Unbiased Analysis of Today's Healthcare Issues
Economic theory would say that in normal markets, the answer is yes. When prices are widely known, suppliers can compete on prices–as well as quality–and markets become more efficient. In the health care setting, however, a key question is ‘which price’? For hospital services, patients are the ultimate consumers of the service and do pay…
At least that is the finding from a study in the UK from Parkinson et al. (2019): We investigate hospital responses to a 32% increase in price for two treatments in emergency departments in England in April 2011 using data on 11,532,304 attendances (79 hospitals) between 2009/2010 and 2013/2014. We compare changes in the volumes…
Value measurement using cost-effectiveness analysis (CEA) is one of the core stables of health economic research. CEA often uses quality adjusted life years (QALYs) to capture how a treatment affects a patients mortality and morbidity. CEA makes explicit assumptions about the tradeoffs between mortality and morbidity by assuming these are additive. Further, this approach, however,…
The answer may be ‘yes’. Since immigrants make up a disproportionate share of health care workers–particularly for the elderly–restricting the number of immigrants may lower the quality and increase the cost of health care in the U.S. That is the finding of a recent study by Zallman et al. (2019) in Health Affairs: Using nationally…
It appears that not only does your friend’s behavior affect your behavior, but your perception of their behavior–independent from their actual behavior–affects your behavior. Want a concrete example of this? A paper by Amialchuk et al. (2019) finds the following: Using a nationally representative dataset, we estimate the effect of misperception about friends’ alcohol, smoking,…
An interesting white paper on how to demonstrated value to payers when examining gene therapies has hit the presses. My colleagues Jeremy Schafer, PhD, and Alexander Grosvenor, PhD have written a guide to help you: Understand the disparities between payer and manufacturer expectations for long-term outcomes Determine which elements of treatment are included in the…
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…
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 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…