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Record W2754257427 · doi:10.20381/ruor-13033

Three essays in health economics and public policy

2008· dissertation· en· W2754257427 on OpenAlexaboutno aff
Olga Milliken

Bibliographic record

VenueuO Research (University of Ottawa) · 2008
Typedissertation
Languageen
FieldEconomics, Econometrics and Finance
TopicHealthcare Policy and Management
Canadian institutionsnot available
Fundersnot available
KeywordsHealth economicsPublic healthPublic economicsPositive economicsEconomicsPolitical scienceNeoclassical economicsPublic administrationMedicineNursing

Abstract

fetched live from OpenAlex

Essay One: Genetic Health Risks: The Case for Universal Public Health Insurance. This paper examines the appropriate role for the public sector in providing genetic and health insurance when health risks are genetically determined at conception. The ex ante efficient outcome (when individuals are ignorant about their health risks) is characterized. It is demonstrated that this outcome cannot be achieved by private health insurance markets or by a government which cannot commit to a once-and-for-all transfer policy. In contrast, the desired outcome is attained through public provision of universal health insurance and of genetic testing, coupled with a public pension scheme. Essay Two: Fee-for-Service vs. Capitation: Anything You Can Do - I Can Do Better (and Cheaper). This paper recasts the analysis of optimal physician remuneration - generally presented as a contest between prospective (capitation) and retrospective (fee-for-service) schemes - as a problem in price theory. This approach abstracts from problems of asymmetric information and concentrates on the design of the price mechanism. It demonstrates that when the demand for health care is price-inelastic, the appropriately designed fee-for-service and capitation schemes both lead to Pareto efficient outcomes. When a patient's demand for care is uncertain, or the risk of poor health outcomes depends on the preventive care provision, standard arguments concerning risk bearing are used to prove that paying physicians on a fee-for-service basis can deliver socially-optimal outcomes at a lower cost than if they are paid under a capitation scheme. Essay Three: Comparative Efficiency Assessment of Primary Care Models Using Data Envelopment Analysis. This paper compares the productive efficiency of four models of primary care service delivery in Ontario, Canada, using the methodology of Data Envelopment Analysis. Particular care is taken to include quality of service in the output measure. The influence of the delivery model on productive efficiency is disentangled from patient characteristics using regression analysis. The traditional fee-for-service arrangement ranks highest and the Community Health Centre model (which involves a multidisciplinary team of health care professionals paid on a salary basis) the lowest in efficiency scoring. The reliance of input measures on the costs of running a practice and on the number of patients favours the fee-for-service model.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.005
metaresearch head score (Gemma)0.014
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Other · Consensus signal: none
Teacher disagreement score0.018
Threshold uncertainty score0.062

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0050.014
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.002
Science and technology studies0.0030.012
Scholarly communication0.0070.007
Open science0.0020.004
Research integrity0.0080.006
Insufficient payload (model declined to judge)0.0180.002

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.131
GPT teacher head0.330
Teacher spread0.199 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreOther

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2008
Admission routes1
Has abstractyes

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