Skip to content


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.

Page 2 of 12

  1. Content type: Research article

    Acute otitis media (AOM) is the most common cause of pediatric medical visits and antibiotic prescriptions worldwide, but its current impact on the US healthcare system is not clear. The aim of this study was ...

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

    Citation: BMC Health Services Research 2018 18:318

    Published on:

  2. Content type: Research article

    The burden of HCV among those living with HIV remains a major public health challenge. We aimed to characterize trends in healthcare-related visits (HRV) of people living with HIV (PLW-HIV) and those living with ...

    Authors: Huiting Ma, Conrado Franco Villalobos, Martin St-Jean, Oghenowede Eyawo, Miriam Ruth Lavergne, Lianping Ti, Mark W. Hull, Benita Yip, Lang Wu, Robert S. Hogg, Rolando Barrios, Jean A. Shoveller, Julio S. G. Montaner and Viviane D. Lima

    Citation: BMC Health Services Research 2018 18:319

    Published on:

  3. Content type: Research article

    Pen needles are an important component of insulin delivery among patients with diabetes, but are not universally covered in China. We compared clinical and economic characteristics of insulin-dependent patient...

    Authors: Linong Ji, Arthi Chandran, Timothy J. Inocencio, Zilin Sun, Qifu Li, Guijun Qin, Zheng Wei, Stefan DiMario and Richard H. Chapman

    Citation: BMC Health Services Research 2018 18:300

    Published on:

  4. Content type: Research article

    Despite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age g...

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

    Citation: BMC Health Services Research 2018 18:294

    Published on:

  5. Content type: Research article

    Hospitalization due to dengue illness is an important measure of dengue morbidity. However, limited studies are based on administrative database because the validity of the diagnosis codes is unknown. We valid...

    Authors: Yuan-Liang Woon, Keng-Yee Lee, Siti Fatimah Zahra Mohd Anuar, Pik-Pin Goh and Teck-Onn Lim

    Citation: BMC Health Services Research 2018 18:292

    Published on:

  6. Content type: Research article

    Community-oriented nursing care is an important model of nursing care. Counseling and Nursing Care Service Centers (CNCSCs) have been providing these private services to the Iranian community for nearly two de...

    Authors: Sefollah Alaei, Fatemeh Alhani and Hassan Navipour

    Citation: BMC Health Services Research 2018 18:282

    Published on:

  7. Content type: Research article

    Rwanda has made tremendous progress in reduction of maternal mortality in the last twenty years. Antenatal care is believed to have played a role in that progress. In late 2016, the World Health Organization p...

    Authors: Regis Hitimana, Lars Lindholm, Gunilla Krantz, Manassé Nzayirambaho and Anni-Maria Pulkki-Brännström

    Citation: BMC Health Services Research 2018 18:262

    Published on:

  8. Content type: Research article

    Telemedical programs for patients with chronic heart failure have shown inconsistent effects on survival and hospitalization. Few studies analyzed effects of telemedical interventions on health costs, although...

    Authors: Robert Herold, Wolfgang Hoffmann and Neeltje van den Berg

    Citation: BMC Health Services Research 2018 18:271

    Published on:

  9. Content type: Research article

    This study compared hospital admission rates among adult patients with schizophrenia who switched to antipsychotic monotherapy with lurasidone or quetiapine.

    Authors: John W. Newcomer, Daisy Ng-Mak, Krithika Rajagopalan and Antony Loebel

    Citation: BMC Health Services Research 2018 18:243

    Published on:

  10. Content type: Research article

    Like other sectors, the healthcare sector has to deal with the issue of users’ acceptance of IT. In healthcare, different factors affecting healthcare professionals’ acceptance of software applications have be...

    Authors: Claudio Vitari and Roxana Ologeanu-Taddei

    Citation: BMC Health Services Research 2018 18:194

    Published on:

  11. Content type: Research article

    Housing First is an effective intervention to stably house and alter service use patterns in a large proportion of homeless people with mental illness. However, it is unknown whether there are differences in t...

    Authors: Nick Kerman, John Sylvestre, Tim Aubry and Jino Distasio

    Citation: BMC Health Services Research 2018 18:190

    Published on:

  12. Content type: Research article

    Smoking cessation services provide support to smokers who desire to quit. Published studies to date have looked at the cost and benefit of service provision but typically focus on clinical trial data. Using ro...

    Authors: Neil Walker, Yaling Yang, Vasiliki Kiparoglou, Subhash Pokhrel, Hayley Robinson and Hugo van Woerden

    Citation: BMC Health Services Research 2018 18:182

    Published on:

  13. Content type: Research article

    Lack of health insurance claims (HIC) in the last year of life might indicate suboptimal end-of-life care, but reasons for no HIC are not fully understood because information on causes of death is often missin...

    Authors: Radoslaw Panczak, Viktor von Wyl, Oliver Reich, Xhyljeta Luta, Maud Maessen, Andreas E. Stuck, Claudia Berlin, Kurt Schmidlin, David C. Goodman, Matthias Egger, Kerri Clough-Gorr and Marcel Zwahlen

    Citation: BMC Health Services Research 2018 18:178

    Published on:

  14. Content type: Research article

    In Togo, about half of health care costs are paid at the point of service, which reduces access to health care and exposes households to catastrophic health expenditure (CHE). To address this situation, the To...

    Authors: Esso-Hanam Atake and Djesika D. Amendah

    Citation: BMC Health Services Research 2018 18:175

    Published on:

  15. Content type: Study protocol

    Extracorporeal life support (ECLS) is used to support the cardiorespiratory function in case of severe cardiac and/or respiratory failure in critically ill patients. According to the ELSO guidelines ECLS shoul...

    Authors: Annemieke Oude Lansink-Hartgring, Dinis Dos Reis Miranda, Dirk W. Donker, Jacinta J. Maas, Thijs Delnoij, Marijn Kuijpers, Judith van den Brule, Erik Scholten, Hendrik Endeman, Alexander P. J. Vlaar and Walter M. van den Bergh

    Citation: BMC Health Services Research 2018 18:172

    Published on:

  16. Content type: Research article

    Prison health systems are subject to increasing pressures given the specific health needs of a growing and aging prison population. Identifying the drivers of medical spending among incarcerated individuals is...

    Authors: Karine Moschetti, Véra Zabrodina, Tenzin Wangmo, Alberto Holly, Jean-Blaise Wasserfallen, Bernice S. Elger and Bruno Gravier

    Citation: BMC Health Services Research 2018 18:160

    Published on:

  17. Content type: Research article

    In the United States, home-based primary care (HBPC) is increasingly proposed as a means of enabling frail elders to remain at home for as long as possible, while still receiving needed medical care. However, ...

    Authors: Stephen A. Stanhope, Mary C. Cooley, Linda F. Ellington, Gregory P. Gadbois, Andrew L. Richardson, Timothy C. Zeddes and Jay P. LaBine

    Citation: BMC Health Services Research 2018 18:161

    Published on:

  18. Content type: Research article

    Korea’s rapidly aging population has led to a rise in the prevalence of knee osteoarthritis (which reached upwards of 21.3% in 2017) in elderly people aged 65 years and over. Most patients with knee osteoarthr...

    Authors: Boyoung Jung, Kyoung Hee Cho, Dong Hyun Lee and Soyoon Kim

    Citation: BMC Health Services Research 2018 18:152

    Published on:

  19. Content type: Research article

    In an era of a growing economic pressure for all health systems, the interest for “disinvestment” in healthcare increased. In this context, evidence based approaches such as Health Technology Assessment (HTA) ...

    Authors: G. E. Calabrò, G. La Torre, C. de Waure, P. Villari, A. Federici, W. Ricciardi and M. L. Specchia

    Citation: BMC Health Services Research 2018 18:148

    Published on:

  20. Content type: Research article

    The present study estimated the cost of advanced non-small cell lung cancer care for a cohort of 251 patients enrolled in a Brazilian public hospital and identified factors associated with the cost of treating...

    Authors: Carla de Barros Reis, Renata Erthal Knust, Claudia Cristina de Aguiar Pereira and Margareth Crisóstomo Portela

    Citation: BMC Health Services Research 2018 18:124

    Published on:

  21. Content type: Research article

    Despite economic growth and improved health outcomes over the past few decades, China still experiences striking urban-rural health inequalities. Urban and rural residents distinguished by the hukou system may...

    Authors: Jiajia Li, Leiyu Shi, Hailun Liang, Gan Ding and Lingzhong Xu

    Citation: BMC Health Services Research 2018 18:102

    Published on:

  22. Content type: Research article

    To estimate changes in the cost and utilization of Medicare among beneficiaries over age 65 who have been impacted by a natural disaster, we merged publically available county-level Medicare claims for the yea...

