Ownership structure and provider efficiencyThe purpose of the paper is to investigate the relationship between ownership structure of health care providers and technical efficiency of health care in the regions of Poland. A model built with the use of data envelopment analysis methodology is used for the estimation of efficiency of the health care production process in the regions. The inputs of the process are densities of doctors and nurses as well as per capita expenditures for health care in each of the regions; the outputs are numbers of ambulatory and stationary care services produced. Generally, the results show that the regions with a higher proportion of non-public providers are characterized by a higher technical efficiency, however the results are not unambiguous. The correlation between efficiency and the development of the non-public sector is statistically significant only in the case of ambulatory care providers, while it is insignificant when the proportion of non-public hospitals is considered.
The aim of the paper is to identify and quantify the social and economic determinants of private health expenditures by Polish households with a primary interest in the role of income. Panel data regression analysis is used to estimate relationships between socioeconomic factors and households’ health expenditures. Fixed-effects, instrumental variables and dynamic panel approaches are used in the estimation. The data is taken from the Local Data Bank of Poland’s Central Statistical Office (GUS) and covers the period 1999-2015. Real per capita health expenditures are used as a dependent variable and the covariates are real disposable income, health status, healthcare availability, healthcare prices, pollution, and population age structure. Depending on model specification, the income elasticity of household health expenditure ranges from 0.45 to 0.87. Income elasticity lower than one means that healthcare financed directly from household budgets has the characteristics of a necessity good in Poland. Other factors that correlate with health spending are the proportion of the population over 70 years old and health status measured by life expectancy. Meanwhile, healthcare supply was a factor that proved to be unrelated to households’ health expenditure. On the other hand, the impact of healthcare prices and pollution is unclear.
PL
Celem artykułu jest identyfikacja oraz kwantyfikacja społecznych i ekonomicznych determinant prywatnych wydatków na zdrowie ponoszonych przez gospodarstwa domowe w Polsce. Głównym przedmiotem zainteresowania jest przy tym wpływ wysokości dochodów na wydatki na zdrowie. W celu oszacowania tych zależności posłużono się analizą regresji dla danych panelowych, stosując przy tym modele z efektami ustalonymi, metodę zmiennych instrumentalnych oraz panel dynamiczny. Dane wykorzystane przy szacowaniu modeli pochodzą z Banku Danych Lokalnych GUS i dotyczą lat 1999-2015. Zmienną zależną w szacowanych równaniach są realne wydatki na zdrowie, wśród zmiennych objaśniających znalazły się zmienne ilustrujące realny dochód rozporządzalny; stan zdrowia; dostępność opieki zdrowotnej; cenę opieki zdrowotnej, zanieczyszczenie środowiska i strukturę wiekową populacji. W zależności od specyfikacji modelu elastyczność dochodowa wydatków na zdrowie waha się między 0,45 a 0,87. Elastyczność dochodowa popytu na poziomie mniejszym od 1 oznacza, że opieka zdrowotna finansowana bezpośrednio przez gospodarstwa domowe z funduszy własnych ma w Polsce cechy dobra podstawowego. Innymi czynnikami wpływającymi na wydatkami na zdrowie okazały się odsetek osób powyżej 70. roku życia i stan zdrowia mierzony trwaniem życia. Czynnikiem nieistotnym dla kształtowania wydatków na zdrowie gospodarstw domowych okazała się podaż opieki zdrowotnej. Niejednoznaczne wnioski w tym zakresie dotyczą natomiast cen opieki zdrowotnej i zanieczyszczenia środowiska.
The aim of the paper is to discuss crucial methodological and conceptual issues in an estimation of national health care systems efficiency. The paper consists of following parts: introduction; interpretation of efficiency in health care context; practical issues in efficiency model building; inputs and outputs selection in production process; and summary. In the appendix, the example of efficiency model with use of the data envelopment analysis method is presented.
The aim of the paper is to investigate the structure of health care financing systems in OECD countries. In the theoretical part the following areas of health care financing are discussed: fund collection, fund pooling and provider reimbursement. The empirical part analyses trends in health care expenditures and institutional arrangements in health care financing in OECD countries. Health care financing systems in these countries vary in terms of financing sources, fund and risk pooling mechanisms as well as reimbursement systems. Though, reforming processes in the last decades leads to convergence of health care financing arrangements.
Objectives: Occupational accidents constitute a substantial health and economic burden for societies around the world and a variety of factors determine the frequency of accidents at work. The aim of this paper is to investigate the relationship between the economic situation and the rate of occupational accidents in Poland. Material and Methods: The analysis comprised data for 66 Polish sub-regions taken from the Central Statistical Office’s Local Data Bank. The regression analysis with panel data for period 2002–2014 was applied to identify the relationships involved. Four measures of accidents were used: the rates of total occupational accidents, accidents among men and women separately as well as days of incapacity to work due to accidents at work per employee. Four alternative measures assessed the economic situation: gross domestic product (GDP) per capita, average remuneration, the unemployment rate and number of dwelling permits. The confounding variables included were: employment in hazardous conditions and the size of enterprises. Results: The results of the regression estimates show that the number of occupational accidents in Poland exhibits procyclical behavior, which means that more accidents are observed during the times of economic expansion. Stronger relationships were observed in the equations explaining men’s accident rates as well as total rates. A weaker and not always statistically significant impact of economic situation was identified for women’s accident rates and days of incapacity to work. Conclusions: The results have important implications for occupational health and safety actions. In the periods of higher work intensity employers should focus on appropriate training and supervision of inexperienced workers as well as on ensuring enough time for already experienced employees to recuperate. In terms of public health actions, policy makers should focus on scrutinizing working conditions, educating employers and counteracting possible discrimination of injured employees. Int J Occup Med Environ Health 2018;31(2):151–164
Celem opracowania było zbadanie zależności między zróżnicowaniem teryto¬rialnym dochodów a wzrostem gospodarczym w polskich województwach w latach 2002¬-2011. W celu pomiaru nierówności w dochodach w poszczególnych województwach za¬stosowano ważony współczynnik zmienności przeciętnych wynagrodzeń w powiatach poszczególnych województw. Wyniki badania jednoznacznie wskazują, że istnieje silna zależ¬ność między poziomem rozwoju gospodarczego, mierzonym PKB per capita, a terytorialnym zróżnicowaniem dochodów. Regiony charakteryzujące się silniejszą polaryzacją dochodów ce¬chuje jednocześnie wyższy poziom PKB per capita. Mniej istotne zależności łączą dynamikę PKB per capita i zróżnicowanie wynagrodzeń. Istnieją pewne przesłanki pozwalające sądzić, że polaryzacja dochodów w regionach sprzyja ich bardziej dynamicznemu wzrostowi gospo¬darczemu, zależności te jednak podlegają silnym i różnokierunkowym zmianom w czasie.
EN
The purpose of the paper was to investigate the relationship between territo¬rial income disparities and economic growth in Polish regions (województwo) in years 2002-2011. For the purpose of measuring income disparities, the weighted coefficient of variation of average remuneration in counties (powiat) located in particular regions was used. The results clearly indicate that there is strong correlation between level of econo¬mic development measured by per person GDP and territorial income disparities. Re¬gions characterized by higher income polarization are at the same time those with higher per capita GDP. Less significant relationship characterizes the dynamics of per capita GDP and income disparities. The reasons were found that allow to conclude that higher income dispersion in the regions favours more dynamic economic growth, though the re¬lationship is highly instable in time.
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