Unbiased Analysis of Today's Healthcare Issues

Effect of publicly reported surgical quality measures and outcomes

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 […]

Read the rest of this entry »

Open Source Surgery

Currently, robot-assisted surgery today is dominated by the da Vinci Surgical System.  The device is highly regarded, but is heavy (weighs half a ton) and expensive ($1.8m).  Plus it uses proprietary software, which means that physicians and engineers not associated with da Vinci cannot alter its operating system. Change is on the horizon, however. “None […]

Read the rest of this entry »

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 […]

Read the rest of this entry »

Surgical Complications and Mortality Rates

Mortality during surgery is dependent on two factors.  The first is the probability of having complications during surgery.  The second is the probability of dying conditional on having a complication.  One would expect that hospitals with low mortality rates would have both fewer complications and lower probability of death conditional on a complication.   A […]

Read the rest of this entry »

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 […]

Read the rest of this entry »

Medical Errors and Ninety-Day Cost and Outcomes

A hospital is a place of healing.  It can also be a place of injury.  In the U.S., 2.9% of people who enter the hospital are actually harmed by the care they receive.  Yet what are the costs of these injuries? A paper by Encinosa and Hellinger (HSR 2008) attempts to estimate the cost of hospitals failing […]

Read the rest of this entry »

Book Review: The Great American Heart Hoax

A new book by Dr. Michael Ozner takes on the cardiovascular surgery industry head-on.  The aptly titled Great American Heart Hoax claims that although insurers pay $60 billion per year  invasive cardiovascular surgery, 70%-90% of these procedures are unnecessary.   The book has three major themes: What is heart disease?  Why is heart surgery a […]

Read the rest of this entry »

A Study in Quality: Ambulatory Surgery Centers vs. Hospital Outpatient Departments

There has been a recent trend for more and more surgeries to take place in ambulatory surgery centers (ASCs). In fact according to the Medicare Payment Advisory Commission, in 2004 up to 70% of surgeries took place in these ASCs. Do ASCs offer better quality surgical procedures than Hospital Outpatient Departments (HOPD)? ASCs may be […]

Read the rest of this entry »