    Authors: Nathanael Rosenheim, Shannon Grabich and Jennifer A. Horney

    Citation: BMC Health Services Research 2018 18:89

    Published on:

  23. Content type: Research article

    Patients with type 2 diabetes (T2D) typically use several drug treatments during their lifetime. There is a debate about the best second-line therapy after metformin monotherapy failure due to the increasing n...

    Authors: Christina S. Kwon, Enrique Seoane-Vazquez and Rosa Rodriguez-Monguio

    Citation: BMC Health Services Research 2018 18:78

    Published on:

  24. Content type: Research article

    Emergency department visits and hospitalizations (EDVH) place a large burden on patients and the health care system. The presence of informal caregivers may be beneficial for reducing EDVH among patients with ...

    Authors: Robert Abtan, Nooshin Khobzi Rotondi, Alison Macpherson and Michael Anthony Rotondi

    Citation: BMC Health Services Research 2018 18:73

    Published on:

  25. Content type: Research article

    Previous works that uses patterns of prior spending to predict future mental health care expenses (utilization models) are mainly concerned with demand (need) variables. In this paper, we introduce supply vari...

    Authors: Knut Reidar Wangen and Sverre Grepperud

    Citation: BMC Health Services Research 2018 18:60

    Published on:

  26. Content type: Research article

    Undocumented migrants face particular challenges in accessing healthcare services in many European countries. The aim of this study was to systematically review the academic literature on the utilization of he...

    Authors: Marjolein Winters, Bernd Rechel, Lea de Jong and Milena Pavlova

    Citation: BMC Health Services Research 2018 18:30

    Published on:

  27. Content type: Research article

    Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses– cl...

    Authors: Steven W. Howard, Zidong Zhang, Paula Buchanan, Stephanie L. Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill and Jose A. Pineda

    Citation: BMC Health Services Research 2018 18:20

    Published on:

  28. Content type: Research article

    A rapid increase of Medicaid expenditures has been a serious concern, and housing stability has been discussed as a means to reduce Medicaid costs. A program evaluation of a New York City supportive housing pr...

    Authors: Sungwoo Lim, Qi Gao, Elsa Stazesky, Tejinder P. Singh, Tiffany G. Harris and Amber Levanon Seligson

    Citation: BMC Health Services Research 2018 18:15

    Published on:

  29. Content type: Research article

    Dengue fever is rapidly expanding geographically, with about half of the world’s population now at risk. Among the various diagnostic options, rapid diagnostic tests (RDTs) are convenient and prompt, but limit...

    Authors: Jacqueline Kyungah Lim, Neal Alexander and Gian Luca Di Tanna

    Citation: BMC Health Services Research 2017 17:850

    Published on:

  30. Content type: Research article

    China is reforming the way it finances health care as it moves towards Universal Health Coverage (UHC) after the failure of market-oriented mechanisms for health care. Improving financing equity is a major pol...

    Authors: Mingsheng Chen, Andrew J. Palmer and Lei Si

    Citation: BMC Health Services Research 2017 17:852

    Published on:

  31. Content type: Research article

    Multiple sclerosis (MS) is a chronic disease with a high socioeconomic impact. The aim of this study was to assess healthcare resources utilization and costs in a sample of patients with MS.

    Authors: Antoni Sicras-Mainar, Elena Ruíz-Beato, Ruth Navarro-Artieda and Jorge Maurino

    Citation: BMC Health Services Research 2017 17:854

    Published on:

  32. Content type: Research article

    Generic substitution in several countries has become a common practice. Besides, it is considered as a major cost minimizing strategy meant to contain pharmaceutical expenditure without compromising healthcare...

    Authors: Naser Y. Shraim, Tasneem A. Al Taha, Rawan F. Qawasmeh, Hiba N. Jarrar, Maram A. N. Shtaya, Lama A. Shayeb and Waleed M. Sweileh

    Citation: BMC Health Services Research 2017 17:847

    Published on:

  33. Content type: Research article

    World Health Organisation recommends routine Human Papilloma Virus (HPV) vaccination for girls when its cost-effectiveness in the country or region has been duly considered. We therefore aimed to evaluate cost...

