three different healthcare data/analytics’ firms that he sold to publicly-traded or venture-capital-backed firms. After each acquisition, he served as a corporate officer or as a member of its board of directors. Plummer was the Editor-in-Chief of two peer-reviewed monthly periodicals for senior healthcare executives and has published 300+ trade-journal articles on the business of healthcare.

Abstract:

This analysis focuses on the impact of 5-digit ZIP-code level competition on U.S.-based acute-care hospital charges per case and charges per day. Similar to FTC horizontal merger guidelines that use the Herfindahl-Hirschman Index (“HHI”) of concentration for competitive significance, this analysis identifies where firms (competitors) in the candidate market (the ZIP code) have charges per-day or charges per-case that impose at least a small but significant and non-transitory increase in price (“SSNIP”) of five percent or more above the mean charges experiences by all ZIP code cases. This study uses 2017-to-present-day data from multiple sources. The analysis suggests that there is an increase in patient charges as the number of competitors (standalone or system-aggregated) decreases in all geographical market sizes, including metropolitan (50,000+ population), micropolitan (10,000-50,000) and rural (<10,000) analysis areas.

Biography:

Manjushri Sharma has done MBBS and Masters in Hospital Management with distinction. She has worked for Haryana State Medical Services as a Medical Officer for eleven years before moving on to working in corporate hospitals at various senior management positions for two years. For the last nine years, she is working in Panjab University, Chandigarh, India as Assistant Professor, Hospital Management.

Abstract:

Socioeconomic status (SES) has long been known to influence the cardiovascular health of an individual. A number of recent studies have brought out the role of biological, behavioral and psychosocial risk factors that favor the presence of cardiovascular disease (CVD) in socially and economically disadvantaged population, with SES being now labeled as the determinant of the prevalence of risk factors for CVD. This calls for an urgent attention of the health policy makers, especially from the middle and low income countries, so that targeted and cost effective strategies can be drawn out in low resource settings.

This case control study was done to analyses the difference in level of exposure to certain health variables in two groups of respondents, cases being the ones with angiographic ally proven Myocardial Infarction (MI), and controls being the ones without demonstrable MI, with any difference in these two groups assumed to represent an impact of the variable on the outcome. Finally, an attempt was made to draw a statistical association between the socioeconomic statuses of the respondents with the presence of outcome of interest, i.e. MI, and its risk factors. Statistical analysis was done using SPSS 20.0 software. The study found significantly higher risk of CVD amongst the respondents belonging to poor SES as compared to those in middle or high SES. Even for modifiable risk factors associated with CVD, the prevalence was found to be significantly higher in poor SES as compared to high SES category respondents for most of the variables.

Biography:

Mahmoud AlYamany Graduated from Medical School at King Saud University as Medical Doctor. He then did the full training & obtained the American & the Canadian Board in Neurosurgery. Later he obtained his Executive Masters in Health Administration from Washington University in St. Louis. He worked as a Neurosurgeon, Healthcare Executive & board member in several organizations in Saudi where he did most of his clinical & administrative practice. He presently works as the President of the Central Second Healthcare Cluster that constitutes a Medical City, 4 Hospitals & 70 Primary & Specialty Clinics located in Riyadh, Saudi Arabia.

Abstract:

The cost of the Saudi healthcare system is streaming up exponentially. It is a multi-payer, multi-provider system with 75% of the provision done by the different government sectors. & 25% by the private providers, the ministry of health provides 60% of the total care & also regulates healthcare provision by the private sector. The government covers 80% of the cost of care provided by the different sectors & the private insurance & out of pocket cover the remaining 20%.

The collective per-capita health expenditure in Saudi Arabia is in close to 1,200 US$ constituting about 5% of the GDP which is considered among the lower middle range of expenditure & the current access ratios & quality & outcomes are considered reasonably comparable to advanced healthcare systems.

