Papers by Sverre O Grepperud
Health Economics Review, Apr 1, 2023
Background Lower-middle-income countries (LMICs) have a common goal to achieve universal health c... more Background Lower-middle-income countries (LMICs) have a common goal to achieve universal health coverage (UHC) through voluntary health insurance schemes. This is important to improve access to healthcare services and ensure financial protection for all by reducing out-of-pocket expenditures. This study aimed to examine the role of risk preferences on enrollment status (currently insured, previously insured, and never insured) into a Tanzanian voluntary health insurance scheme targeted at the informal sector. Methods Data were collected from households in a random sample of 722 respondents. The risk preference measure was based on a hypothetical lottery game which applies the BJKS instrument. This instrument measures income risk where the respondents are to choose between a certain income and a lottery. Both multinomial and simple logistic regression models have been used to analyze the relationship between risk aversion and enrollment status. Results On average, the respondents have a high degree of risk aversion, and the insured are more risk averse than the uninsured (previously insured and never insured). There is a weak tendency for the wealthiest, measured by household income or total household expenditure, to be somewhat more risk averse than the less wealthy. Logistic and multinomial logistic regressions show that risk aversion is strongly associated with enrollment status. A higher degree of risk aversion significantly increases the probability of being insured, relative to being previously insured, and relative to being never insured. Conclusion Risk aversion matters in a decision to enroll into the iCHF scheme. Strengthening the benefit package for the scheme, might increase the enrollment rate and hence improve access to healthcare services for people in rural areas and those employed in the informal sector.
RePEc: Research Papers in Economics, Jun 21, 2009
This work examines the role of penalties as providers of incentives to prevent medical errors and... more This work examines the role of penalties as providers of incentives to prevent medical errors and ensure that such incidents, once they occur, become common knowledge. It is shown that a scheme with two penalties (accountability and non-report) is able to induce the first-best solution. However, this scheme needs not imply a punitive environment, but may, under given circumstances, yield insignificant and even negative penalties. Alternative incentive systems, such as voluntary reporting and legal immunity, are found to have less desirable properties. An exception is the principle of confidentiality (anonymity) which turns out to be an optimal scheme. It is also shown that when a judicial upper limit is binding, for the non-report penalty, it becomes rationale to go "soft" on the accountability penalty.
RePEc: Research Papers in Economics, 2018
I denne artikkelen drøftes forhold som bør tas i betraktning når man vurderer en økt fremtidig sa... more I denne artikkelen drøftes forhold som bør tas i betraktning når man vurderer en økt fremtidig satsing på grønn omsorg. Brukere av grønne tjenester er typisk svakt informert om tjenestekvalitet, samtidig som leverandører kan ha mangelfull kompetanse, noe som i sum nødvendiggjør regulering. Selve utformingen av kontrakter mellom leverandører og sponsorer er viktig for å sikre målsettinger om kostnadsbevissthet, kvalitet og rekruttering. Mer forskning på effekter og ressursbruk av slike tjenester er nødvendig.
BMC Health Services Research, Jan 30, 2018
Background: Previous works that uses patterns of prior spending to predict future mental health c... more Background: Previous works that uses patterns of prior spending to predict future mental health care expenses (utilization models) are mainly concerned with demand (need) variables. In this paper, we introduce supply variables, both individual rater variables and center variables. The aim is to assess these variables' explanatory power, and to investigate whether not accounting for such variables could create biased estimates for the effects of need variables. Methods: We employed an observational study design where the same set of referrals was assessed by a sample of clinicians, thus creating data with a panel structure being particularly relevant for analyzing supply factors. The referrals were obtained from Norwegian Community Mental Health Centers (outpatient services), and the clinicians assessed the referrals with respect to recommended treatment costs and health status. Results: Supply variables accounted for more than 10% of the total variation and about one third of the explained variation. Two groups of supply variables, individual rater variables and center variables (institutions) were equally important. Conclusions: Our results confirm that supply factors are important but ignoring such variables, when analyzing demand variables, do not generally seem to produce biased (confounded) coefficients.
