Unbiased Analysis of Today's Healthcare Issues
Diarrheal disease is a leading cause of childhood mortality in many developing countries. The best treatment when diarrhea strikes is to give the patient Oral Rehydration Solution (ORS). Who provides better care for this disease, public or private providers? A paper in Health Economics by Waters, Hatt and Black (2008) looks at data from the…
An interesting article (“Sudden Death…“) at the Covert Rationing blog addresses the poor care given to cardiac patients in hospitals. Dr. Rich states that: “…hospitalized patients who have cardiac arrest (sudden loss of cardiac function due to the onset of a heart arrhythmia known as ventricular fibrillation) are often not receiving defibrillation (an electrical shock…
There has been a recent trend for more and more surgeries to take place in ambulatory surgery centers (ASCs). In fact according to the Medicare Payment Advisory Commission, in 2004 up to 70% of surgeries took place in these ASCs. Do ASCs offer better quality surgical procedures than Hospital Outpatient Departments (HOPD)? ASCs may be…
Doctors are often perceived as benevolent professionals. They are hard-working individuals who extend their largesse by giving away free medical care to those in need. Studies by Cunningham and May (2006) and the American Hospital Association find that doctors provide uncompensated care equal to 6.3% or 5.6% of their cots annually respectively. A recent Journal…
A New Yorker article (“The Checklist“) recounts Peter Pronovost’s efforts to improve the delivery of medical care. One of his simplest ideas was to invent a 5 step checklist to reduce line infections: Doctors are supposed to (1) wash their hands with soap, (2) clean the patientâs skin with chlorhexidine antiseptic, (3) put sterile drapes…
A paper by Alexander S. Preker and April Harding at the World Bank analyze the roles of the public and private sector in health care. One of the more interesting portions discusses medical care financing using some examples from ancient history. “Ideological views on the roles of the state and the private sector belong to…
Economists and health researchers have generally shown that when doctors are paid on a fee-for-service basis, they will advice the patient to undergo more medical procedures than when the doctor is paid on a capitation or salaried basis (see my own paper: “Operating on Commission“). Which payment method maximizes welfare has not been proven and…
“On the biggest shopping weekend of the year, you’ll know the price of the big-screen TV and the Wii you’re about to buy – but you’ll likely be in the dark about the cost of any health care you need.” Two Wisconsin state senators are trying to change this. The Milwaukee Journal Sentinel (“…Health cost…
I recently read a Health Affairs article analyzing a pay-for-performance (P4P) demonstration. The Local Initiative Rewarding Results (LIRR) demonstration in California involved seven Medicaid-focused health plans in California between 2003 and 2005. Here are some of my most recent thoughts on P4P: The article seemed to show that P4P worked best when there was much…
Arnold Kling of the EconLog site has some commentary on P4P when discussing Tim Hartford’s latest book (“The Logic of Life“). I have a very different approach to compensation. I think that the key is to change compensation schemes frequently. The reason is that any scheme can be gamed, and the longer you wait to…