Skip to main content


Utilization, expenditure, economics and financing systems

Section edited by Milena Pavlova and Evelina Pappa

This section aims to publish studies looking at a population's use of hospital services and their health and health-related expenditures. The section also accepts economic evaluations of health interventions and services and studies looking at recommendations for people to be able access needed services while avoiding catastrophic expenditure and impoverishment.

Page 5 of 13

  1. Content type: Study protocol

    The MODEM project (A comprehensive approach to MODelling outcome and costs impacts of interventions for DEMentia) explores how changes in arrangements for the future treatment and care of people living with demen...

    Authors: Adelina Comas-Herrera, Martin Knapp, Raphael Wittenberg, Sube Banerjee, Ann Bowling, Emily Grundy, Carol Jagger, Nicolas Farina, Daniel Lombard, Klara Lorenz and David McDaid

    Citation: BMC Health Services Research 2017 17:25

    Published on:

  2. Content type: Research article

    Post-stroke healthcare consumption is strongly associated with a mental health diagnosis. This study aimed to identify stroke patients who utilised mental healthcare facilities, explored their mental healthcar...

    Authors: M. van Eeden, G. A. P. G. van Mastrigt, S. M. A. A. Evers, E. P. M. van Raak, G. A. M. Driessen and C. M. van Heugten

    Citation: BMC Health Services Research 2016 16:688

    Published on:

  3. Content type: Research article

    Medication reviews have become part of pharmacy practice across developed countries. This study aimed to identify factors affecting the likelihood of eligible Ontario seniors receiving a pharmacy-led medicatio...

    Authors: Petros Pechlivanoglou, Lusine Abrahamyan, Linda MacKeigan, Giulia P. Consiglio, Lisa Dolovich, Ping Li, Suzanne M. Cadarette, Valeria E. Rac, Jonghyun Shin and Murray Krahn

    Citation: BMC Health Services Research 2016 16:666

    Published on:

  4. Content type: Research article

    Due to widespread PSA testing incidence rates of localized prostate cancer increase but curative treatment is often not required. Overtreatment imposes a substantial economic burden on health care systems. We ...

    Authors: Alina Brandes, Florian Koerber, Larissa Schwarzkopf, Matthias Hunger, Wolf H. Rogowski and Raphaela Waidelich

    Citation: BMC Health Services Research 2016 16:664

    Published on:

  5. Content type: Research article

    The American Behaviour Change Consortium (BCC) framework acknowledges patients as active participants and supports the need to investigate the fidelity with which they receive interventions, i.e. receipt. Acco...

    Authors: Lorna Rixon, Justine Baron, Nadine McGale, Fabiana Lorencatto, Jill Francis and Anna Davies

    Citation: BMC Health Services Research 2016 16:663

    Published on:

  6. Content type: Research article

    In 2003, the New Cooperative Medical Scheme (NCMS) was introduced in China to re-establish health insurance for the country’s vast rural population. In addition, the coverage of NCMS has been expanding after t...

    Authors: Na Guo, Tor Iversen, Mingshan Lu, Jian Wang and Luwen Shi

    Citation: BMC Health Services Research 2016 16:653

    Published on:

  7. Content type: Research article

    People with intellectual disabilities (ID) are known to have more diseases and are believed to start aging earlier than the general population. The population of older people with ID is growing, but knowledge ...

    Authors: Magnus Sandberg, Gerd Ahlström, Anna Axmon and Jimmie Kristensson

    Citation: BMC Health Services Research 2016 16:642

    Published on:

  8. Content type: Research article

    Studies of chronic diseases are associated with a financial burden on households. We aimed to determine if survivors of acute coronary syndrome (ACS) experience household economic burden and to quantify any po...

    Authors: Karice K. Hyun, Beverley M. Essue, Mark Woodward, Stephen Jan, David Brieger, Derek Chew, Kellie Nallaiah, Tegwen Howell, Tom Briffa, Isuru Ranasinghe, Carolyn Astley and Julie Redfern

    Citation: BMC Health Services Research 2016 16:636

    Published on:

  9. Content type: Research article

    Low-risk pulmonary embolism (PE) patients may be candidates for outpatient treatment or abbreviated hospital stay. There is a need for a claims-based prediction rule that payers/hospitals can use to risk strat...

