IDEAS home Printed from https://ideas.repec.org/p/lue/wpaper/284.html
   My bibliography  Save this paper

Cost Containment and Managed Care: Evidence from German Macro Data

Author

Listed:
  • Andree Ehlert

    () (Leuphana University of Lueneburg, Germany)

  • Dirk Oberschachtsiek

    () (Leuphana University of Lueneburg, Germany)

  • Stefan Prawda

    () (Leuphana University of Lueneburg, Germany)

Abstract

The major German health care reforms undertaken since the late 1990s resulted in the adoption of selective contracting mechanisms in a formerly sectorally separated health care system. These reforms marked the launch of managed care in Germany that is expected to yield both a higher quality of care and cost containment. We investigate if managed care had an in fluence on the structure of health care expenditure in Germany during the start-up phase of managed care from 2004 to 2008. We focus on pharmaceutical spending by statutory sickness funds (i.e. German law- enforced health insurance). We followed a macroeconomic evaluation approach based on a regional panel data set in contrast to previous research and were thus able to control for a comprehensive set of regional and demographic variables. We discuss alternative model specifications and include a range of sensitivity analyses. Our results suggest that in contrast to public perception the share of managed care contracts has a positive impact on pharmaceutical spending.

Suggested Citation

  • Andree Ehlert & Dirk Oberschachtsiek & Stefan Prawda, 2013. "Cost Containment and Managed Care: Evidence from German Macro Data," Working Paper Series in Economics 284, University of Lüneburg, Institute of Economics.
  • Handle: RePEc:lue:wpaper:284
    as

    Download full text from publisher

    File URL: https://www.leuphana.de/fileadmin/user_upload/Forschungseinrichtungen/ifvwl/WorkingPapers/lue/pdf/wp_284_Upload.pdf
    Download Restriction: no

    References listed on IDEAS

    as
    1. Gerdtham, Ulf-G. & Jonsson, Bengt, 2000. "International comparisons of health expenditure: Theory, data and econometric analysis," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 1, pages 11-53 Elsevier.
    2. Atella, Vincenzo, 2000. "Drug cost containment policies in Italy: are they really effective in the long-run?: The case of minimum reference price," Health Policy, Elsevier, vol. 50(3), pages 197-218, January.
    3. Guillem López-Casasnovas & Marc Saez, 2007. "A multilevel analysis on the determinants of regional health care expenditure: a note," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(1), pages 59-65, March.
    4. Okunade, Albert A. & Suraratdecha, Chutima, 2006. "The pervasiveness of pharmaceutical expenditure inertia in the OECD countries," Social Science & Medicine, Elsevier, vol. 63(1), pages 225-238, July.
    5. Joan Costa-Font & Jordi Pons-Novell, 2007. "Public health expenditure and spatial interactions in a decentralized national health system," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 291-306.
    6. Baltagi, Badi H. & Li, Qi, 1991. "A joint test for serial correlation and random individual effects," Statistics & Probability Letters, Elsevier, vol. 11(3), pages 277-280, March.
    7. David Prieto & Santiago Lago-Peñas, 2012. "Decomposing the determinants of health care expenditure: the case of Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(1), pages 19-27, February.
    8. Schmitz, Hendrik, 2011. "Why are the unemployed in worse health? The causal effect of unemployment on health," Labour Economics, Elsevier, vol. 18(1), pages 71-78, January.
    9. Marisa Elena Domino & David S. Salkever, 2003. "Price elasticity and pharmaceutical selection: the influence of managed care," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 565-586.
    10. Gerdtham, Ulf-G. & Sogaard, Jes & Andersson, Fredrik & Jonsson, Bengt, 1992. "An econometric analysis of health care expenditure: A cross-section study of the OECD countries," Journal of Health Economics, Elsevier, vol. 11(1), pages 63-84, May.
    11. Parkin, David & McGuire, Alistair & Yule, Brian, 1987. "Aggregate health care expenditures and national income : Is health care a luxury good?," Journal of Health Economics, Elsevier, vol. 6(2), pages 109-127, June.
    12. Croissant, Yves & Millo, Giovanni, 2008. "Panel Data Econometrics in R: The plm Package," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 27(i02).
    13. Baltagi, Badi H. & Li, Qi, 1995. "Testing AR(1) against MA(1) disturbances in an error component model," Journal of Econometrics, Elsevier, vol. 68(1), pages 133-151, July.
    14. Hitiris, Theo & Posnett, John, 1992. "The determinants and effects of health expenditure in developed countries," Journal of Health Economics, Elsevier, vol. 11(2), pages 173-181, August.
    15. Oliver Reich & Cornelia Weins & Claudia Schusterschitz & Magdalena Thöni, 2012. "Exploring the disparities of regional health care expenditures in Switzerland: some empirical evidence," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(2), pages 193-202, April.
    16. Luca Crivelli & Massimo Filippini & Ilaria Mosca, 2006. "Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 535-541.
    Full references (including those not matched with items on IDEAS)

    More about this item

    Keywords

    Managed care; Health care expenditure; Pharmaceutical expenditur; Panel data; German health care reform;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L14 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Transactional Relationships; Contracts and Reputation
    • O52 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Europe

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:lue:wpaper:284. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Joachim Wagner). General contact details of provider: https://leuphana.de/institute/ivwl.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.