Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Specialists' Category

Can physicians affect medication adherence?

According to a recent study by Koulayev, Simeonova, and Skipper (2016) using data from Denmark, the answer is ‘yes’. Non-compliance with medication therapy remains an unsolved and expensive problem for healthcare systems around the world, yet we know little about the factors that affect a patient’s decision to follow treatment recommendations. In particular, there is […]

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How does market structure affect technology adoption?

The answer: more competition leads to more technology adoption.  This is the finding from a study by Karaca-Mandic et al. (2016).  They use data from 100% Medicare claim in 2003 and 2004 as well as linked information on hospitals [American Hospital Association (AHA) Annual Survey] and physicians [American Medical Association (AMA) Masterfile]. Competition is measured two […]

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Psych Boarding in the ER

The president of the American College of Emergency Physicians, Michael Gerardi, was recently interviewed about his plans for the organization.  One of his key initiatives will be to stop the practice of housing psychiatric patients in the ER. According to Dr. Gerardi: It is inhumane that a lot of patients, especially adolescent patients, sometimes live in an […]

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Usual Source of Care Increases Spending

Does having a specialist as your usual source of care (USOC) increase costs? “Among high-cost beneficiaries, the 27.8 percent attributed to a medical specialist as their USOCphysician had U.S.$1,839 greater costs than those attributed to primary care physicians, representing roughly 4 percent of the mean cost of care. Although this may reflect unmeasured patient preferences […]

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MRIs, Back Surgery and Primary Care

Do MRIs increase the liklihood a patient receives back surgery? “Orthopedists and primary care physicians who begin billing for the performance of MRI procedures, rather than referring patients outside of their practice for MRI, appear to change their practice patterns such that they use more MRI for their patients with low back pain. These increases […]

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Sigmoidoscopy: The colonoscopy’s cheaper, equally effective predecessor

Physicians claims that colonoscopies are the gold standard of preventive medicine.  In 2008 the American Cancer Society deemed the colonoscopy as the preferred test and the health reform law (PPACA) will compel insurance companies to cover colonoscopies.  But does the sigmoidoscopy–the colonoscopy’s predecessor–offer less expensive, less invasive, equally effective preventive care? “[The sigmoidoscopy] looks at […]

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Economics 2.0: Are more experienced Heart Surgeons better?

According Economics 2.0’s review of Huckman and Pisano (2006): WIth each additional operation the surgeon preforms in a clinic, the mortality factor of his or her patients there drops by 0.018 percentage points.  When that doctor performs an operation in another clinic during the same three-month period, patients’ death rates decline by only 0.001.   Few heart surgeons are […]

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Shortage! Shortage!…Shortage???

In the news, you often hear that there are shortages of nurses and physicians.  We need more nurses and physicians, right?  According to an editorial by Laurence Baker in Health Services Review, we should be a little skeptical of calls for more and more healthcare providers.  If supplier-induced demand is a problem, more providers will […]

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How do patients choose their doctor?

The Center for Studying Health System Change gives some insight into how patients choose their doctor: “Among consumers who found a new provider, few engaged in active shopping or considered price or quality information—especially when choosing specialists or facilities for medical procedures. When selecting new primary care physicians, half of all consumers relied on word-of-mouth […]

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Lifetime Benefits of Medical Technology

Revascularization (bypass surgery or angioplasty) have been frequently used procedures to treat patients who have experienced a myocardial infarction (MI). These procedure are expensive, but are supposed to enhance longevity. Do they? This is the question analyzed by David Cutler in his NBER working paper titled “The Lifetime Benefits of Medical Technology.” The problem with […]

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