Medicare Spending per Beneficiary

Medicare’s Hospital Compare website evaluates hospital quality.  One of the most recent measures to be added to Hospital Compare is a measure of efficiency.  The measure calculates a price-standardized, case-mix adjusted measure of spending during period before, during and after a hospital admission. The Healthcare Economist (Jason Shafrin) and a team at Acumen (including Tom…

Is America’s Cancer Care World Class?

U.S. life expectancy after cancer diagnosis is higher than that those for ten European countries.  A recent study in Health Affairs cites these statistics as evidence that the more expensive treatments American physicians employ is worth it. “We found that US cancer patients experienced greater survival gains than their European counterparts; even after considering higher US costs, this investment…

The Decline of Mental Hospitals, 1950s

The movement of mental health care from mental hospitals to treatment in outpatient settings and nursing homes  began in the 1950s.  Here is how it happened. “The field of medicine where the ‘rediscovery of community’ found an immediately welcome reception was mental health services.  A movement away from mental hospitals had already begun in the…

Thursday Links

Is rationing gaining acceptance? New Hampshire bill prohibits health exchanges. Does increasing the number of nurses improve hospital care? U(h,w) = h · log(w). SF-8 vs. SF-36. Is customized drug prescribing on the horizon? Getting fired for biopsying Warren Buffet’s prostate. Plus… Jennifer Salopek and Sarah Sonies have posted Health Wonk Review: Shiny Happy (Mostly)…

Why is end-of-life spending so high?

The answer is because using more intensive services does reduce mortality. This is the finding of a recent JAMA paper. After controlling for patient case mix, the authors examine variation in hospital spending in the last year of a patient’s life. The authors note that “Higher-spending hospitals differed in many ways, such as greater use…

The Downside of Concentrated Health Care Markets

Many recent healthcare policies aim to consolidate the provision of medical services.  For instance, Accountable Care Organizations consolidate providers with the goal of providing seamless, integrated patient care.  Consolidation can increase efficiency and (potentially) drive down prices.  If a market is highly concentrated, however, problems in a single supplier can lead to shortages.  Consider the…

Home Births: Feminists vs. OB/GYNs

Why aren’t physicians more supportive of home births and midwifery?  The answer is that it eats into their market share and reduces their income. “[In the 1970s] feminists argued that medical care needed to be demystified and women’s lives demedicalized.  They maintained that childbirth was not a disease and normal deliveries did not require hospitalization…