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CINCH - Health Economics Research Center

Monday Health Economics Seminar


On Monday December 11, 2017, 14:00 - 15:30 Katja Grasic (CHE, York) will present:

How should hospital reimbursement be refined to support the concentration of complex care services?

The English National Health Service is promoting the concentration of the treatment of patients with relatively rare and complex conditions into a limited number of specialist centres. If these patients are more costly to treat, the prospective payment system based on Healthcare Resource Groups (HRGs) may need refinement because these centres will be financially disadvantaged. To assess the funding implications of this concentration policy, we estimate the cost differentials associated with caring for patients that receive complex care and examine the extent to which complex care services are concentrated across hospitals and HRGs. We estimate random effects models using patient-level activity and cost data for all patients admitted to English hospitals construct different measures of the concentration of complex services. Payments for complex care services need to be adjusted if they have large cost differentials and if provision is concentrated within a few hospitals.


Room: WST-C.02.11, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.

New CINCH working paper


A new working paper has been added to the CINCH working paper series: “Learning Intensity Effects in Students’ Mental and Physical Health – Evidence from a Large Scale Natural Experiment in Germany” by Sarah Hofmann and Andrea Mühlenweg.

In this study, we analyze health effects of a recent education reform in Germany exposing students to increased schooling intensity. The reform shortened the higher secondary education track by one year. As the overall curriculum required for graduation was held constant, this led to an increase in instruction hours in the remaining school years. The reform has been introduced at different points in time across federal states, providing us with a difference-in-difference setup for analysis. Based on data from the German Socio-Economic Panel Study (SOEP), our results imply that the reform significantly reduced adolescents’ self-rated mental health status. The overall effect on the mental component summary score (MCS) is about a quarter of a standard deviation. Examining MCS sub-dimensions, we find detrimental effects of the reform on vitality and on emotional balance. We also observe significant impacts on self-assessed general physical health.

See all working papers.

Monday Health Economics Seminar


On Monday December 04, 2017, 14:00 - 15:30 Friederike Arndt (CINCH) will present:

Physician drug choices based on preferred drug quotas – a retrospective analysis of physician association policies in Germany

Due to rapidly increasing health expenditures, many countries have implemented cost-control strategies in the health care sector by regulating physician treatment discretion. We study how regional variation in preferred drug lists within the German statutory health insurance affects physicians’ prescribing behavior with respect to compliance and efficiency. We use a nationally representative panel of ambulatory care physicians between 2011 and 2014 linked to marketing data to study the effects of variation in preferred statin drug quotas in three German regions. We apply a difference-in-difference econometric framework by comparing physician prescribing behaviour in regions that were and were not subject to policy interventions, respectively. We find that the composition of physician patient base with respect to health insurance (statutory vs. private) significantly influenced the level of compliance with the preferred drug and the market concentration of products prescribed. The effect of abolishing the quota policy did not change physician behaviour on statutory health insurance patients indicating that physicians have internalized the preferred drug regulation after abolishment.

Room: WST-C.02.11, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.