    Authors: Craig I. Coleman, W. Frank Peacock, Gregory J. Fermann, Concetta Crivera, Erin R. Weeda, Michael Hull, Mary DuCharme, Laura Becker and Jeff R. Schein

    Citation: BMC Health Services Research 2016 16:610

    Published on:

  10. Content type: Research article

    Healthcare mobility, defined as healthcare utilization in more than one distinct healthcare system, may have detrimental effects on outcomes of care. We characterized healthcare mobility and associated charact...

    Authors: Karen H. Wang, Joseph L. Goulet, Constance M. Carroll, Melissa Skanderson, Samah Fodeh, Joseph Erdos, Julie A. Womack, Erica A. Abel, Harini Bathulapalli, Amy C. Justice, Marcella Nunez-Smith and Cynthia A. Brandt

    Citation: BMC Health Services Research 2016 16:609

    Published on:

  11. Content type: Research article

    Although bodies of evidence on copayment effects on access to care and quality of care in general have not been conclusive, allowing copayment in the case of emergency medical conditions might pose a high risk...

    Authors: Paibul Suriyawongpaisal, Wichai Aekplakorn, Samrit Srithamrongsawat, Chaisit Srithongchai, Orawan Prasitsiriphon and Rassamee Tansirisithikul

    Citation: BMC Health Services Research 2016 16:606

    Published on:

  12. Content type: Research article

    Treatment costs for children with growth hormone (GH) deficiency are subsidized by the government in Japan if the children meet clinical criteria, including height limits (boys: 156.4 cm; girls: 145.4 cm). How...

    Authors: Eri Maeda, Takahiro Higashi, Tomonobu Hasegawa, Susumu Yokoya, Takahiro Mochizuki, Tomohiro Ishii, Junko Ito, Susumu Kanzaki, Akira Shimatsu, Koji Takano, Toshihiro Tajima, Hiroyuki Tanaka, Yusuke Tanahashi, Akira Teramoto, Toshiro Nagai, Kunihiko Hanew…

    Citation: BMC Health Services Research 2016 16:602

    Published on:

  13. Content type: Research article

    The Maternal and Child Health Voucher Scheme (MCHVS) was introduced in Myanmar to address the high rate of maternal and infant mortalities. It aimed to increase access to maternal and child health (MCH) servic...

    Authors: Songyot Pilasant, Wantanee Kulpeng, Pitsaphun Werayingyong, Nattha Tritasavit, Inthira Yamabhai, Yot Teerawattananon, Sangay Wangmo and Sripen Tantivess

    Citation: BMC Health Services Research 2016 16:600

    Published on:

  14. Content type: Research article

    User fees have generally fallen out of favor across Africa, and they have been associated with reductions in access to healthcare. We examined the effects of the introduction and removal of user fees on outpat...

    Authors: S. I. Watson, E. B. Wroe, E. L. Dunbar, J. Mukherjee, S. B. Squire, L. Nazimera, L. Dullie and R. J. Lilford

    Citation: BMC Health Services Research 2016 16:595

    Published on:

    The Erratum to this article has been published in BMC Health Services Research 2016 16:629

  15. Content type: Research article

    The burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral ...

    Authors: M. P. Molete, L. Chola and K. J. Hofman

    Citation: BMC Health Services Research 2016 16:590

    Published on:

  16. Content type: Research article

    Public health care dominated the services provision in China before 1980s. However, the number of private health care providers in China has been increasing since then. The growth of private hospitals escalate...

    Authors: Chengxiang Tang, Judy Xu and Meng Zhang

    Citation: BMC Health Services Research 2016 16:580

    Published on:

  17. Content type: Research article

    Microscopic Observation Drug Susceptibility (MODS) and Xpert MTB/Rif (Xpert) are highly sensitive tests for diagnosis of pulmonary tuberculosis (PTB). This study evaluated the cost effectiveness of utilizing M...

