Health care provider choice in the case of patient-initiated contacts. An extended version of discrete choice of model demand

This paper analyzes the nature of health care provider choice inthe case of patient-initiated contacts, with special reference toa National Health Service setting, where monetary prices are zeroand general practitioners act as gatekeepers to publicly financedspecialized care. We focus our attention on the factors that mayexplain the continuously increasing use of hospital emergencyvisits as opposed to other provider alternatives. An extendedversion of a discrete choice model of demand for patient-initiatedcontacts is presented, allowing for individual and town residencesize differences in perceived quality (preferences) betweenalternative providers and including travel and waiting time asnon-monetary costs. Results of a nested multinomial logit model ofprovider choice are presented. Individual choice betweenalternatives considers, in a repeated nested structure, self-care,primary care, hospital and clinic emergency services. Welfareimplications and income effects are analyzed by computingcompensating variations, and by simulating the effects of userfees by levels of income. Results indicate that compensatingvariation per visit is higher than the direct marginal cost ofemergency visits, and consequently, emergency visits do not appearas an inefficient alternative even for non-urgent conditions.

"Leonardi Aretini commentarii de bello punico.

Acquis le 22 avril 1824 de madame Vial avec les mss. latin 11393 et italien 1076, pour le prix global de 100 francs; cf. B.n.F., département des Manuscrits, Archives Modernes 492ter, registre des acquisitions du département des Manuscrits 1821-1830, f. 137 "Leonardi Aretini in commentarios de primo bello punico, un vol. fol."; — ex-libris mutilé d'une main italienne du XVIe s. "Ioannis Baptae [...]" (1)

Histoire scolastique de P. le Mangeur.

Contient : Evangile apocryphe ; Méditations et matériaux pour les prédicateurs

Dialogua familiaris Alani et sodalis super deploratione calamitatis gallicane.

Franc. Philelfi orationes (34). - Philelfus Francisco Sforcie (92). - Guarinus Veron. Conrado Alcaldo (96). - De matrimonio inter Stephanum Salvanum et Margaritam Pontam (96 v°). - Plutarchus, de liberis educandis, interprete Garino Veron. (101).

Volgarizzamento della storia De Excidio Troiae di Guido Giudice.

Du Fresne.

An investigation of the relationship between job characteristics and the gender wage gap

This paper re-examines gender wage differences, taking into account notonly worker characteristics but also job characteristics. Considerationof a wide set of job quality indicators can explain a fraction of thewage gap that would otherwise be attributed to pure wage discrimination.In any case, the fraction of the wage gap that remains associated todifferential rewards for identical factors across sexes is stillsubstantial. Our results suggest that in order to avoid overestimationof the fraction of the wage gap attributable to discrimination, it isnecessary to control for job characteristics.

« Le Livre de leesse ».

Commençant par : « Mesdames, je requier mercy, A vous me vueil excuser cy... » et finissant par : « Des dames l'onneur et proesse Prenez en gré, nous vous pryon » .

Livre fait par GILLES LE BOUVIER, dit Le Hérault Berry, où l'on peut « savoir au vray la manière, la forme et les propriétés des choses qu'ilz sont en tous les royaulmes crestiens, et des autres royaulmes » où il s'est trouvé, « de la longueur d'iceulx, des montaignes qui y sont et des fleuves qui y passent ; de la propriété des païs, des hommes, et des aultres choses estranges ».

Premiers mots : « Pour ce que plusieurs gens de diverses nacions et contrées se delectent et prennent plaisir, comme j'ay fait le temps passé, à veoir le monde... ». Derniers mots : «... En ces Espaignes et en Arragon a grant multitude de Sarrazins et de Juifz, qui tiennent terres, maisons et prossessions, et communiquent avecques les crestiens. Et les tiennent les roys, pour le prouffit qu'ilz ont d'eulx ». Suit la rubrique : « Ce livre a fait le roy d'armes de Berry, herault du roy de France, des pays et regions où il a esté en son vivant, avec les fleuves et cités principaulx de toute crestienté. Doxa Theo ». Armoiries.

