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Contribution of high-technology procedures to public healthcare expenditures: the case of ischemic heart disease in Portugal, 2002–2015

Author

Listed:
  • Wenkang Ma

    (University of York)

  • Ana Timóteo

    (Nova University of Lisbon
    Nova University of Lisbon)

  • Vanessa Ribeiro

    (Central Administration of the Health System)

  • Céu Mateus

    (Lancaster University)

  • Julian Perelman

    (Nova University of Lisbon
    Nova National School of Public Health)

Abstract

The magnitude of the impact of technological innovations on healthcare expenditure is unclear. This paper estimated the impact of high-technology procedures on public healthcare expenditure for patients with ischemic heart disease (IHD) in Portugal. The Blinder–Oaxaca decomposition method was applied to Portuguese NHS administrative data for IHD discharges during two periods, 2008–2015 vs. 2002–2007 (N = 434,870). We modelled per episode healthcare expenditures on the introduction of new technologies, adjusting for GDP, patient age, and comorbidities. The per episode healthcare expenditure was significantly higher in 2008–2015 compared to 2002–2007 for IHD discharges. The increase in the use of high-technology procedures contributed to 28.6% of this growth among all IHD patients, and to 18.4%, 6.8%, 11.1%, and 29.2% for acute myocardial infarction, unstable angina, stable angina, and other IHDs, respectively. Changes in the use of stents and embolic protection and/or coronary brachytherapy devices were the largest contributors to expenditure growth. High-technology procedures were confirmed as a key driver of public healthcare expenditure growth in Portugal, contributing to more than a quarter of this growth.

Suggested Citation

  • Wenkang Ma & Ana Timóteo & Vanessa Ribeiro & Céu Mateus & Julian Perelman, 2024. "Contribution of high-technology procedures to public healthcare expenditures: the case of ischemic heart disease in Portugal, 2002–2015," International Journal of Health Economics and Management, Springer, vol. 24(3), pages 419-437, September.
    • Handle: RePEc:kap:ijhcfe:v:24:y:2024:i:3:d:10.1007_s10754-024-09372-5
    DOI: 10.1007/s10754-024-09372-5
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    1. Vasudeva N. R. Murthy & Natalya Ketenci, 2017. "Is technology still a major driver of health expenditure in the United States? Evidence from cointegration analysis with multiple structural breaks," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 29-50, March.
    2. Fırat Bilgel & Kien C. Tran, 2013. "The determinants of Canadian provincial health expenditures: evidence from a dynamic panel," Applied Economics, Taylor & Francis Journals, vol. 45(2), pages 201-212, January.
    3. Amitabh Chandra & Jonathan Skinner, 2012. "Technology Growth and Expenditure Growth in Health Care," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 645-680, September.
    4. Mesbah Fathy Sharaf & Ahmed Shoukry Rashad, 2016. "Regional inequalities in child malnutrition in Egypt, Jordan, and Yemen: a Blinder-Oaxaca decomposition analysis," Health Economics Review, Springer, vol. 6(1), pages 1-11, December.
    5. Jonathan Skinner & Douglas Staiger, 2015. "Technology Diffusion and Productivity Growth in Health Care," The Review of Economics and Statistics, MIT Press, vol. 97(5), pages 951-964, December.
    6. Jochen Hartwig & Jan-Egbert Sturm, 2014. "Robust determinants of health care expenditure growth," Applied Economics, Taylor & Francis Journals, vol. 46(36), pages 4455-4474, December.
    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. Po-Chin Wu & Shiao-Yen Liu & Sheng-Chieh Pan, 2014. "Nonlinear relationship between health care expenditure and its determinants: a panel smooth transition regression model," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 41(4), pages 713-729, November.
    9. Son Hong Nghiem & Luke Brian Connelly, 2017. "Convergence and determinants of health expenditures in OECD countries," Health Economics Review, Springer, vol. 7(1), pages 1-11, December.
    10. Barros, Pedro Pita, 2012. "Health policy reform in tough times: The case of Portugal," Health Policy, Elsevier, vol. 106(1), pages 17-22.
    11. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    12. Ben Jann, 2008. "The Blinder–Oaxaca decomposition for linear regression models," Stata Journal, StataCorp LLC, vol. 8(4), pages 453-479, December.
    13. Murthy, Vasudeva N.R. & Okunade, Albert A., 2016. "Determinants of U.S. health expenditure: Evidence from autoregressive distributed lag (ARDL) approach to cointegration," Economic Modelling, Elsevier, vol. 59(C), pages 67-73.
    14. Xiaohui You & Albert A. Okunade, 2017. "Income and Technology as Drivers of Australian Healthcare Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 853-862, July.
    15. Idaira Rodriguez Santana & María José Aragón & Nigel Rice & Anne Rosemary Mason, 2020. "Trends in and drivers of healthcare expenditure in the English NHS: a retrospective analysis," Health Economics Review, Springer, vol. 10(1), pages 1-11, December.
    16. Mary Charlson & Martin T Wells & Ralph Ullman & Fionnuala King & Celia Shmukler, 2014. "The Charlson Comorbidity Index Can Be Used Prospectively to Identify Patients Who Will Incur High Future Costs," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-16, December.
    17. Alan S. Blinder, 1973. "Wage Discrimination: Reduced Form and Structural Estimates," Journal of Human Resources, University of Wisconsin Press, vol. 8(4), pages 436-455.
    18. Okunade, Albert A. & Osmani, Ahmad Reshad, 2018. "Technology, Productivity, and Costs in Healthcare," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, pages 1-21.
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    More about this item

    Keywords

    Health expenditure; Medical technology; Decomposition methods; Ischemic heart disease; Portugal;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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