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Utilization, expenditure, economics and financing systems

Section edited by Milena Pavlova and Evelina Pappa

This section aims to publish studies looking at a population's use of hospital services and their health and health-related expenditures. The section also accepts economic evaluations of health interventions and services and studies looking at recommendations for people to be able access needed services while avoiding catastrophic expenditure and impoverishment.

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  1. Content type: Research article

    PRIMEtime CE is a multistate life table model that can directly compare the cost effectiveness of public health interventions affecting diet and physical activity levels, helping to inform decisions about how ...

    Authors: Adam D. M. Briggs, Jane Wolstenholme and Peter Scarborough

    Citation: BMC Health Services Research 2019 19:489

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    The Research article to this article has been published in BMC Health Services Research 2019 19:485

  2. Content type: Research article

    Non-communicable diseases are the leading cause of death in England, and poor diet and physical inactivity are two of the principle behavioural risk factors. In the context of increasingly constrained financia...

    Authors: Adam D. M. Briggs, Linda J. Cobiac, Jane Wolstenholme and Peter Scarborough

    Citation: BMC Health Services Research 2019 19:485

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    The Research article to this article has been published in BMC Health Services Research 2019 19:489

  3. Content type: Research article

    The State of Louisiana spends the most on Medicare beneficiaries per capita, but reports greater disparities in health status and death rates than other states. This project sought to investigate the associati...

    Authors: Blake P. Kruger and Jeremiah R. Brown

    Citation: BMC Health Services Research 2019 19:471

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  4. Content type: Research article

    High utilizers (HUs) are a small group of patients who impose a disproportionately high burden on the healthcare system due to their elevated resource use. Identification of persistent HUs is pertinent as inte...

    Authors: Sheryl Hui-Xian Ng, Nabilah Rahman, Ian Yi Han Ang, Srinath Sridharan, Sravan Ramachandran, Debby D. Wang, Chuen Seng Tan, Sue-Anne Toh and Xin Quan Tan

    Citation: BMC Health Services Research 2019 19:452

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  5. Content type: Research article

    As healthcare expenditure and utilization continue to rise, understanding key drivers of hospital expenditure and utilization is crucial in policy development and service planning. This study aims to investiga...

    Authors: Nabilah Rahman, Sheryl Hui-Xian Ng, Sravan Ramachandran, Debby D. Wang, Srinath Sridharan, Chuen Seng Tan, Astrid Khoo and Xin Quan Tan

    Citation: BMC Health Services Research 2019 19:442

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  6. Content type: Research article

    An antiemetic triplet regimen of 5-hydrotryptamine-3 receptor antagonist, dexamethasone, and aprepitant is the standard prophylaxis with highly emetogenic chemotherapy (HEC). A randomized phase III trial compa...

    Authors: Munenobu Kashiwa and Ryo Matsushita

    Citation: BMC Health Services Research 2019 19:438

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  7. Content type: Research article

    Published literature suggests that early treatment with natalizumab (“escalation strategy”) is more effective than switch within the same class of immunomodulators (interferons/glatiramer acetate, “switching s...

    Authors: Gianluca Furneri, Laura Santoni, Chiara Ricella and Luca Prosperini

    Citation: BMC Health Services Research 2019 19:436

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  8. Content type: Research article

    Business cases are used to provide a structured justification in favour of investing in new projects, services or interventions. Despite the use of business cases in determining how limited resources will be a...

    Authors: Myles-Jay Linton, Joanna Coast, Iestyn Williams, Joanna Copping and Amanda Owen-Smith

    Citation: BMC Health Services Research 2019 19:433

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  9. Content type: Research article

    In the last decade, mobile radiography services have been introduced in nursing homes in several countries. Earlier research found an underutilisation of diagnostic imaging among nursing home residents. Howeve...

    Authors: Elin Kjelle, Kristin Bakke Lysdahl and Hilde Merete Olerud

    Citation: BMC Health Services Research 2019 19:428

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  10. Content type: Research article

    Due to rapidly growing number of old adults and diminishing supportive functions of family in China, the issue of willingness to use institutional care is of high priority, especially for disabled seniors. The...

