Problems with Risk Adjustment

To evaluate providers based on the health outcomes or the cost of care, one must attempt to evaluate dimensions of care which are strictly within the providers control. For instance, if a physicians treats two patients with breast cancer, but one patient has a more advanced form of breast cancer, one should take this difference…

Medicare Managed Care vs. FFS Beneficiaries: Who receives better care?

Do Medicare beneficiaries in fee-for-service plans access better physicians than those in Medicare Managed Care (MMC) plans?  Huesch (2010) attempts to answer this question for beneficiary access to quality cardiologists.  Using data on heart patients without AMI in Florida, the authors observes the following results: “No evidence was found that Medicare payor type significantly influenced…

The Drunkard’s Walk

The Drunkard’s Walk is not about drinking.  Instead, as the subtitle states, the book discusses ‘How Randomness Rules our Lives.’  Although I personally didn’t enjoy this book, I highly recommend it to most people. There are two categories of people who should not read this book: economists (me) statisticians, or mathematicians.  These people will likely…

A Thanksgiving Post

In October 1789, President George Washington declared his support for a day of “public thanksgiving and prayer to be observed by acknowledging with grateful hearts the many signal favors of Almighty God.” Today, Thanksgiving is a time to give thanks for the many blessings you have in your life. In a time where cholera has…

Defining a Hospital Catchment Area

From what areas does a hospital draw on to fill its beds?  There have been many attempts to define a hospital’s catchment area.  The Dartmouth Atlas Group uses hospital referral regions (HRRs) and hospital service areas (HSAs). One method is to determine a minimum admission rate for a given geographic unit (e.g., county, census tract,…

Does the TSA stop terrorist attacks?

An article on Slate wonders “Does the TSA Ever Catch Terrorists?”  An excerpt: “The aforementioned “behavioral detection program,” also known as SPOT (Screening of Passengers by Observational Techniques), has been one of the TSA’s most roundly criticized initiatives. In May, the Government Accountability Office released a report noting that SPOT’s annual cost is more than…