Unbiased Analysis of Today's Healthcare Issues
Patients assigned to different primary care providers in the US have different levels of spending. This is not surprising, but to what degree is this result driven by variation in health care utilization compared to prices? A paper by Mehrotra et al. (2023) aims to answer this question using 2018 claims data from a large…
Based on one study from Sweden, the answer is ‘no’. A paper by Johansson and Svensson (2022) use data from Sweden on regional variation in drug spending. First, some background on the Swedish approach for prescription drugs spending. The Swedish national health service offers universal coverage for all residents. The system is decentralized in 21…
How do you define if an area is rural? A paper by Bennett et al. (2019) provides some options. Population density. This is one of the simplest approaches and can be applied to any geographic unit. However, it may be problematic for geographic units with a mix of urban and rural sections. MSA-based. The Office…
Access to physician services and pharmaceuticals is vital–particularly among patients with serious mental illness–to insure patients receive the care they need. However, the likelihood patients receive this care depends on where they live. A paper by Manchester (2018) examines a cohort of patients eligible for both Medicare and U.S. Social Security Disability Insurance (SSDI) and…
Quality of care often is seen as how physicians and other health care providers treat patients with a given disease. Accurately diagnosing the disease a patient has, however, is in almost all cases a necessary condition to provide high-quality treatment. Nevertheless, a physician’s ability to accurately diagnose a disease is rarely measured within exsting quality…
Are urban or rural physician practices more likely to adopt electronic medical records (EMR)? The answer is suprrising. A paper by Whitacre (2016) finds the following: Overall practice-level EMR adoption rates generally increase with the degree of rurality and range from 47 percent in the most urban counties to over 60 percent in the most…
Consumer Reports‘ “Choosing Wisely” initiative aims to identify high-cost, low-value treatments that can often be avoided. One question remains is why do providers still offer these services? Do payer coverage policies or reimbursement rules affect these choices? A paper by Colla et al. (2017) attempts to answer that question. The authors used commercial payer claims data…
This is the title of my latest article in JMCP co-authored with Arijit Ganguli, Yuri Sanchez Gonzalez, Jin Joo Shim, and Seth A. Seabury. The paper’s abstract is below. BACKGROUND: There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best…
How do health care costs vary across the country. Although the team at the Dartmouth Atlas has done this exercise with patients in Medicare, there has been less study of region variation in health care spending among the privately insured with the notable exception of a 2013 Institute of Medicine report. In a study by…
According to an HSR editorial by Stephan Arndt, the answer is not very. Generally, county level health rankings are too variable to be of much use. Further, while some metropolitan regions may have large sample sizes, the sample sizes in less densely populated rural counties will be far lower leading to less precise estimates of any…