Health policy open, Dec 1, 2023
Fagbokforlaget eBooks, Mar 17, 2022
BMC Health Services Research, Feb 19, 2021
Background: Several countries including Tanzania, have established voluntary non-profit insurance... more Background: Several countries including Tanzania, have established voluntary non-profit insurance schemes, commonly known as community-based health insurance schemes (CBHIs), that typically target rural populations and the informal sector. This paper considers the importance of household perceptions towards CBHIs in Tanzania and their role in explaining the enrolment decision of households. Methods: This was a cross-sectional household survey that involved 722 households located in Bahi and Chamwino districts in the Dodoma region. A three-stage sampling procedure was used, and the data were analyzed using both factor analysis (FA) and principal component analysis (PCA). Statistical tests such as Bartlett's test of sphericity, Kaiser-Meyer-Olkin (KMO) for sampling adequacy, and Cronbach's alpha test for internal consistency and scale reliability were performed to examine the suitability of the data for PCA and FA. Finally, multivariate logistic regressions were run to determine the associations between the identified factors and the insurance enrolment status. Results: The PCA identified seven perception factors while FA identified four factors. The quality of healthcare services, preferences (social beliefs), and accessibility to insurance scheme administration (convenience) were the most important factors identified by the two methods. Multivariate logistic regressions showed that the factors identified from the two methods differed somewhat in importance when considered as independent predictors of the enrollment status. The most important perception factors in terms of strength of association (odds ratio) and statistical significance were accessibility to insurance scheme administration (convenience), preferences (beliefs), and the quality of health care services. However, age and income were the only socio-demographic characteristics that were statistically significant. Conclusion: Household perceptions were found to influence households' decisions to enroll in CBHIs. Policymakers should recognize and consider these perceptions when designing policies and programs that aim to increase the enrolment into CBHIs.
Sykepleien Nett, 2018
Nittifem prosent av enhetene utfører laboratoriearbeid. Av disse analyserer 99 prosent kapillaere... more Nittifem prosent av enhetene utfører laboratoriearbeid. Av disse analyserer 99 prosent kapillaere prøver. Nittiseks prosent utfører urinstrimmeltest, mens 89 prosent tar venøse prøver. Av dem som tar kapillaere prøver, analyserer 99 prosent glukose, 56 prosent C-reaktivt protein (CRP), 46 prosent hemoglobin, mens 32 prosent analyserer protrombintid internasjonal normalisert ratio (INR). Hovedsakelig er det fastlegene som rekvirerer venøse prøver og kapillaer INR, glukose og hemoglobin, mens hjemmetjenesten ofte selv rekvirerer urinstrimmeltest og CRP. Fastlegekontorene tror de selv rekvirerer en høyere andel av CRP enn de faktisk gjør. Konklusjon: Hjemmetjenesteenhetene har en omfattende laboratorievirksomhet med et analyserepertoar ganske likt det som nnes på sykehjemmene. Gitt det omfattende tilbudet av laboratorietjenester som utføres av hjemmetjenesten og det høye antallet ansatte involvert i slike aktiviteter, er det viktig med kvalitetssikringssystemer kombinert med tilstrekkelig faglig kompetanse.
Background: Several countries including Tanzania, have established voluntary non-profit insurance... more Background: Several countries including Tanzania, have established voluntary non-profit insurance schemes, commonly known as community-based health insurance schemes (CBHIs), that typically target rural populations and the informal sector. This paper considers the importance of household perceptions towards CBHIs in Tanzania and their role in explaining the enrolment decision of households. Methods: This was a cross-sectional household survey that involved 722 households located in Bahi and Chamwino districts in the Dodoma region. A three-stage sampling procedure was used, and the data were analyzed using both factor analysis (FA) and principal component analysis (PCA). Statistical tests such as Bartlett's test of sphericity, Kaiser-Meyer-Olkin (KMO) for sampling adequacy, and Cronbach's alpha test for internal consistency and scale reliability were performed to examine the suitability of the data for PCA and FA. Finally, multivariate logistic regressions were run to determine the associations between the identified factors and the insurance enrolment status. Results: The PCA identified seven perception factors while FA identified four factors. The quality of healthcare services, preferences (social beliefs), and accessibility to insurance scheme administration (convenience) were the most important factors identified by the two methods. Multivariate logistic regressions showed that the factors identified from the two methods differed somewhat in importance when considered as independent predictors of the enrollment status. The most important perception factors in terms of strength of association (odds ratio) and statistical significance were accessibility to insurance scheme administration (convenience), preferences (beliefs), and the quality of health care services. However, age and income were the only socio-demographic characteristics that were statistically significant. Conclusion: Household perceptions were found to influence households' decisions to enroll in CBHIs. Policymakers should recognize and consider these perceptions when designing policies and programs that aim to increase the enrolment into CBHIs.
