Unbiased Analysis of Today's Healthcare Issues
Cost effectiveness and quality analysis of the treatment of cancer has long been a goal of health services researchers. In particular, researchers aim to determine whether various treatments provide cost-effective methods to improve longevity and quality. Physicians, however, use different treatments depending on the patient’s cancer stage. Although most cost-effectiveness researchers want to take into…
Medicare administrative data provides a rich source to conduct health services research. Researchers who wish to use this data, however, often have to restrict their sample population in order to have a similar types of patients and consistent data available. Today I review some popular methods to restrict Medicare samples for research use. Restrictions to…
Medicare spending changes over time for multiple reasons. First, for any cohort of individuals, these individuals the age as time passes. As their age increases, expected medical expenditure will also rise. Second, the individual will likely received different medical services as the standards of care change over time. The standards of care can change…
Oftentimes, researchers use dummy variables to determine how observations classified into different categorical groups affect the dependent variable of interest. One drawback with this approach is using too many dummy variables can create small cell sizes, creating an identification problem. Alternatively, using broad groupings for dummy variables may give the appearance that the effect of…
How can you estimate an individual’s total lifetime cost of medical care? For people who die in your sample, this is simple. In most data sets, however, not all individuals will die during the period of observation. Thus, the data set is censored for those who do not die. In addition, many standard hazard models…
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…
The Problem Many times, researchers wish to transform the dependent variable of a regression in order to estimate parameter values. Performing the transformation, however, complicates the calculation of the expected value of the dependent variable on the untransformed scale. Assume, the Yi is the dependent variable. Assume the function g is used to transform the…
Many states rely on managed care organizations (MCOs) to provide medical services for their Medicaid beneficiaries. Contracting out medical services to private providers relies on the government’s capacity to accurately predict expected cost of care for each beneficiary. This is typically done through risk-adjusted capitation rates. Which risk adjustment strategy works best? The answer of…
Asymptotic theory has played a large role in the development of many recent econometric methods. For instance, the central limit theorem states that distribution of the mean drawn from any large samples is approximately normally distributed. Asymptotic theory, however, generally assumes that sampling occurs infinitely and with replacement. In the real world, populations are not…
Is an average always the best estimate? Let us say that we are evaluating physician quality. Does a physician’s average score across patients (or episodes of care) best represent their true quality level? Stein’s paradox says that when we are evaluating the true quality value for a number of doctors, we can do better than…