    Authors: Na Chen, Xin Li, Ni Yuan, Cheng-chao Zhou and Chang-qing Wang

    Citation: BMC Health Services Research 2019 19:410

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  11. Content type: Research article

    A complete enumeration study was conducted to evaluate trends in national practice patterns and direct medical costs for prostate cancer (PCa) in Korea over a 10-year retrospective period using data from the K...

    Authors: Ho Won Kang, Seok-Joong Yun, Jae Il Chung, Hoon Choi, Jae Heon Kim, Ho Song Yu, Yun-Sok Ha, In-Chang Cho, Hyung Joon Kim, Hyun Chul Chung, Jun Sung Koh, Wun-Jae Kim, Jong-Hyock Park, Ji Youl Lee and So-Young Kim

    Citation: BMC Health Services Research 2019 19:408

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  12. Content type: Research article

    Studies have noted variations in the cost-effectiveness of school-located influenza vaccination (SLIV), but little is known about how SLIV’s cost-effectiveness may vary by targeted age group (e.g., elementary ...

    Authors: Byung-Kwang Yoo, Stanley J. Schaffer, Sharon G. Humiston, Cynthia M. Rand, Nicolas P. N. Goldstein, Christina S. Albertin, Cathleen Concannon and Peter G. Szilagyi

    Citation: BMC Health Services Research 2019 19:407

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  13. Content type: Research article

    There is limited research on the economic burden of low back-related leg pain, including sciatica. The aim of this study was to describe healthcare resource utilisation and factors associated with cost and hea...

    Authors: Jesse Kigozi, Kika Konstantinou, Reuben Ogollah, Kate Dunn, Lewis Martyn and Susan Jowett

    Citation: BMC Health Services Research 2019 19:406

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  14. Content type: Research article

    Failure to keep medical appointments results in inefficiencies and, potentially, in poor outcomes for patients. The aim of this study is to describe non-attendance rate and to investigate predictors of non-att...

    Authors: Donna Lykke Wolff, Frans Boch Waldorff, Christian von Plessen, Christian Backer Mogensen, Thomas Lund Sørensen, Kim Christian Houlind, Søren Bie Bogh and Katrine Hass Rubin

    Citation: BMC Health Services Research 2019 19:386

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  15. Content type: Research article

    Previous studies have shown limited availability of medicines in health facilities in Bangladesh. While medicines are dispensed for free in public facilities, they are paid out-of-pocket in private pharmacies....

    Authors: Lombe Kasonde, David Tordrup, Aliya Naheed, Wu Zeng, Shyfuddin Ahmed and Zaheer-Ud-Din Babar

    Citation: BMC Health Services Research 2019 19:383

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  16. Content type: Research article

    We examined the utilization of rehabilitation resources among children with autism spectrum condition (ASC), a neurodevelopmental condition, in Taiwan.

    Authors: Hsing-Jung Li, Chi-Yuan Chen, Ching-Hong Tsai, Chao-Chan Kuo, Kung-Heng Chen, Kuan-Hsu Chen and Ying-Chun Li

    Citation: BMC Health Services Research 2019 19:354

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  17. Content type: Research article

    Rural women experience health disparities in terms of cardiovascular disease (CVD) risk compared to urban women. Cost-effective CVD-prevention programs are needed for this population. The objective of this stu...

    Authors: Hua Wang, Donald Kenkel, Meredith L. Graham, Lynn C. Paul, Sara C. Folta, Miriam E. Nelson, David Strogatz and Rebecca A. Seguin

    Citation: BMC Health Services Research 2019 19:315

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  18. Content type: Research article

    Most studies that examine comorbidity and its impact on health service utilization focus on a single index-condition and are published in disease-specific journals, which limit opportunities to identify patter...

    Authors: Lauren E. Griffith, Andrea Gruneir, Kathryn Fisher, Dilzayn Panjwani, Amiram Gafni, Christopher Patterson, Maureen Markle-Reid and Jenny Ploeg

    Citation: BMC Health Services Research 2019 19:313

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  19. Content type: Research article

    The global financial crisis and the economic and financial adjustment programme (EFAP) forced the Portuguese government to adopt austerity measures, which also included the health sector. The aim of this study...

    Authors: Gonçalo F. Augusto, Sara S. Dias, Alexandre V. Abrantes and Maria R. O. Martins

    Citation: BMC Health Services Research 2019 19:303

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  20. Content type: Research article

    Literature highlighted the importance of timely access and ongoing care provided at primary care settings in reducing hospitalisation and health care resource uses. However, the effect of timely access to prim...

    Authors: Ninh Thi Ha, Mark Harris, David Preen, Suzanne Robinson and Rachael Moorin

    Citation: BMC Health Services Research 2019 19:276

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  21. Content type: Research article

    As a consequence of the low government expenditure and limited access to health insurance offered by the Social Security Scheme (SSS), out-of-pocket payments (OOPPs) have become the main source of payment for ...

    Authors: Chaw-Yin Myint, Milena Pavlova and Wim Groot

    Citation: BMC Health Services Research 2019 19:258

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  22. Content type: Research article

    Costs for the provision of regional hospital care depend, among other things, on the population density and the maximum reasonable distance to the nearest hospital. In regions with a low population density, it...

    Authors: Neeltje van den Berg, Franziska Radicke, Ulrike Stentzel, Wolfgang Hoffmann and Steffen Flessa

    Citation: BMC Health Services Research 2019 19:245

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  23. Content type: Research article

    Redispensing unused medications that have been returned to outpatient pharmacies by patients may reduce waste and healthcare costs. However, little is known regarding the extra costs associated with this proce...

    Authors: Charlotte L. Bekker, Helga Gardarsdottir, Antoine C. G. Egberts, Hendrik A. Molenaar, Marcel L. Bouvy, Bart J. F. van den Bemt and Anke M. Hövels

    Citation: BMC Health Services Research 2019 19:243

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  24. Content type: Research article

    In most countries, patients can get a second opinion (SO) through public or private healthcare systems. There is lack of data on SO utilization in private vs. public settings. We aim to evaluate the characteri...

    Authors: Liora Shmueli, Nadav Davidovitch, Joseph S. Pliskin, Igal Hekselman, Ran D. Balicer and Geva Greenfield

    Citation: BMC Health Services Research 2019 19:238

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  25. Content type: Research article

    Considering catastrophic health expenses in rural households with hospitalised members were unproportionally high, in 2013, China developed a model of systemic reform in Sanming by adjusting payment method, ph...

    Authors: Zhaolin Meng, Min Zhu, Yuanyi Cai, Xiaohong Cao and Huazhang Wu

    Citation: BMC Health Services Research 2019 19:231

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  26. Content type: Research article

    Globally, public housing is utilized to provide affordable housing for low-income households. Studies have shown an association between public housing and negative health outcomes. There is paucity of data per...

    Authors: Jun Jie Benjamin Seng, Vanessa Zi Kun Lim, Yu Heng Kwan, Julian Thumboo and Lian Leng LOW

    Citation: BMC Health Services Research 2019 19:227

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  27. Content type: Research article

    More people are surviving stroke but are living with functional limitations that pose increasing demands on their families and the healthcare system. The aim of this study was to determine the extent to which ...

    Authors: Adebimpe O. Obembe, Lisa A. Simpson, Brodie M. Sakakibara and Janice J. Eng

    Citation: BMC Health Services Research 2019 19:192

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  28. Content type: Research article

    Efforts to decrease hospitalization costs could increase post-acute care costs. This effect could undermine initiatives to reduce overall episode costs and have implications for the design of health care under...

    Authors: Sudhakar V. Nuti, Shu-Xia Li, Xiao Xu, Lesli S. Ott, Tara Lagu, Nihar R. Desai, Karthik Murugiah, Michael Duan, John Martin, Nancy Kim and Harlan M. Krumholz

    Citation: BMC Health Services Research 2019 19:190

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  29. Content type: Research article

    Rural residents are less likely to receive screening for colorectal cancer (CRC) than urban residents. However, the mechanisms underlying this disparity, especially among people aged 50–64 years old with priva...