    Authors: Simon Walusimbi, Brendan Kwesiga, Rashmi Rodrigues, Melles Haile, Ayesha de Costa, Lennart Bogg and Achilles Katamba

    Citation: BMC Health Services Research 2016 16:563

    Published on:

  18. Content type: Research article

    Treatment costs of induced abortion complications can consume a substantial amount of hospital resources. This use of hospitals scarce resources to treat induced abortion complications may affect hospitals’ ca...

    Authors: Patrick G. C. Ilboudo, Giulia Greco, Johanne Sundby and Gaute Torsvik

    Citation: BMC Health Services Research 2016 16:559

    Published on:

  19. Content type: Research article

    Reimbursement systems provide incentives to health care providers and may drive physician behaviour. This review assesses the impact of reimbursement system on socioeconomic and racial inequalities in access, ...

    Authors: Wenjing Tao, Janne Agerholm and Bo Burström

    Citation: BMC Health Services Research 2016 16:542

    Published on:

  20. Content type: Research article

    Our objective was to assess the efficiency of treatments in patients with localized prostate cancer, by synthesizing available evidence from European economic evaluations through systematic review.

    Authors: Virginia Becerra, Mónica Ávila, Jorge Jimenez, Laura Cortes-Sanabria, Yolanda Pardo, Olatz Garin, Angels Pont, Jordi Alonso, Francesc Cots and Montse Ferrer

    Citation: BMC Health Services Research 2016 16:541

    Published on:

  21. Content type: Research article

    To evaluate the cost-effectiveness of trimetazidine (TMZ) as add-on therapy to standard-of-care (SoC) compared to SoC alone in patients with chronic stable angina who did not respond adequately to first line t...

    Authors: Georgia Kourlaba, George Gourzoulidis, George Andrikopoulos, Konstantinos Tsioufis, Alexandra Beletsi and Nikos Maniadakis

    Citation: BMC Health Services Research 2016 16:520

    Published on:

  22. Content type: Research article

    Surveys are often used for analysis of health status and healthcare utilization in different socioeconomic groups. However, differential non-response rates may bias results. The aim of this study was to compar...

    Authors: Janne Agerholm, Daniel Bruce and Bo Burström

    Citation: BMC Health Services Research 2016 16:510

    Published on:

  23. Content type: Research article

    Evidence from population-based studies on the economic burden imposed by chronic non-communicable diseases (CNCDs) is still sparse in Sub-Saharan Africa. Our study aimed to fill this existing gap in knowledge ...

    Authors: Qun Wang, Stephan Brenner, Olivier Kalmus, Hastings Thomas Banda and Manuela De Allegri

    Citation: BMC Health Services Research 2016 16:457

    Published on:

  24. Content type: Research article

    Chronic kidney disease (CKD) is a disorder with high morbidity and mortality worldwide whose complications generate multiple costs. In Ecuador, only a few healthcare institutions have implemented management pr...

    Authors: Luis Manjarres, Pilar Sanchez, María C. Cabezas, Marco Fornasini, Valeria Freire and Adelin Albert

    Citation: BMC Health Services Research 2016 16:443

    Published on:

  25. Content type: Research article

    The interRAI-Home Care (interRAI-HC) instrument is commonly used in routine care to assess care and service needs, resource utilisation and health outcomes of community dwelling home care clients. Potentially,...

    Authors: Lisanne I. van Lier, Henriëtte G. van der Roest, Hein P. J. van Hout, Liza van Eenoo, Anja Declercq, Vjenka Garms-Homolová, Graziano Onder, Harriet Finne-Soveri, Pálmi V. Jónsson, Cees M. P. M. Hertogh and Judith. E. Bosmans

    Citation: BMC Health Services Research 2016 16:440

    Published on:

  26. Content type: Research article

    Cervical cancer, a preventable disease, is the third leading cause of cancer morbidity and mortality in the Lao People’s Democratic Republic (Lao PDR). Since many cervical cancers are linked to human papilloma...

