AMU - AMSE
5-9 Boulevard Maurice Bourdet, CS 50498
13205 Marseille Cedex 1
Ventelou
Publications
The relationship between the length of GP consultation in primary care and drug prescribing practices is still a subject for debate. Patients' morbidity, generating both very long consultation times and large volumes of prescriptions, may mask an underlying substitution among GPs regarding the length of time they offer to patients versus the alternative of prescribing pharmaceuticals. We propose to pursue the debate by analyzing the results of a case vignette, submitted to 1,900 GPs, in which patient morbidity is controlled for by definition. In this case - a hypothetical patient suffering from mild depression - we observe the choice between three types of treatment strategy: psychotherapy, drug therapy and a combination of the two. We observe that the GPs with the highest consultation rates were twice as likely to adopt the drug therapy option as their counterparts with lower rates of consultation. Moreover, for more than 50% of drug prescriptions, the medical decisions contradict clinical practice guidelines.
Since 2000, the fight against aids, tuberculosis and malaria has contributed to significant shifts in the main paradigms of the health economics literature applied to developing countries: improvements in public health of the population are now considered a prerequisite, rather than a consequence, of economic growth; for health care financing, priority is given to promoting prepayment and health insurance mechanisms rather than "cost recovery" policies and user fees at the point of consumption; differential pricing for access to essential medicines and flexibility in international norms for intellectual property rights are increasingly recommended; disease-targeted "vertical" programs are viewed as a way to improve efficiency and strengthen health care systems as a whole. The article discusses the theoretical and empirical limitations of these new paradigms. Classification JEL : G22, I1, I18, O11, O34
The book is based on original data and field studies from Brazil, Thailand, India and Sub-Saharan Africa. Focusing on the issue of universal and free access to treatment (a goal now taken to heart by the international community), it assesses the progress made and presents a rigorous diagnosis of the obstacles that remain, especially the constraints imposed by TRIPS and the poor state of most public health systems in Southern countries. In so doing, the book renews our understanding of the political economy of HIV/AIDS in these vast regions, where it continues to spread with devastating social and economic consequences.
Cancer survivors frequently shift to part-time job, unemployment and early retirement, probably more than the general population. We re-evaluated the impact of cancer in the labour market, using ?comparative? transition matrices between occupational states. The proper consequences of cancer were measured by a significant deviation of the transition matrix for cancer survivors, compared to a prior matrix standardised on the general population. The methodology was declined with stratifications by social class or gender. We disentangle whether systematic differences in socioeconomic status regarding ability to return to work, are illness related (cancer sites or diagnosis prognosis), or job related (physical demands). Results of the paper are in favour of a specific concern of the policy-maker towards manual workers affected by cancer. JEL classification: I10 ; J210 ; J24.
No abstract is available for this item.
No abstract is available for this item.
The aim of this paper is to re-examine the consequences of AIDS on economic growth inAfrica.The model is based on two crucial hypothesis: i) AIDS has a short-term impact on a flow variable (the flow of labour available and capable of working at a moment t in the economy); ii) AIDS has a long-term impact on stock variables (human capital, i.e. the stock of health or the stock of education and competence incorporated in the workers; and physical capital). Integrating these two impacts in a model of growth with multiple factors of accumulation reverses the standard impact-evaluations based on classicaltools(Solow-typemodelofgrowth,with?catching-upeffect?asmechanismof development). An involution trap appears for a reasonable range of epidemiological shocks, corresponding to a modification of the long-term growth regime of the economy.
In this paper, a micro-founded model dealing with the effects of regional sizing on economic growth is developed. Departing from bigger sizes, reduction involves more efficient public choices because of proximity to individual preferences and needs, but also creates the risk of underestimation of the real profitability of public expenditure by local governments due to cross border spillovers and “predator” behaviors. Hence the optimal size depends on the relative strength of both effects. Moreover, we show that different institutional arrangements between fiscal tiers involve different results for each possible size. Using data from the Spanish regions during the period 1984–1996, the relationship between productive spending and jurisdiction size is then analyzed. Copyright Springer Science+Business Media, Inc. 2006