    Authors: Mesnad Alyabsi, Mary Charlton, Jane Meza, K. M. Monirul Islam, Amr Soliman and Shinobu Watanabe-Galloway

    Citation: BMC Health Services Research 2019 19:172

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  30. Content type: Research article

    Medicare beneficiaries hospitalized under observation status have significant cost-sharing responsibilities under Medicare Part B. Prior work has demonstrated an association between increased cost-sharing and ...

    Authors: Jennifer N. Goldstein, J. Sanford Schwartz, Patricia McGraw and LeRoi S. Hicks

    Citation: BMC Health Services Research 2019 19:149

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  31. Content type: Research article

    Floating Catchment Area (FCA) metrics provide a comprehensive measure of potential spatial accessibility to health care services and are often used to identify geographic disparities in health care access. An ...

    Authors: Paul L. Delamater, Ashton M. Shortridge and Rachel C. Kilcoyne

    Citation: BMC Health Services Research 2019 19:144

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  32. Content type: Research article

    The objective of this paper is to utilise a clinical costing system to investigate differences in the patient journey, defined as the sequence and timing of contacts with the Gold Coast Hospital and Health Ser...

    Authors: James Todd, Adrian Gepp, Bruce Vanstone and Brent Richards

    Citation: BMC Health Services Research 2019 19:136

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  33. Content type: Research article

    We investigate factors affecting Australian general practitioners’ decisions to adopt novel oral anticoagulants (NOACs) for the prevention of stroke/systemic embolism among patients with atrial fibrillation. A...

    Authors: Yuting Zhang, Susan J. Méndez and Anthony Scott

    Citation: BMC Health Services Research 2019 19:94

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  34. Content type: Research article

    The literature describes the obstacles to sufficient care faced by people with dementia and their informal caregivers. Although factors influencing access and utilisation are frequently studied, the body of kn...

    Authors: Anja Bieber, Natalie Nguyen, Gabriele Meyer and Astrid Stephan

    Citation: BMC Health Services Research 2019 19:88

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  35. Content type: Research article

    Plain abdominal radiography (PAR) is routinely performed in emergency departments (EDs). This study aimed to (1) identify the indications for PAR in EDs and compare them against international guidelines, (2) u...

    Authors: Christophe L. Bertin, Simon Ponthus, Hari Vivekanantham, Pierre-Alexandre Poletti, Omar Kherad and Olivier T. Rutschmann

    Citation: BMC Health Services Research 2019 19:36

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  36. Content type: Research article

    Diabetic macular oedema (DMO) may lead to visual loss and blindness. Several pharmacological treatments are available on the National Health Service (NHS) to United Kingdom patients affected by this condition,...

    Authors: Michal Pochopien, Annette Beiderbeck, Phil McEwan, Richard Zur, Mondher Toumi and Samuel Aballéa

    Citation: BMC Health Services Research 2019 19:22

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  37. Content type: Research article

    The implementation of an innovative and sustainable professional pharmacy service in routine care requires substantial resources borne by the pharmacy owner. Although a community pharmacy is a business setting...

    Authors: Clemence Perraudin, Jean-François Locca, Christophe Rossier, Olivier Bugnon and Marie-Paule Schneider

    Citation: BMC Health Services Research 2019 19:15

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  38. Content type: Research article

    The global Choosing Wisely campaign has identified the following psychotropic prescribing as low-value (harmful or wasteful): (1) benzodiazepine use in the elderly, (2) antipsychotic use in dementia and (3) presc...

    Authors: Jonathan Brett, Helga Zoega, Nicholas A. Buckley, Benjamin J. Daniels, Adam G. Elshaug and Sallie-Anne Pearson

    Citation: BMC Health Services Research 2018 18:1009

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  39. Content type: Research article

    Strategic purchasing of health care services has become a key policy measure on the path to achieving universal health coverage. National provider payment systems for health services are typically characterize...

    Authors: Isabelle Feldhaus and Inke Mathauer

    Citation: BMC Health Services Research 2018 18:996

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  40. Content type: Research article

    The elicitation of contact information, notification and testing of sex partners of HIV infected patients (aPS), is an effective HIV testing strategy in low-income settings but may not necessarily be affordabl...

