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- W2725064766 abstract "The cream skimming’ effect in the insurance sector occurs when the insurerhas the possibility to select individuals whose risk-adjusted per capita payment heconsiders to be above the expected cost level. To avoid this possibility of selection, thepublic authority has to determine a financing formula which takes account of the severaldeterminants of costs, to create homogeneous payment groups. We consider the creamskimming effect at the hospital level, through the relationship between socio-economicstatus (SES) and inpatient length of stay. The Belgian hospitals’ financing of day of stayis based upon pathologies (APDRG) and age. The omission of SES may be an incentivefor hospitals to select its patients. Our data set contains data from 60 Belgian hospitalsfor the year 1995, i.e. 466, 087 individual observations, with fully comparable explanatoryvariables such as pathology, age, length of stay and income, and also community-based observations on social isolation and quality of accommodation. We test theincidence of social factors on length of stay controlling for age, pathologies, type ofhospital (public or private), occupation rate, and type of exit (death or transfer). Themain outcome is that length of stay is decreasing with income, and is positively relatedto social isolation. Length of stay is also higher for unemployed or retired people, andfor benefit-recipients." @default.
- W2725064766 created "2017-07-14" @default.
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- W2725064766 date "2003-01-01" @default.
- W2725064766 modified "2023-09-23" @default.
- W2725064766 title "The Impact of Social Factors on Healthcare Expenditures: How to Ensure that Fairness and Access to Healthcare Are Not Sacrificed in the Quest for Efficiency" @default.
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