Special Issue "The International Healthcare Industry Supply in a Changing Global Demand"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (30 July 2017).

Special Issue Editors

Prof. Dr. Stuart O. Schweitzer
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Guest Editor
UCLA Fielding School of Public Health, Department of Health Policy and Management, Torrance, USA
Prof. Dr. Marco R. Di Tommaso
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Guest Editor
1. Department of Economics and Management, University of Ferrara, Ferrara, Italy
2. School of Business Administration, South China University of Technology, Guangzhou, China
Dr. Manli Huang
E-Mail Website
Guest Editor
School of Business Administration, South China University of Technology, Guangzhou, China
Dr. Elisa Barbieri
E-Mail Website
Guest Editor
Department of Economics and Statistics, University of Udine, Udine, Italy

Special Issue Information

Dear Colleagues,

Aging of population is a topic of particular significance among the main economies of the world (US, Europe and China) stimulating a change in the structure and composition of domestic healthcare demands. In the case of China, the transformation is even more relevant and impressive: the healthcare demand is rapidly growing and changing because of the significant increase in the middle-income urban class. These dynamics are coupled with a dramatic change in the healthcare industry supply chain that is experiencing significant global reorganization, involving both manufacturing and R&D activities in emerging and mature economies.

This Special Issue focuses particularly on the evolution of the global supply of healthcare manufacturing and research commodities. We envisage to provide an introductory overview of the general trends of the changing global demand for healthcare, with emphasis on those induced by demographic dynamics—in particular, the aging population; to offer a comprehensive analysis of the changes in the global healthcare supply chain that may be generated by both public and private agents.

Specifically, the Issue intends to explore the structure, mechanisms and policies related to the healthcare industry in the US, Europe and China, investigating the interactions that characterize the international organization of production. In this context, we attribute a particular emphasis to a series of issues related to the global healthcare industry scenario, such as the rising competition in high value-added manufacturing and research between Western leaders (US and Europe) and China; the recent Chinese activism in promoting sectorial upgrading policies and international health research networks; and, finally, the increasing tendency on the part of market leaders towards subcontracting the low value-added productive activities to peripheral countries.

Subject Coverage

Topics include, but are not limited to, the following:

  • International Healthcare Changing Demands: The Scenario
  • Aging of population and the new demand for health in the US.
  • Aging of population and the new demand for health in Europe.
  • Aging of population, increase of income and the new demand for health in China.
  • Health Industry Global Supply Chain
  • Health industry manufacturing in Europe and the US.
  • China's entry in the global “Western Medicine” manufacturing and the TCM industry: Production, investments, mergers and acquisitions.
  • Emerging countries manufacturing in health: standard productions and subcontracting.
  • Science-based research in healthcare industries in the US, Europe and China.
  • Transnational research networks in health sectors: The US, Europe and China.

Prof. Stuart O. Schweitzer
Prof. Marco R. Di Tommaso
Dr. Manli Huang
Dr. Elisa Barbieri
Guest Editors

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Published Papers (8 papers)