Price increase and stability with new entries in Cournot markets

It is widely accepted in the literature about the classicalCournot oligopoly model that the loss of quasi competitiveness is linked,in the long run as new firms enter the market, to instability of the equilibrium. In this paper, though, we present a model in which a stableunique symmetric equilibrium is reached for any number of oligopolistsas industry price increases with each new entry. Consequently, the suspicion that non quasi competitiveness implies, in the long run, instabilityis proved false.

Demand for private health insurance: Is there a quality gap?

Quality of care is qualified as a main determinant of the demand forvoluntary private health insurance (PHI) in National Health Systems(NHS). This paper provides new evidence on the influence of the qualitygap between public and private health insurance and other demanddeterminants in the demand for PHI in Catalonia. The demand for PHI ismodelled as a demand for health care quality. Unlike previous studies, the database employed allows for the development of a link between thetheoretical and the empirical model dealing with unobserved heterogeneityand endogeneity issues. Results suggest that a rise in PHI qualityenhances an equivalent influence in the demand for PHI as an equalreduction of NHS quality. Income and price elasticity estimates areconsistent with the observed feature that PHI appears to be a luxurygood and individuals tend to be relatively insensible to tax relief'sand monetary co-payments in insurance contracts.

Generic entry into a regulated pharmaceutical market

The aim of this paper is to analyse empirically entry decisions by generic firms intomarkets with tough regulation. Generic drugs might be a key driver of competitionand cost containment in pharmaceutical markets. The dynamics of reforms ofpatents and pricing across drug markets in Spain are useful to identify the impact ofregulations on generic entry. Estimates from a count data model using a panel of 86active ingredients during the 1999 2005 period show that the drivers of genericentry in markets with price regulations are similar to less regulated markets: genericfirms entries are positively affected by the market size and time trend, and negativelyaffected by the number of incumbent laboratories and the number of substitutesactive ingredients. We also find that contrary to what policy makers expected, thesystem of reference pricing restrains considerably the generic entry. Short run brandname drug price reductions are obtained by governments at the cost of long runbenefits from fostering generic entry and post-patent competition into the markets.

Approximation of quadratic irrationals and their pierce expansions

In this article two aims are pursued: on the one hand, to present arapidly converging algorithm for the approximation of square roots; on theother hand and based on the previous algorithm, to find the Pierce expansionsof a certain class of quadratic irrationals as an alternative way to themethod presented in 1984 by J.O. Shallit; we extend the method to findalso the Pierce expansions of quadratic irrationals of the form $2 (p-1)(p - \sqrt{p^2 - 1})$ which are not covered in Shallit's work.

Rethinking the effects of financial liberalization

During the last few decades, many emerging markets have lifted restrictions on cross-borderfinancial transactions. The conventional view was that this would allow these countries to: (i)receive capital inflows from advanced countries that would finance higher investment and growth;(ii) insure against aggregate shocks and reduce consumption volatility; and (iii) accelerate thedevelopment of domestic financial markets and achieve a more efficient domestic allocationof capital and better sharing of individual risks. However, the evidence suggests that thisconventional view was wrong.In this paper, we present a simple model that can account for the observed effects of financialliberalization. The model emphasizes the role of imperfect enforcement of domestic debts and theinteractions between domestic and international financial transactions. In the model, financialliberalization might lead to different outcomes: (i) domestic capital flight and ambiguous effectson net capital flows, investment, and growth; (ii) large capital inflows and higher investmentand growth; or (iii) volatile capital flows and unstable domestic financial markets. The modelshows how these outcomes depend on the level of development, the depth of domestic financialmarkets, and the quality of institutions.

On a problem of Alfréd Rényi

Alfréd Rényi, in a paper of 1962, A new approach to the theory ofEngel's series, proposed a problem related to the growth of theelements of an Engel's series. In this paper, we reformulate andsolve Rényi's problem for both, Engel's series and Pierceexpansions.