Fagbokforlaget eBooks, Mar 17, 2022
Managerial and Decision Economics, 2021
Managerial and Decision Economics, 2019
Accreditation is increasingly important worldwide; however, some industries have higher accredita... more Accreditation is increasingly important worldwide; however, some industries have higher accreditation rates than others. We suggest a duopoly model to discuss how market characteristics affect the incentive for firms to seek accreditation. The discussion relates to the effects accreditation might have on the costs and demands in the markets, the degree of product differentiation (addressing both substitutable and complementary goods), type of competition (various Cournot and Bertrand games), and welfare for society. It follows that markets with high accreditation rates are either characterized by fierce competition (price competition in substitutable goods) or by a high degree of coordination (complementarity).
Fuel and Energy Abstracts, Nov 1, 1999
This paper concerns optimal emissions of greenhouse gases when catastrophic consequences are poss... more This paper concerns optimal emissions of greenhouse gases when catastrophic consequences are possible. A numerical model is presented which takes into account both continuous climate-feedback damages as well as the possibility of a catastrophic outcome. The uncertainty in the model concerns whether or not a future catastrophe will occur. However, the welfare losses imposed by such an outcome are assumed known to the decision-maker. An important result is that the possibility of a climate catastrophe is a major argument for greenhouse gas abatement even in absence of continuous damage. Special attention is given to analyses on the probability of a catastrophe and the pure rate of time preferences, and the implicit values of these parameters are calculated if the Rio stabilisation target is assumed to be optimal. Finally, the expected value of perfect information about the probability of the arrival of a catastrophe is estimated.
Economic analyses of sources of legal compliance mainly address the threat of formal penalties. F... more Economic analyses of sources of legal compliance mainly address the threat of formal penalties. Formal penalties are state-imposed and involve material or physical deprivations in the form of fines and incarceration. The other disciplines, however, especially psychology and sociology, go beyond the issue of formal penalties by discussing the role of informal ones in refraining individuals from certain socially unwanted acts. We define such informal penalties as either socially imposed (shame) or self-imposed (guilt). Socially imposed penalties include embarrassment or loss of respect that individuals might experience from significant others when they violate social norms. Such penalties also arise if one feels that he/she might be potentially judged by significant others for behavior that is inappropriate or immoral. Self-imposed costs, on the other hand, are feelings of guilt that arise when individuals offend their own conscience by engaging in behavior they consider morally wrong...
Background: Several countries including Tanzania, have established voluntary non-profit insurance... more Background: Several countries including Tanzania, have established voluntary non-profit insurance schemes, commonly known as community-based health insurance schemes (CBHIs), that typically target rural populations and the informal sector. This paper considers the importance of household perceptions towards CBHIs in Tanzania and their role in explaining the enrolment decision of households. Methods: This was a cross-sectional household survey that involved 722 households located in Bahi and Chamwino districts in the Dodoma region. A three-stage sampling procedure was used, and the data were analyzed using both factor analysis (FA) and principal component analysis (PCA). Statistical tests such as Bartlett’s test of sphericity, Kaiser-Meyer-Olkin (KMO) for sampling adequacy, and Cronbach’s alpha test for internal consistency and scale reliability were performed to examine the suitability of the data for PCA and FA. Finally, multivariate logistic regressions were run to determine the a...
Applied Economics, 2005
ABSTRACT The purpose of this paper is to analyse the impacts of adaptation to failing health. Thi... more ABSTRACT The purpose of this paper is to analyse the impacts of adaptation to failing health. This is done by integrating adaptation processes in a Grossman type of pure consumption model. Model simulations show that adaptation affects the health variables by lowering the incentives to invest in health, as well as smoothing the optimal health stock path over the life cycle. Whether or not the risk of mortality is an object of choice has important effects when studying adaptation, as well as for the joint development of the health variables.
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Papers by Sverre O Grepperud