    Authors: Phetsavanh Chanthavilay, Daniel Reinharz, Mayfong Mayxay, Keokedthong Phongsavan, Donald E. Marsden, Lynne Moore and Lisa J. White

    Citation: BMC Health Services Research 2016 16:418

    Published on:

  27. Content type: Research article

    Globally, about 150 million people experience catastrophic healthcare expenditure services annually. Among low and middle income countries, out-of-pocket expenditure pushes about 100 million people into povert...

    Authors: Barnabas Africanus Mbogo and Deborah McGill

    Citation: BMC Health Services Research 2016 16:413

    Published on:

  28. Content type: Research article

    The disparity between government health expenditures across regions is more severe in developing countries than it is in developed countries. The capitation subsidy method has been proven effective in develope...

    Authors: Guoying Zhang, Luwen Zhang, Shaolong Wu, Xiaoqiong Xia and Liming Lu

    Citation: BMC Health Services Research 2016 16:408

    Published on:

  29. Content type: Research article

    Reducing low-value care is a core component of healthcare reforms in many Western countries. A comprehensive and sound set of low-value care measures is needed in order to monitor low-value care use in general...

    Authors: Eline F. de Vries, Jeroen N. Struijs, Richard Heijink, Roy J. P. Hendrikx and Caroline A. Baan

    Citation: BMC Health Services Research 2016 16:405

    Published on:

  30. Content type: Research article

    The objective of the study is to estimate the frequency of multimorbidity in type 2 diabetes patients classified by health statuses in a European region and to determine the impact on pharmaceutical expenditure.

    Authors: Carla Sancho-Mestre, David Vivas-Consuelo, Luis Alvis-Estrada, Martin Romero, Ruth Usó-Talamantes and Vicent Caballer-Tarazona

    Citation: BMC Health Services Research 2016 16:394

    Published on:

  31. Content type: Research article

    Potentially Preventable Hospitalizations (PPH) are hospital admissions for conditions which are preventable with timely and appropriate outpatient care being Chronic Obstructive Pulmonary Disease (COPD) admiss...

    Authors: Julián Librero, Berta Ibañez-Beroiz, Salvador Peiró, M. Ridao-López, Clara L. Rodríguez-Bernal, Francisco J. Gómez-Romero and Enrique Bernal-Delgado

    Citation: BMC Health Services Research 2016 16:367

    Published on:

  32. Content type: Research article

    Urinary tract infections (UTIs) are among the most common bacterial infections. Despite this burden, there are few studies of the costs of UTIs. The objective of this study was to determine the costs of UTIs i...

    Authors: M. François, T. Hanslik, B. Dervaux, Y. Le Strat, C. Souty, S. Vaux, S. Maugat, C. Rondet, M. Sarazin, B. Heym, B. Coignard and L. Rossignol

    Citation: BMC Health Services Research 2016 16:365

    Published on:

  33. Content type: Research article

    In 2012 the Norwegian Coordination Reform was implemented. The main motivation was to encourage municipalities to expand local, primary health care services. From 2012 to 2014, under the Municipal Co-Financing...

    Authors: Lars C. Monkerud and Trond Tjerbo

    Citation: BMC Health Services Research 2016 16:353

    Published on:

  34. Content type: Research article

    Health services utilization by Veterans following release may be different than the general population as the result of occupational conditions, requirements and injuries. This study provides the first longitu...

    Authors: Alice B. Aiken, Alyson L. Mahar, Paul Kurdyak, Marlo Whitehead and Patti A. Groome

    Citation: BMC Health Services Research 2016 16:351

    Published on:

  35. Content type: Research article

    The prevalence of diabetes among adults in Mexico has increased markedly from 6.7 % in 1994 to 14.7 % in 2015. Although the main diabetic complications can be prevented or delayed with timely and effective pri...

    Authors: David G. Lugo-Palacios, John Cairns and Cynthia Masetto

    Citation: BMC Health Services Research 2016 16:333

    Published on:

  36. Content type: Research article

    Silent-members are members of a medical health plan who submit no claims for healthcare services in a benefit year despite 12 months of continuous-enrollment. This study was conducted to evaluate the future ex...

