For many years, evidence from the USA has pointed out to the existence of upcoding in management practices. Upcoding is defined as classifying patients in diagnosis-related groups codes associated with larger payments. The incentive for upcoding is not restricted to private providers of care. Conceptually, any patient classification system that is used for payment purposes may be vulnerable to this sort of strategic behaviour by providers. We document here that upcoding occurs in a National Health Service where public hospitals have their payment (budget) tied to the classification of treatment episodes. Using diagnosis-related groups data from Portugal, we found that the practice of upcoding has been used in the hospitals in a way leading to larger budgets (age of patients plays a key role). The effect is quantitatively small. Copyright © 2016 John Wiley & Sons, Ltd.
We investigate the effect of a family-based primary health care program (Healthly Early Childhood Program) on infant mortality in the state of Rio Grande do Sul, Brazil. We estimate infant mortality's counterfactual trajectories using the differences-in-differences approach, combined with the use of longitudinal data for all municipalities in the state of Rio Grande do Sul. Our main result is that the program reduced the number of deaths caused by external causes. The length of exposure to the program seems to potentiate the effects. For the number of deaths by general causes, there is no evidence of impact. Our findings are consistent with the nature of the program that aims to improve adults care with children. The Healthly Early Childhood Program is effective in reducing the number of avoidable deaths in infants.
La evidencia empírica internacional muestra que las mujeres tienen menos acceso al financiamiento, tanto al crédito personal como al crédito empresario (según el género de quién lidera la empresa). Esta brecha de género, que se debe a factores de oferta y de demanda, preocupa, tanto desde el punto de vista de equidad o igualdad de oportunidades, como de la eficiencia, ya que en una economía de mercado el acceso al financiamiento es clave para la asignación eficiente de los recursos, y cualquier imperfección en su funcionamiento se puede traducir en menos crecimiento económico. En este trabajo se analiza la brecha de género con tres bases de datos distintas, Global Findex, una encuesta a nivel de individuos, SME Finance Forum, datos agregados estimados, y Enterprise Survey, una encuesta a nivel empresarial que informa el género del gerente general. Se destaca que, en ningún caso, ni a nivel personal ni a nivel empresarial, ha sido posible eliminar las brechas incluyendo factores observables. Por lo tanto, las mujeres en la región están más desaventajadas y esto es un motivo de preocupación, ya que incide en la productividad de la economía, la fertilidad y la tasa de acumulación del capital humano, tres dimensiones donde los países estudiados muestran déficit.
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