Unbiased Analysis of Today's Healthcare Issues
A number of studies have claimed that increased health expenditures may result in no better, or even worse outcomes. For instance, a paper by Fisher et al. (2003) looking at patients with acute myocardial infarction, colorectal cancer, or hip fracture finds that “Quality of care in higher-spending regions was no better on most measures 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…
How do you measure the quality of care patients with cancer receive? How long they live? Avoiding side effects? Patient satisfaction? Process measures? Further, there are multiple types of cancer and different cancer have different recommended treatments and methods of providing care. To further complicate the issue, new cancer treatments are being introduced in rapid succession;…
There have been a number of studies that have examined how publicly reporting quality ratings (for health plans, physicians, hospitals or other health care providers) affects market share. Less attention has been paid to the effect of measured quality on health care prices. A paper by Huang and Hirth (2016) aim to answer just this…
Medicare aims to tie 90% of reimbursement to quality measures. The potential for quality-linked reimbursement to incentivized improved quality of care, however, depends critically on whether physician quality can be measured reliably. Profiling individual physicians is difficult. Sample sizes are small and attributing patients to a single physician can be difficult (as Mehtrotra et al. 2010…
Maybe not. That is the answer from a study by Thompson et al. (2016). Using data from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) for six states (AR, FL, IA, MA, NY,WA) from 2011 to 2013, the authors measure hospital performance reliability for the Hospital Readmission Reduction Program (HRRP). The define reliability as follows:…
Many people have feared that robots, computers, and other forms of technology will take people’s jobs. Conventional wisdom holds that healthcare workers have been largely immune from these technological changes to date. However, a new paper from Lu, Rui and Seidmann examines whether technological advances–specifically computerized provider order entry (CPOE)–affects employment at nursing homes. Using…
The Incidental Economist is one of my favorite blogs to read. This week’s post on a recent BMJ article on the failure of P4P did not disappoint. The article (Figueroa et al. 2016) looks at 4267 acute care hospitals in the United States that participated in Medicare’s Hospital Value Based Purchasing (HVBP) system. During my time…
Is it a bargain? Or do low prices represent low quality? Or is cost independent of quality? To try to answer this question Phillips, Schleifer, and Hagelskamp (2016) conducted a nationally representative survey to investigate whether consumers believe that price and quality are associated. They found that: Most Americans (58–71 percent, depending on question framing) did not think that…
There has been a shift towards making quality data publicly available for patients to examine when choosing physicians. A commentary by Burns et al. (2016) finds that there is mixed evidence regarding whether making surgery-related mortality data publicly available improves patient outcomes (see table below). Article Time Period Country Participants Key Findings Hannan 1994 1989-1992 US NY State cardiac…