Does more spending improve outcomes?

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…

Are expensive cancer drugs worth the money?

A paper by Sebastian Salas-Vega and Elias Mossialos attempts to answer this question looking at nine countries (Australia, Canada, France, Germany, Italy, Japan, Sweden, the United Kingdom, and the United States) using data between 2004 and 2014.  They find that: All nine countries—most notably France and Japan—witnessed an improvement in neoplasm-related years of potential life lost,…

Health care cost rising by almost 10%

Many times I have been asked whether the Affordable Care Act is a good thing.  The 1 sentence answer is: “Yes, because it expands health insurance coverage to more Americans, but no because it adds many layers of regulation and does little to slow cost growth.”  This last point is rearing its ugly head.  Sally Pipes…

Does Increased Hospital Spending Reduce Mortality?

According to Romley, Jena and Goldman (2011), the answer is yes. For each of 6 diagnoses at admission—acute myocardial infarction, congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia—patient admission to higher-spending hospitals was associated with lower risk-adjusted inpatient mortality. During 1999 to 2003, for example, patients admitted with acute myocardial infarction to…

Why is end-of-life spending so high?

The answer is because using more intensive services does reduce mortality. This is the finding of a recent JAMA paper. After controlling for patient case mix, the authors examine variation in hospital spending in the last year of a patient’s life. The authors note that “Higher-spending hospitals differed in many ways, such as greater use…