The critical issue is the cumulative annual growth rate (CAGR) of expenditures on healthcare that approaches 6% while the country’s annual GDP grows at 4%, furthermore, with the rapidly growing population (2.3% /year) & the increasing expected age at birth in addition to the unhealthy habits of the population & the inefficiencies in the public providers side, the demand will continue to significantly increase in the future leading to further increase in the gap between health CAGR & national GDP, hence the proposal for the major transformation of healthcare, which focuses on engaging the beneficiaries, leveraging innovation & passing risk to providers as part of the system-wide vision 2030 for diversification of income & efficient spending in order to sustain subsidizing healthcare for all.

Biography:

Eivind Jørgensen holds an M.Phil in economics from University of Oslo. He has been working in the field of health economics and market access since 2000. He is Managing Director of his own consulting company Oecona AS.

Abstract:

Recent years' more effective but also expensive treatment options make prioritizing increasingly challenging. Patients are to a greater extent denied access to treatment options with known good effect, with reference to the fact that the added health benefits do not come at a reasonable cost.

An economically correct allocation of the resources in the health service is not the one that maximizes the population's health, e.g. expressed as the number QALYs. Although the amount of good years of life is obviously a goal in itself, the distribution of these good years of life is also important in order to obtain the highest possible health-related welfare level. This means that all approaches to priorities in the health service involve dilemmas. Everyone can't be as satisfied.

In 2018 absolute shortfall was introduced in Norway as a measure of severity, and is closely related to the concept of alternative costs of introducing new an expensive treatment into a given health care budget.

What are the pitfalls of absolute shortfall and what distributional effects can the application of the concept have? To what extent will proportional shortfall give markedly different effects.

Biography:

Yan Chen has graduated from department of Global Health of Wuhan University China and acquired his bachelor’s degree. Currently he is doing his post-graduate study at Department of Social Medicine and Health Management in the same university and his research interests focus on efficiency and productivity evaluation of health care organizations. He has published 3 Chinese and English papers in reputed journals.

Abstract:

In recent times, there has been an increasing imbalance between supply and demand for healthcare services in China. How to effectively improve the productive efficiency of healthcare provision is crucial to the improvement of healthcare performance, as well as optimizing the allocation of regional healthcare resources. The purpose of this study is to evaluate the regional dynamic changes of productive efficiency of healthcare provision in Hubei Province based on prefectures, and to generate policy implications for better improvement.

Methodology: Based on the 2008-2014 panel data of inputs and outputs from 17 prefectures of Hubei Province (China), Bootstrap-Malmquist Data Envelopment Analysis (DEA) model was used to measure the total factor productivity changes (TFPC) and their decomposition indices.

Results: Overall the regional healthcare inputs and outputs in Hubei Province had increased from 2008 to 2014, and TFP of the 17 prefectures had increased at varying degrees in six years. On average, technical efficiency changes (TEC) in Hubei Province had first showed a downward trend from 2008 to 2010, and then an upward trend in the following four consecutive years. The trend in technological changes (TC) was consistent with that in TFPC between 2008 and 2014. Conclusion: TFP growth of the 17 prefectures in Hubei may have resulted from the new round of Chinese healthcare reform vigorously implemented since 2009. However, a substantial improvement in TC is the major contributor to TFP growth. Prefectures with inefficient healthcare productive efficiency should focus on improving their technical efficiency (TE).

Biography:

Aktolkyn Amantaykyzy MA in Asian studies HSE University, Moscow. Has 4 years of work experience as an assistant at the Foreign Economic Relations Department of The Ministry for investment and development of the Republic of Kazakhstan and as a research assistant at the Higher School of Economics. Actively involved as an expert in “Health childhood and socioeconomic status in Kazakhstan” project funded by the Ministry of Education of the Republic of Kazakhstan. The areas of work in the project: Data gathering and analysis, literature review and results dissemination.

Abstract:

Infant mortality rate is one of the key indicators of the Millennium Development Goals from the United Nations. In the last two decades, this indicator became 6 times smaller during 1990 to 2017 (from 54.1 deaths/1,000 live births to 8.9) in Kazakhstan. This decrease on infant mortality rate have been much faster in Kazakhstan than in other countries of Central Asia, so it would be useful to understand the reasons why. Thus, the aim of the paper is to analyze the socio-economic determinants of infant mortality in Kazakhstan in order to shed light on the factors behind its huge reduction. In order to estimate the determinants of infant mortality we run a legit model based on Multiple Indicator Cluster Surveys (MICS) database provided by UNICEF for Kazakhstan in 2006, 2010-2011, 2015. Results show that the access to health resources is the main determinant to reduce infant mortality. On the one hand, the probability that women had experienced the death of children decreases for the 4^th and 5^th quintile of wealth, i.e. for those who have a better access to the health resources. On the other hand, the probability that the kid dies almost is double for families living the rural area compared with urban areas (explained for the difficulties of reaching the health facilities in rural areas). Additionally, the probability of women experienced the death of a born child is reducing for the mothers with higher education. Results of this paper can be used to keep the positive path in the infant mortality decrease for Kazakhstan and taken as an example for other countries in Central Asia where infant mortality is still high.

Biography:

Amal Al Asswad has done Doctor of Philosophy from the the university of Sheffield and currently she is Assistant Hospital Director for Patient Service at Dammam Medical Complex.

Abstract:

Background: Electronic Medical Record Systems (EMR) has been implemented in different Saudi Hospitals with level of variations with no clear reasons.

Objective: The aim of this research is to investigate the role of benefits management in progressing and sustaining the implementation process of EMR systems in rural areas.

Methodology: This is a case study research conducted in one of Saudi hospitals in an isolated location.

Mixed research methods are adopted having 69 questionnaires analyzed, 6 in-depth interviews with decision makers, and 2 focus groups.

Results: This case had achieved most of the requirements of stage 3 and stage 4 as six systems of EMR were installed and running at the time of the study. Since this case was superior in terms of its achieving a high level of EMR implementation than the average hospital in Saudi Arabia, it was interesting to explore why this case had been able to achieve this even when facing the same financial and governmental conditions due to its location in a rural area. The top management was well motivated before, after and during the EMR implementation. Doctors and nurses “owned” the benefits of the systems. They have plans towards delivering the expected benefits from the system, which are called benefits realization plans. The benefits were reviewed periodically with punishment and rewarding system was supporting the review process.  All of that improved the engagement and the desire to continuous as the doctors and nurses  perceived the benefits of EMR and believed to improve the productivity, integrated in the daily practices, and source of value and power for to outperform their former performance.

There were three frustrating and uncontrollable technical hindrances: IT problems (hardware and software), a lack of IT human resources and improper service level agreements between the case and the vendor to ensure the quality of EMR.

The perceived outcomes are quality of data benefits (improved communications, reliability of data, and availability of data in timely and convenient ways). These outcomes lead to different capabilities: decision making capabilities (i.e. controllability of the process) and process competence capabilities (i.e. preventing errors and eliminating non-added value activities). These capabilities created patient related benefits (i.e. improved responsiveness and improved patient safety).

Biography:

Akbobek Akhmedyarova candidate at Nazarbayev University, Nur-Sultan, Kazakhstan. Akbobek does research in health economics. Her research interests focus the effect of healthcare policy in Kazakhstan on utilization rate of medical care.

Abstract:

The paper provides estimates of the utilization rates of inpatient and outpatient care in Kazakhstan. In 2013 the share of inpatient care in Kazakhstan constituted 51 percent, whereas in OECD that constituted 34 percent. The goal is to bring the share of inpatient care down to 38 percent by 2030. Lower funding of primary healthcare is one of the reasons for high share of emergency hospitalization and, as a result, inpatient care. In 2016 the share of primary healthcare financing in state-guaranteed free medical care remained 32.5 percent, which is below that of OECD countries where the share of funding of primary care constitutes 61 percent. The key component of the health care reform is to move the medical care industry from government-funded to compulsory social health insurance. Starting 2017 employees were transferring one percent of payroll income to the Social Health Insurance Fund with the plan to increase this rate to three percent in 2022. The objective of our paper is to analyze the effect of the healthcare reform in Kazakhstan on the healthcare utilization rates using the data from the Household Budget Survey (HBS) conducted by Committee of Statistic under the Ministry of National Economy of the Republic of Kazakhstan and collected on the annual basis. We will use econometrics and machine learning techniques to make the inference about the change in variables of interest. Our hypothesis is that policy reforms in Kazakhstan will positively influence the usage of medical facilities by citizens; that is the utilization rate will increase on average.

Biography:

Akbobek Akhmedyarova candidate at Nazarbayev University, Nur-Sultan, Kazakhstan. Akbobek does research in health economics. Her research interests focus the effect of healthcare policy in Kazakhstan on utilization rate of medical care.

Abstract:

The paper provides estimates of the utilization rates of inpatient and outpatient care in Kazakhstan. In 2013 the share of inpatient care in Kazakhstan constituted 51 percent, whereas in OECD that constituted 34 percent. The goal is to bring the share of inpatient care down to 38 percent by 2030. Lower funding of primary healthcare is one of the reasons for high share of emergency hospitalization and, as a result, inpatient care. In 2016 the share of primary healthcare financing in state-guaranteed free medical care remained 32.5 percent, which is below that of OECD countries where the share of funding of primary care constitutes 61 percent. The key component of the health care reform is to move the medical care industry from government-funded to compulsory social health insurance. Starting 2017 employees were transferring one percent of payroll income to the Social Health Insurance Fund with the plan to increase this rate to three percent in 2022. The objective of our paper is to analyze the effect of the healthcare reform in Kazakhstan on the healthcare utilization rates using the data from the Household Budget Survey (HBS) conducted by Committee of Statistic under the Ministry of National Economy of the Republic of Kazakhstan and collected on the annual basis. We will use econometrics and machine learning techniques to make the inference about the change in variables of interest. Our hypothesis is that policy reforms in Kazakhstan will positively influence the usage of medical facilities by citizens; that is the utilization rate will increase on average.

Biography:

After completion of medical graduation, she start profession with different National and international NGO in different position for about seven years. Then switch the profession and start work as an Academician at Institute of Health Economics in University of Dhaka. She published about ten papers and four are in printing. She took classes on Medical Sociology, Introduction to Health Science, Health System, Management in Health Sector and Policy and Planning in Health Sector. Here beside compliance with different task provide from institute also work with UNICEF, SURCH and KOIKA research firm to conduct different research. She is member of Public Health Foundation, Bangladesh and PhD apprentice.

Abstract:

World Economic Forum state $ 6.5 trillion spent worldwide on healthcare. Out of that 30-50percent is wasted. It is projected that the world healthcare spending increase from $7.7 trillion to $ 10.1 trillion in the year 2017 to 2022.Healthcare service delivery becomes a business commodities offering a package or range of services for money,that is why the volume of service is a matter ignoring efficiency, quality, and equity.

Methodology: objective; how user fees plays role good value for money spent on healthcare service. A conceptual framework makes for use. Secondary data was used. Findings: Supply side inefficiency revealed (provider disparity, logistics). Regard quality and equity revealed most components of PHC is achieved. In child and maternal healthcare not achieved the desired level. Social behavior change communication (SBCC) left behind till. Major diseases responsible for mortality and morbidity are mostly seen at district to below level facilities. If fees for services are imposed based on the outcome of patient health status along with justification of provider (physician, test, treatment protocol) involvement are not only valued dollar spent for health outcome but also ensure quality and equity.

Conclusion and significance: in developing and low-income countries people spent direct, indirect and out of pocket expenditure with the hope to get a better outcome of healthcare service. This pushes them the viscous cycle of poverty. So, this is very high time for global health policymakers to shift the focus healthcare service delivery from the volume and profitability of services provided physician visits to the patient outcome achieved for the 21st century.