Hospitalists emerging role

Generalists can give holistic, cost-effective care to patients, but may be limited in their ability to treat complex diseases.  Specialist may offer a superior quality of medical services and advance knowledge in their field, but this premium medicine comes at a high cost.  Generalist or specialist…Specialist or generalist…which to chose?   A 1996 New England Journal of…

Information asymmetry, insurance and the decision to hospitalize

There is a dynamic relationship between generalists and specialists.  Currently, 4.5% of visits to PCPs result in a referral.  A RAND study and my own investigation of the 1998-1999 Community Tracking Survey show that about 10% of individuals are hospitalized at least once each year.  How should we model the decision patients face between generalist and specialist care.…

Disproportionate Stratified Sampling

Many data sets that social scientists come across use disproportionate stratified sampling. If a subpopulation is small, the survey designers may want to oversample this group. For example, in the Survey of Income and Program Participation (SIPP) poor individuals are oversampled and in the Community Tracking Study (CTS) uninsured individuals are oversampled in order to…

The upcoming stock market crash?

In 5 years, the oldest baby boomers will hit 65 years old.  As the boomers begin to retire, this enormous cohort will start to sell off their financial assets in order to finance consumption in their non-working years.  One begins to wonder if there will be a stock market crash since equities demand may drop significantly. …

Phree Trade for Pharmaceuticals

The Envisioning 2.0 (“Drug Importation“) speaks to the fact that the FDA has consistently tried to prohibit the importation of drugs from abroad, despite the fact that drug importation has broad popular support.  Further the post cites a USA Today report which says that the US (but not Canada) has a serious drug counterfeiting problem. 

Mandatory Vaccines in Michigan

Seven hundred twenty million dollars.  This would the the annual cost to immunize all girls against the human papilloma virus (HPV).  According to the Detroit Free Press (“Law…“), the state of Michigan is considering requiring all girls entering the sixth grade to receive the HPV vaccine.  Is this good policy? Cervical cancer affects 9,700 women…

Hospitals Negotiating Leverage

In the early- and mid- 1990s, hospitals were under pressure.  Managed care was taking off and forcing hospitals to reduce prices.  These managed care plans had the upper hand because: Competition between hospitals was intense.  Each hospital had to fight to secure contracts from managed plans in order to direct large chunks of patients to their…

Poisson Distribution Estimation

The Poisson distribution is one that is often used in health economics.  Wikipedia has a nice basic summary of the Poisson distribution; Wolfram MathWorld gives a more sophisticated analysis.  The distribution is where ‘λ‘ is equal to the number of expected occurrences in a period.  The distribution expresses the probability of a number of events…