Unbiased Analysis of Today's Healthcare Issues
A paper by McDermott et al. (2019) examines how primary care services are commissioned in the United Kingdom under the National Health Service (NHS). Interestingly, the study provides a nice overview of the history of GP contracting in the UK as well. An excerpt is below. The current primary care system in England, whereby GPs…
To answer this question, one can examine how individuals choose health plans based on premiums, expected out of pocket cost, plan quality, and other factors. A paper by Abaluck and Gruber (2011) use data from 2006 and find that up to 70% of seniors appear to choose plans that are not optimal. Do these conclusions…
Health Utility Book (HUB) Can doctors talk teenagers out of risky drinking? Impact of physician disclosures on patient trust. Quadratic voting in practice. Why doctors don’t like email.
Does a treatment improve patient health? Does a policy intervention improve quality of life? Does more education increase income? These are fundamental questions that are difficult to answer with standard observational approaches. The reason? Selection bias. Patients who are sick take medicine; patients who are sicker may take more medicine. Thus, one could observe that…
Is caregiving by family members superior to paid home health caregiving? According to a paper by Coe et al. (2019), the answer is ‘yes’. We find that some family involvement in home‐based care significantly decreases health‐care utilization: lower likelihood of emergency room use, Medicaid‐financed inpatient days, any Medicaid hospital expenditures, and fewer months with Medicaid‐paid…
If you work in research, you may have heard that you need to worry about confounding. But what is confounding? And how can you address the problems it causes. What is confounding? An example Let us say that you are interested in the effect of an Ivy League education on a child’s long-term income. You…
The National Institute for Health Care Management (NIHCM) has some nice slides describing trends in hospital consolidation. First, we see a trend of increased hospitalizations over time. Further, these mergers are not small. In 49% of cases, the acquired (i.e., smaller) hospital has revenue of >$100m and in 19% of cases the acquired hospitals has…
An interesting article in Value in Health reviews how HTA bodies have (or have not) required testing for violation of the proportional hazards assumption. The Academic Health Economists Blog describes why simply assuming proportional hazards is a bad idea and reviews the Monnickendam et al. (ViH 2019) article: If you are an HTA body…[testing for…
P4P fail. Alexa is HIPAA compliant. NHS gender pay gap increases. The importance of at-home caregivers. Is hospital quality unidimensional?
The patient-physician relationship is one built on trust. Physicians will advise patients of treatment options and patients will weigh their own preferences and thoughts against the physician’s recommendations. If you trust your physician, you probably will follow their recommendations more frequently; if you do not trust them, you may side with your gut instinct more…