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Research

Open AccessArticle
Estimation and Evaluation of Future Demand and Supply of Healthcare Services Based on a Patient Access Area Model
Int. J. Environ. Res. Public Health 2017, 14(11), 1367; https://doi.org/10.3390/ijerph14111367 - 10 Nov 2017
Cited by 1
Abstract
Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the [...] Read more.
Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM), which simulates patients’ access time to healthcare service institutions using a geographic information system (GIS). Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy. Full article
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Open AccessArticle
Restructuring the Production of Medicines: An Investigation on the Pharmaceutical Sector in China and the Role of Mergers and Acquisitions
Int. J. Environ. Res. Public Health 2017, 14(10), 1179; https://doi.org/10.3390/ijerph14101179 - 05 Oct 2017
Cited by 5
Abstract
In places like China, an ageing population coupled with changes in living standards and increases in disposable income, imply a shift of the demand for health-related goods and services which is likely to affect the whole organization of the industries that supply such [...] Read more.
In places like China, an ageing population coupled with changes in living standards and increases in disposable income, imply a shift of the demand for health-related goods and services which is likely to affect the whole organization of the industries that supply such goods and services at the global level. One of the industries most likely to be affected is the pharmaceutical sector. In the early 2000s China was already the second largest global producer of pharmaceutical ingredients. The pharmaceutical sector has become one of the most important industries promoted by the Chinese government and Five-Year Plan of China’s Strategic Emerging Sectors, mergers and acquisition (M&A) activity has been the key strategy to restructure the sector and increase its competitiveness. This paper firstly provides an updated picture of the evolution of M&As in the pharmaceutical sector, compared to other sectors, in China in the period 2005–2013. Secondly, we develop a composite indicator to measure the industrial performance of all Chinese industrial sectors over time, which allows us to assess the performance of the pharmaceutical industry compared to that of other sectors of the Chinese economy. Finally, we develop and estimate an empirical model that tests the relationship between the number of M&A in a sector and its performance, with a particular focus on the pharmaceutical case. The results offer some initial evidence of positive effects from the process of restructuring of the pharmaceutical sector in China. Full article
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Open AccessArticle
Simple vs. Complex Carbohydrate Dietary Patterns and the Global Overweight and Obesity Pandemic
Int. J. Environ. Res. Public Health 2017, 14(10), 1174; https://doi.org/10.3390/ijerph14101174 - 04 Oct 2017
Cited by 5
Abstract
Nowadays, obesity and being overweight are among the major global health concerns. Many, diet-related diseases impose high tangible and intangible costs, and threaten the sustainability of health-care systems worldwide. In this study, we model, at the macroeconomic level, the impact of energy intake [...] Read more.
Nowadays, obesity and being overweight are among the major global health concerns. Many, diet-related diseases impose high tangible and intangible costs, and threaten the sustainability of health-care systems worldwide. In this study, we model, at the macroeconomic level, the impact of energy intake from different types of carbohydrates on the population’s BMI (body mass index). We proceed in three steps. First, we develop a framework to analyse both the consumption choices between simple and complex carbohydrates and the effects of these choices on people health conditions. Second, we collect figures for 185 countries (over the period 2012–2014) regarding the shares of simple (sugar and sweetener) and complex (cereal) carbohydrates in each country’s total dietary energy supply. Third, we use regression techniques to: (1) estimate the impact of these shares on the country’s prevalence of obesity and being overweight; (2) compute for each country an indicator of dietary pattern based on the ratio between simple and complex carbohydrates, weighted by their estimated effects on the prevalence of obesity and being overweight; and (3) measure the elasticity of the prevalence of obesity and being overweight with respect to changes in both carbohydrate dietary pattern and income per capita. We find that unhealthy eating habits and the associated prevalence of excessive body fat accumulation tend to behave as a ‘normal good’ in low, medium- and high-HDI (Human Development Index) countries, but as an ‘inferior good’ in very high-HDI countries. Full article
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Open AccessArticle
Study of the Relevance of the Quality of Care, Operating Efficiency and Inefficient Quality Competition of Senior Care Facilities
Int. J. Environ. Res. Public Health 2017, 14(9), 1047; https://doi.org/10.3390/ijerph14091047 - 11 Sep 2017
Cited by 3
Abstract
The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care [...] Read more.
The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities. Full article
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Open AccessFeature PaperArticle
Determinants of FDI Localization in China: A County-Level Analysis for the Pharmaceutical Industry
Int. J. Environ. Res. Public Health 2017, 14(9), 985; https://doi.org/10.3390/ijerph14090985 - 30 Aug 2017
Cited by 3
Abstract
Foreign direct investments (FDIs) have been widely recognized as a crucial feature of the Chinese industrial development process. Over the past decades, China has been attracting huge amounts of inward FDIs as a consequence of both spontaneous market dynamics and place-based preferential policies [...] Read more.
Foreign direct investments (FDIs) have been widely recognized as a crucial feature of the Chinese industrial development process. Over the past decades, China has been attracting huge amounts of inward FDIs as a consequence of both spontaneous market dynamics and place-based preferential policies at the sub-national level. However, the Chinese market exhibits large dissimilarities in terms of FDI localization across territories that are worth investigating at a more disaggregated level. In this regards, our study explores the determinants of attraction of inward FDIs in China, at the county level. It focuses on the pharmaceutical industry and attempts to assess whether factors related to location advantages, agglomeration dynamics, information cost effects and environmental regulation costs affect foreign firms’ localization choices as well as invested amounts in that location. By means of discrete choice models, our paper confirms the findings of the prevalent literature about the positive effects of location advantages on pharmaceutical FDI attraction. Different from our expectations, a higher proportion of foreign enterprises do not stimulate significant effects on FDI localization, while preferential policies and sectoral agglomeration are positively correlated with the localization of pharmaceutical foreign firms. Finally, our results suggest that investing firms tend to avoid areas with strict environment regulation. Full article
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Open AccessFeature PaperArticle
Pharmaceutical Industry in Vietnam: Sluggish Sector in a Growing Market
Int. J. Environ. Res. Public Health 2017, 14(9), 976; https://doi.org/10.3390/ijerph14090976 - 29 Aug 2017
Cited by 9
Abstract
Vietnam is a fast growing economy in the Asian region with a significantly high population (over 92 million in 2015). Although still expanding (about 1.1% on average during 2000–2015), the Vietnamese population is considered to be entering the ageing stage at a very [...] Read more.
Vietnam is a fast growing economy in the Asian region with a significantly high population (over 92 million in 2015). Although still expanding (about 1.1% on average during 2000–2015), the Vietnamese population is considered to be entering the ageing stage at a very high rate. The rapid expansion of the middle-income urban class and the ageing people ratio have dramatically pushed up the demand for healthcare goods, particularly in terms of pharmaceutical products. Since the early 1990s the government has addressed the necessities of rising demand for healthcare products by formulating a series of policies aimed at promoting the development of the pharmaceutical industry. However, the implementation of such policies does not seem to have been completely efficient given that the country still needs to import up to 90% of its pharmaceutical consumption. This paper aims to explore the development of the pharmaceutical industry during the years 1990–2015 and to identify a series of weaknesses in the government promotion of the industry. Future developments will also be discussed on how the Vietnamese pharmaceutical industry could increase its participation in the regional supply chain, which is currently being dominated by big players like India and China. Full article
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Open AccessFeature PaperArticle
Transnational Research Networks in Chinese Scientific Production. An Investigation on Health-Industry Related Sectors
Int. J. Environ. Res. Public Health 2017, 14(9), 975; https://doi.org/10.3390/ijerph14090975 - 29 Aug 2017
Cited by 2
Abstract
Transnational research networks (TRN) are becoming increasingly complex. Such complexity may have both positive and negative effects on the quality of research. Our work studies the evolution over time of Chinese TRN and the role of complexity on the quality of Chinese research, [...] Read more.
Transnational research networks (TRN) are becoming increasingly complex. Such complexity may have both positive and negative effects on the quality of research. Our work studies the evolution over time of Chinese TRN and the role of complexity on the quality of Chinese research, given the leading role this country has recently acquired in international science. We focus on the fields of geriatrics and gerontology. We build an original dataset of all scientific publications of China in these areas in 2009, 2012 and 2015, starting from the ISI Web of Knowledge (ISI WoK) database. Using Social Network Analysis (SNA), we analyze the change in scientific network structure across time. Second, we design indices to control for the different aspects of networks complexity (number of authors, country heterogeneity and institutional heterogeneity) and we perform negative binomial regressions to identify the main determinants of research quality. Our analysis shows that research networks in the field of geriatrics and gerontology have gradually become wider in terms of countries and have become more balanced. Furthermore, our results identify that different forms of complexity have different impacts on quality, including a reciprocal moderating effect. In particular, according to our analysis, research quality benefits from complex research networks both in terms of countries and of types of institutions involved, but that such networks should be “compact” in terms of number of authors. Eventually, we suggest that complexity should be carefully taken into account when designing policies aimed at enhancing the quality of research. Full article
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Open AccessArticle
Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China
Int. J. Environ. Res. Public Health 2017, 14(4), 356; https://doi.org/10.3390/ijerph14040356 - 29 Mar 2017
Cited by 4
Abstract
This study aims to examine whether the urban elderly in the Zhejiang Province of China signed contracts with their general practitioner (GP) based on their health service needs, and to further identify the determinants of their demand and signing decisions. A community-based cross-sectional [...] Read more.
This study aims to examine whether the urban elderly in the Zhejiang Province of China signed contracts with their general practitioner (GP) based on their health service needs, and to further identify the determinants of their demand and signing decisions. A community-based cross-sectional study was conducted in 16 community health service (CHS) institutions in Zhejiang Province, China. The urban elderly over 60 years of age were enrolled when visiting the sampled CHS. Baseline characteristics were compared between participants using Chi-Square tests for categorical variables. Univariate and multivariable logistic regression analyses were used to identify determinants of the GP contract service demand and signing decisions, respectively. Among the 1440 urban elderly, 56.67% had signed contracts with their GP, and 55.35% had a demand of the GP contract service. The influencing factors of demand were a history of diabetes or cardiovascular disease (OR = 1.33, 95% CI, 1.05–1.68); urban resident basic medical insurance (URBMI) vs. urban employee basic medical insurance (UEBMI) (OR = 1.96, 95% CI, 1.46–2.61); and middle-income vs. low-income (OR = 0.67, 95% CI, 0.50–0.90 for RMB 1001–3000; OR = 0.59, 95% CI, 0.39–0.90 for RMB 3001–5000). Having a demand for the GP contract service was the strongest determinant of signing decisions (OR = 13.20, 95% CI, 10.09–17.27). Other factors also contributed to these decisions, including gender, caregiver, and income. The urban elderly who had signed contracts with GPs were mainly based on their health care needs. Elderly people with a history of diabetes or cardiovascular disease, as well as those with URBMI, were found to have stronger needs of a GP contract service. It is believed that the high-income elderly should be given equal priority to those of low-income. Full article
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