Unbiased Analysis of Today's Healthcare Issues
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…
A few months ago, I wrote about what marginal structural models (MSM) were and why one should consider using them in cases where the treatment of interest or confounders vary over time. I linked to how to implement this with statistical programming languages as well. The original paper that developed MSM actually has a very…
A policy paper by the HHS describing proposals to promote choice and competition in health care. Before getting into policy recommendations, however, it outlines how increased provider consolidation has lead to less choice. One recent study by Gaynor et al. …found that the mean HHI [Herfindahl-Hirschman Index] across MSAs in the inpatient hospital industry increased…
I recently started reading a fascinating book Reputation and Power: Organizational Image and Pharmaceutical Regulation at the FDA by Daniel Carpenter. As I read through it, I will be highlighting interesting points throughout. One key point is that while the Food and Drug Administration (FDA) regulates pharmaceuticals in the US, how it does so influences…
The the health and economic of serious mental illness (SMI) is often overlooked by the health policy and some provider communities. One key question is how how can we quantify the economic burden of SMI. Further, how can we reduce this burden. Much of my research has looked at how medications can improve health and…
Bayesian analysis is increasingly common in health economic research. To apply Bayesian models, however, you need to select a prior distribution. How do you select your prior? Andrew Gelman (of the excellent Statistical Modeling, Causal Inference, and Social Science blog) provides some advice on selecting a prior on the stan-dev GitHub website. I review some…