    Authors: Trudy Millard Krause, Elifnur Yay Donderici, Cecilia Ganduglia Cazaban and Luisa Franzini

    Citation: BMC Health Services Research 2016 16:319

    Published on:

  37. Content type: Research article

    Human resources are a major cost driver in childhood pneumonia case management. Introduction of 13-valent pneumococcal conjugate vaccine (PCV-13) in Malawi can lead to savings on staff time and salaries due to...

    Authors: Fiammetta Maria Bozzani, Matthias Arnold, Timothy Colbourn, Norman Lufesi, Bejoy Nambiar, Gibson Masache and Jolene Skordis-Worrall

    Citation: BMC Health Services Research 2016 16:314

    Published on:

  38. Content type: Research article

    Antimicrobial stewardship programs have been widely introduced in hospitals as a response to increasing antimicrobial resistance. Although such programs are commonly used, the long-term effects on antimicrobia...

    Authors: Peter Lanbeck, Gunnel Ragnarson Tennvall and Fredrik Resman

    Citation: BMC Health Services Research 2016 16:311

    Published on:

  39. Content type: Research article

    Sickle cell disease (SCD) constitutes a major public health problem in sub-Saharan Africa (SSA). Newborn screening and early subsequent clinical intervention can reduce early mortality and increase life expect...

    Authors: Andreas Kuznik, Abdulrazaq G. Habib, Deogratias Munube and Mohammed Lamorde

    Citation: BMC Health Services Research 2016 16:304

    Published on:

  40. Content type: Research article

    Multiple sclerosis (MS) is a chronic progressive condition affecting the central nervous system. Progression of MS results in increased level of disability and most patients will eventually experience some deg...

    Authors: E. Jones, J. Pike, T. Marshall and X. Ye

    Citation: BMC Health Services Research 2016 16:294

    Published on:

  41. Content type: Research article

    Previous studies have found a high prevalence of depression and post-traumatic stress disorder (PTSD) among survivors of human trafficking. European countries are required to assist trafficked people in their ...

    Authors: Maria Cary, Siân Oram, Louise M. Howard, Kylee Trevillion and Sarah Byford

    Citation: BMC Health Services Research 2016 16:284

    Published on:

  42. Content type: Research article

    “Chiranjeevi Yojana (CY)”, a state-led large-scale demand-side financing scheme (DSF) under public-private partnership to increase institutional delivery, has been implemented across Gujarat state, India since...

    Authors: Sandul Yasobant, Kranti Suresh Vora, Hemant Deepak Shewade, Kristi Sidney Annerstedt, Petros Isaakidis, Dileep V. Mavalankar, Nishith B. Dholakia and Ayesha De Costa

    Citation: BMC Health Services Research 2016 16:266

    Published on:

  43. Content type: Research article

    Many Americans find themselves with problems paying medical bills, and medical debt can lead to numerous negative financial, social and access to healthcare outcomes. One potential market-based solution to the...

    Authors: Laura Lessard and Julie Solomon

    Citation: BMC Health Services Research 2016 16:264

    Published on:

  44. Content type: Research article

    Asthma and chronic obstructive pulmonary disease (COPD) are common chronic inflammatory respiratory diseases, which impose a substantial burden on healthcare systems and society. Fixed-dose combinations (FDCs)...

    Authors: A. Lewis, S. Torvinen, P. N. R. Dekhuijzen, H. Chrystyn, A. T. Watson, M. Blackney and A. Plich

    Citation: BMC Health Services Research 2016 16:251

    Published on:

  45. Content type: Research article

    Administrative data are increasingly used in healthcare research. However, in order to avoid biases, their use requires careful study planning. This paper describes the methodological principles and criteria u...

    Authors: Cristina Mazzali, Anna Maria Paganoni, Francesca Ieva, Cristina Masella, Mauro Maistrello, Ornella Agostoni, Simonetta Scalvini and Maria Frigerio

    Citation: BMC Health Services Research 2016 16:234

    Published on: