Time-study research on maxillofacial prosthetic treatment

Unreasonable medical fees can cause problems such as increased medical costs, greater medical disparities, decreased medical standards, and physician shortages. To prevent such problems, it is important to set appropriate medical fees, ensure their proper use, and improve the efficiency of medical care. The treatment of patients with maxillofacial defects is generally more expensive compared with general prosthodontic treatment because it involves more materials and requires more frequently follow-ups for longer period. However, the actual time required for maxillofacial prosthetic treatment is unclear. Therefore, in this study, we aimed to clarify the amount of time spent treating maxillofacial prosthetic patients. We analyzed clinical data from patients undergoing routine maxillofacial prosthetic treatment, irrespective of difficulty level, at 8 university hospitals and 2 dental clinics. We also collected data from maxillofacial prosthodontists on the treatment time required for various Japanese health insurance items, including the fabrication of maxillofacial prostheses. The results revealed that some aspects of maxillofacial prosthetic treatment may take longer to perform and are more costly to perform than previously thought, suggesting the need for some adjustments to the health insurance reimbursement system. Maintaining an appropriate balance between expenditures and fees will greatly benefit patients and physicians, ensuring positive health outcomes and a healthy society.

Inter-regional patient mobility in decentralised Spain: Explaining regional budget imbalances

Inter-regional patient mobility represents both a resource and a challenge for the organization and financing of health systems, particularly in decentralised countries. We use cross-sectional time series regression analysis to test the determinants of imbalances in regional funds to finance inter-regional patient mobility for the 17 Spanish regions for the period 2014-2020. The findings indicate that highly specialised health centres and bilateral agreements partly explain the budget imbalance from inter-regional patient referrals, while local tourism partly explains the budget imbalance from non-referred patient mobility. Developing effective national schemes to compensate net patient recipient regions would be fundamental to addressing territorial imbalances.

The national accounting paradox: how statistical norms corrode international economic data

The transnationalization and digitization of economic activity has undermined the quality of official economic statistics, which still center on national territories and material production. Why do we not witness more vigorous efforts to bring statistical standards in line with present-day economic realities, or admissions that precision in economic data has become increasingly illusive? The paradoxical answer, we argue, lies in the norms underpinning global statistical practice. Users expect statistics to draw on unambiguous sources, to allow for comparison over time and across countries, and they prize coherence-both internally and with holistic macroeconomic models. Yet as we show, the ambition of the transnational statistical community to meet these norms has in fact undermined the ability of economic data to represent economic life more faithfully. We base our findings on interviews with two dozen leading statisticians at international economic organizations, archival research at the International Monetary Fund and a thorough review of debates among statistical experts.

Debt and development in historical perspective: The external constraints of late industrialisation revisited through South Korea and Brazil

Current debates about the role of external finance in development mostly overlook the insights from early development economics that late industrialisation generates a structural tendency to run trade deficits, thereby exacerbating rather than relieving external foreign exchange constraints. The developmental role of external finance is therefore based on its strategic marginal contribution to relieve such constraints. External debt in particular also allows countries to pursue industrial strategies without reliance on foreign direct investment. These insights are revisited in this paper as a critical input to both mainstream and heterodox contemporary scholarship on debt and development. While the mainstream generally avoids discussion of state-led industrial policy, the heterodox has converged on a view that developing countries should avoid external finance. The contrasting external account histories of South Korea and Brazil are examined to demonstrate the validity of the classic insights and the contemporary fallacies. While the South Korean case speaks much to its geopolitical context, this does not necessarily refute the principle that post-war late development engenders an intensive demand for external finance, which must be met if industrialisation strategies are not to be stymied, as in the case of Brazil, no matter how effectively domestic strategies are conceived and implemented.