The Impact of Health Care Policy Initiatives on Productivity

Abstract

This paper analyses productivity growth in health care delivery in Sweden and the impact of health care policy initiatives on productivity. In particular we consider the maximum waiting time guarantee introduced in Sweden 1992. The intention of the maximum waiting time guarantee was to shorten the waiting lists, partly through increased productivity. We measure productivity growth by estimating Malmquist productivity indices using non-parametric linear programming models. The productivity models are applied to data from a sample of public ophthalmology departments from 1988 to 1993. Positive productivity changes are found in several years, although no significant differences between the periods are found.

The death of cost‐minimization analysis?

“…Given recent advances in the analysis and presentation of costeffectiveness under uncertainty -most notably net benefit analysis [9,10] and acceptability curves…”

“…The central focus of our discussion is how analysts determine whether programmes have 'the same' outcomes under uncertainty. Given recent advances in the analysis and presentation of costeffectiveness under uncertainty -most notably net benefit analysis [9,10] and acceptability curves [11] -we argue that it is inappropriate for separate and sequential hypothesis tests on differences in effects and costs to determine whether incremental cost-effectiveness (or cost-utility) should be estimated. We argue that the analytic focus should be on the estimation of the joint density of cost and effect differences, the quantification of uncertainty surrounding the incremental cost-effectiveness ratio and the presentation of such data as cost-effectiveness acceptability curves.…”