    Authors: Peter Cherutich, Carey Farquhar, Beatrice Wamuti, Felix A. Otieno, Ann Ng’ang’a, Peter Maingi Mutiti, Paul Macharia, Betsy Sambai, David Bukusi and Carol Levin

    Citation: BMC Health Services Research 2018 18:721

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  41. Content type: Research article

    Pneumonia is the leading cause of morbidity and mortality worldwide. Pneumococcal conjugate vaccines have reduced the burden of pneumonia, but data on the current burden of pneumonia and its impact on the heal...

    Authors: Sabine Tong, Caroline Amand, Alexia Kieffer and Moe H. Kyaw

    Citation: BMC Health Services Research 2018 18:715

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  42. Content type: Research article

    For children and adolescents with mental health problems, there is a lack of data as to whether the type of residential area (urban vs. rural) influences healthcare costs for affected individuals. The aim of t...

    Authors: Heike Gerhardt, Monika Heinzel-Gutenbrunner and Christian J. Bachmann

    Citation: BMC Health Services Research 2018 18:714

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  43. Content type: Research article

    With the implementation of Chinese economic reform and rapid urbanization, policies and values surrounding migration have changed and given rise to unprecedented population mobility. This study is designed to ...

    Authors: Yangyang Qian, Dandan Ge, Li Zhang, Long Sun, Jiajia Li and Chengchao Zhou

    Citation: BMC Health Services Research 2018 18:704

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  44. Content type: Research article

    Management of nontuberculous mycobacterial lung disease (NTMLD) consists of a long-term multi-drug antibiotic regimen, yet many patients do not achieve culture conversion. We estimated the NTMLD-related direct...

    Authors: S. M. Goring, J. B. Wilson, N. R. Risebrough, J. Gallagher, S. Carroll, K. J. Heap, M. Obradovic, M. R. Loebinger and R. Diel

    Citation: BMC Health Services Research 2018 18:700

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  45. Content type: Research article

    In Spain, hospital expenditure represents the biggest share of overall public healthcare expenditure, the most important welfare system directly run by the Autonomous Communities (ACs). Since 2001, public heal...

    Authors: Manuel Ridao-López, Micaela Comendeiro-Maaløe, Natalia Martínez-Lizaga and Enrique Bernal-Delgado

    Citation: BMC Health Services Research 2018 18:696

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  46. Content type: Research article

    The number of human immunodeficiency virus (HIV)-related hospitalizations has decreased worldwide in recent years, due to the availability of combined antiretroviral therapies (cART). The present analysis aime...

    Authors: Lucia Taramasso, Federica Demma, Rossella Bitonti, Antonio Ferrazin, Barbara Giannini, Mauro Giacomini, Sabrina Beltramini, Elisabetta Sasso, Claudio Viscoli and Antonio Di Biagio

    Citation: BMC Health Services Research 2018 18:691

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  47. Content type: Research article

    After 2008 global economic crisis, Italian governments progressively reduced public healthcare financing. Describing the time trend of health outcomes and health expenditure may be helpful for policy makers du...

    Authors: Davide Golinelli, Andrea Bucci, Fabrizio Toscano, Filippo Filicori and Maria Pia Fantini

    Citation: BMC Health Services Research 2018 18:671

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  48. Content type: Research article

    Prior research suggests that many patients do not spontaneously include work/income loss when responding to utility assessments, although this remains unconfirmed in the US due to almost no published US-based ...

    Authors: Kelly D. Johnson, Susan K. Brenneman, Chrisann Newransky, Seth Sheffler-Collins, Laura K. Becker, Angela Belland and Camilo J. Acosta

    Citation: BMC Health Services Research 2018 18:662

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  49. Content type: Research article

    The aim of this systematic literature review is to identify and critique full economic evaluations of interventions for high risk young people with the purpose of informing the design of future rigorous econom...

    Authors: Kim Edmunds, Rod Ling, Anthony Shakeshaft, Chris Doran and Andrew Searles

    Citation: BMC Health Services Research 2018 18:660

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