    Authors: Obinna I. Ekwunife and Stefan K. Lhachimi

    Citation: BMC Health Services Research 2017 17:815

    Published on:

  34. Content type: Research article

    We examined the association of dialysis facility characteristics with payment reductions and change in clinical performance measures during the first year of the United States Centers for Medicare & Medicaid S...

    Authors: Milda R. Saunders, Haena Lee and Marshall H. Chin

    Citation: BMC Health Services Research 2017 17:816

    Published on:

  35. Content type: Research article

    In South Africa, the financing and sustainability of HIV services is a priority. Community-based HIV testing services (CB-HTS) play a vital role in diagnosis and linkage to HIV care for those least likely to u...

    Authors: Sue-Ann Meehan, Nulda Beyers and Ronelle Burger

    Citation: BMC Health Services Research 2017 17:801

    Published on:

  36. Content type: Research article

    Advance care planning (ACP) is a process of planning for future health and personal care. A person’s values and preferences are made known so that they can guide decision making at a future time when that pers...

    Authors: Kim-Huong Nguyen, Marcus Sellars, Meera Agar, Sue Kurrle, Adele Kelly and Tracy Comans

    Citation: BMC Health Services Research 2017 17:797

    Published on:

  37. Content type: Research article

    Like much of the developed world, healthcare costs in Canada are rising. A small proportion of patients account for a large proportion of healthcare spending and much of this spending occurs in acute care sett...

    Authors: Babak Rashidi, Daniel M. Kobewka, David J. T. Campbell, Alan J. Forster and Paul E. Ronksley

    Citation: BMC Health Services Research 2017 17:777

    Published on:

  38. Content type: Research article

    Glucagon-like peptide-1 (GLP-1) receptor agonists are often recommended as part of combination therapy for type 2 diabetes when oral medication does not result in sufficient glycemic control. Several GLP-1 rec...

    Authors: Louis S. Matza, Kristina S. Boye, Katie D. Stewart, Evan W. Davies and Rosirene Paczkowski

    Citation: BMC Health Services Research 2017 17:774

    Published on:

  39. Content type: Research article

    A comprehensive Compensation Plan for pharmacy services delivered by community pharmacists was implemented in Alberta, Canada in July 2012. Services covered by the Compensation Plan include care planning servi...

    Authors: Christine A. Hughes, Rene R. Breault, Deborah Hicks and Theresa J. Schindel

    Citation: BMC Health Services Research 2017 17:770

    Published on:

  40. Content type: Research article

    Several stakeholders have undertaken initiatives to propose solutions towards a more sustainable health system and Spain, as an example of a European country affected by austerity measures, is looking for ways...

    Authors: David Cantarero-Prieto, Marta Pascual-Sáez and Noelia Gonzalez-Prieto

    Citation: BMC Health Services Research 2017 17:716

    Published on:

  41. Content type: Research article

    Women and children constitute a large proportion of any population. They are the most vulnerable to morbidity and mortality especially in developing countries. In many situations the problem of poor maternal a...

    Authors: C. C. Agunwa, I. E. Obi, A. C. Ndu, I. B. Omotowo, C. A. Idoko, A. K. Umeobieri and E. C. Aniwada

    Citation: BMC Health Services Research 2017 17:715

    Published on:

  42. Content type: Research article

    Generic medicines are essential to controlling health expenditures. Their market share is still small in France. The discourse and practices of prescribers may play a major role in their use. The purpose of th...

    Authors: Béatrice Riner, Adèle Bussy, Jeannie Hélène-Pelage, Nycrees Moueza, Sébastien Lamy and Philippe Carrère

    Citation: BMC Health Services Research 2017 17:707

    Published on:

  43. Content type: Research article

    In the last 20–30 years, many international studies have found substantial differences in the use of (older) psychotropic medication between European countries. The majority mentioned an important role for att...

    Authors: J. M. Hoebert, A. K. Mantel-Teeuwisse, H. G. M. Leufkens and L. van Dijk

    Citation: BMC Health Services Research 2017 17:702

    Published on:

  44. Content type: Research article

    The Community-based Health Planning and Services (CHPS) initiative was introduced to improve coverage and utilization of basic health services for people in remote rural communities whose use of orthodox healt...

    Authors: Kenneth Wiru, Akwasi Kumi-Kyereme, Emmanuel N. Mahama, Seeba Amenga-Etego and Seth Owusu-Agyei

    Citation: BMC Health Services Research 2017 17:679

    Published on: