Unbiased Analysis of Today's Healthcare Issues
There is an interesting article (“Unintended Consequences“) from February 2000 edition of the New England Journal of Medicine in which author Dr. Lawrence Casalino gives his view of how measuring physician quality impacts care. Dr. Casalino cites many unintended consequences of implementing an quality measuring system including 1) more paperwork, 2) the fact that certain…
Why is it taking so long for the medical industry to adopt information and communication technology? Is it a good thing that it is taking so long? This is the question addressed by an interesting and non-technical NBER working paper by Michael Christensen and Dahlia Remler (“ICT in Chronic Disease Care“) What is Information and…
Pay-for-performance or health care quality report cards are the latest fad in medicine. Different types of report cards, however, measure different things. Eve Kerr and co-authors investigate (‘Quality by any other name?’) how different quality measures compare against each other. The authors look at 3 types of physician review: Implicit Review: This involves using ‘subjective’…
Which hospitals are the innovators of 2007? Joe Paduda points us to to the Fierce Healthcare website which lists the top 10 hopsital innovators of 2007. Two of the top ten include St. Joseph’s Hospital in West Bend, WI and Cedars-Sinai Medical Center in Los Angeles. Mr. Paduda is not overly impressed by the innovation…
To follow up on Monday’s post, I take a few quotations from Rachel Werner and David Asch’s paper (“The Unintended Consequences“) in the March 9, 2005 edition of JAMA. First, I look at the unintended consequence of coronary artery bypass graft (CABG) report cards in a number of U.S. states: In Pennsylvania, which also introduced…
Are quality based incentive programs the solution for improving physician quality without increasing cost? While I believe that measuring quality is an important avenue by which quality can be improved, it is not a magic bullet. A study by Gilmore, et al. (HSR 2007) looks at a pay-for-performance scheme developed in Hawaii. The authors look…
The National Committee for Quality Assurance (NCQA) is a “not-for-profit organization dedicated to improving health care quality.” One of their major initiatives is the Health Plan Employer Data and Information Set (HEDIS) which aims to evaluate the quality of care offered by various health plans. In a 2001 NBER working paper (“Learning…“), researchers Michael Chernew,…
Last month’s Wall Street Journal (“Faltering Family MDs get Technology Lifeline“) has an interesting article about how small-practice physicians are using technology as a weapon against the economies of scale which physicians working for large-scale practices enjoy. The article tells the story of Dr. Gordon Moore. When he worked at a large, hospital-owned medical practice,…
Child mortality from unintentional injury or accident has been dropping over the last thirty years. Among children under 5, accident rates resulting in death have fallen from 44 deaths per 100,000 population in 1960 to 18.6 deaths per 100,000 in 1990. For children aged six to twelve years old, the analogous fall is from 19.6…
“Cancer cured with soothing balmy oils.” Appeal to Reason “According to this repeated nationwide survey, more doctors smoke Camels than any other cigarette.” – TV ad Regarding patent medicine sold at the end of the nineteenth century: “…the medicines were ineffectual. Some of the syrups contained as much as 80 per cent alcohol; many of…