Author Interviews, Cost of Health Care / 08.09.2014

Steffie Woolhandler MD MPH Professor at the School of Public Health and Hunter College, CUNY; Professor of Medicine Harvard Medical School Cambridge HospitalMedicalResearch.com Interview with: Steffie Woolhandler MD MPH Professor School of Public Health and Hunter College, CUNY; Professor of Medicine Harvard Medical School Cambridge Hospital Medical Research: What are the main findings of the study? Dr. Woolhandler: In 2011, U.S. hospitals spent $215 billion on billing and administration. Meanwhile, other countries spent far less. None of the other seven countries we studied spent even half as much as the U.S., and they all have modern, high quality hospitals. While we spent nearly $700 per capita on hospital paperwork, Scotland and Canada spent less than $200. This means that if U.S. hospitals ran as efficiently as Canada’s, the average family of four would save $2,000 annually on health care. (more…)
Author Interviews, Blood Pressure - Hypertension, Cost of Health Care / 15.07.2014

Alejandro Arrieta, PhD Assistant Professor Department of Health Policy and Management Florida International UniversityMedicalResearch.com Interview with: Alejandro Arrieta, PhD Assistant Professor Department of Health Policy and Management Florida International University Medical Research: What are the main findings of the study? Dr. Arrieta: We found that it makes business sense for insurance companies to reimburse patients for the cost of blood pressure monitors that they can use at home. In just the first year, we estimate that insurance companies can produce returns that range from $0.85 to $3.75 per dollar invested in blood pressure monitors provided to their members. (more…)
Author Interviews, Cost of Health Care, General Medicine, Heart Disease / 10.07.2014

Jeff Trost, MD Assistant Professor of Medicine Johns Hopkins MedicineMedicalResearch.com Interview with: Jeff Trost, MD Assistant Professor of Medicine Johns Hopkins Medicine Medical Research: What are the main findings of the study? Dr. Trost: In our study, we reported the use of two relatively simple tactics to significantly reduce the number of unnecessary blood tests to assess symptoms of heart attack and chest pain and to achieve a large decrease in patient charges. Specifically, we
  • 1) Provided information and education to physicians about proven testing guidelines and
  • 2) Made changes to the computerized provider order entry system at the medical center, part of the Johns Hopkins Health System. The guidelines call for more limited use of blood tests for so-called cardiac biomarkers. A year after implementation, our intervention led to an estimated $1.25 million reduction in laboratory charges.
(more…)
Author Interviews, BMJ, Cost of Health Care, General Medicine, Tobacco / 10.07.2014

Ms Qi Wu: Mental Health and Addiction Research Group, Department of Health Sciences University of York, Heslington York UKMedicalResearch.com Interview with: Ms Qi Wu: Mental Health and Addiction Research Group, Department of Health Sciences University of York, Heslington York  UK Medical Research: What are the main findings of the study? Ms Qi Wu: At any time in the UK about one in six adults has a mental health problem, the prevalence of smoking in this group is over 33%, which is around 50% higher than in the general population. It is estimated that 3 million adults with mental disorders were smokers in 2009-10. Meanwhile, people with mental health disorders are also more likely to smoke heavily, this group accounts for as much as 42% of the total national tobacco consumption.  In this study, we calculated the avoidable economic burden of smoking in people with mental disorders. The main finding was that people with mental disorders who smoke cost the UK economy £2.34 billion a year. The total costs are more or less equally divided among losses sustained from premature death, lost productivity, and healthcare costs to treat smoking related diseases such as lung cancer, cardiovascular disease and chronic obstructive pulmonary disease (COPD) in this group.  An estimated £719 million (31% of the total cost) was spent on treating diseases caused by smoking. Productivity losses due to smoking-related diseases were about £823 million (35%) for work- related absenteeism and £797 million (34%) was associated with premature mortality. (more…)
AHA Journals, Author Interviews, Electronic Records, Medicare, Stroke / 04.07.2014

MedicalResearch.com Interview with Hiraku Kumamar, MD, MPH Department of Epidemiology Harvard School of Public Health, Boston, MA and Soko Setoguchi-Iwata, M.D. Duke Clinical Research Institute Durham, NC 27715 Medical Research: What are the main findings of the study? Answer: We evaluated the accuracy of discharge diagnosis of stroke in the Medicare claims database by linking it to a nationwide epidemiological study cohort with 30239 participants called REasons for Geographic And Racial Differences in Stroke (REGARDS). We found that among the 282 events captured using a strict claims definition of stroke, 91% were true events.  We also found that 12% of the overall strokes had been identified only by Medicare claims, strongly supporting the use of these readily available data for event follow-up in cohort studies. (more…)
Author Interviews, Cost of Health Care, Global Health, Lancet / 01.07.2014

MedicalResearch.com Interview with:  M Luca Lorenzoni OECD Organisation for Economic Co-operation and Development Health Accounts, Asian Health and Social Policy Outreach ELS/Health Division MedicalResearch: What are the main findings of the study? Answer: 
  • The United States is an outlier in the scenery of OECD as it ranks first for health care expenditure, but last for coverage.
  • The slowdown in US health care spending during the past decade brought the growth rate closer to that of other high-spending countries -Canada, France, Germany, the Netherlands and Switzerland- at around 1%. Previously in 2002, the US's health expenditure growth was around 7%, much higher than the approximate 3% which was the average for the other countries examined in the study
  • Higher health-sector prices (e.g., hospital care and prescription drugs) are thought to be the main driver of expenditure differences between the US and other high-spending countries, and recent price dynamics largely explain declines in health expenditure growth. (more…)
Author Interviews, BMC, Cost of Health Care / 19.06.2014

MedicalResearch.com Interview with: Natasha K Brusco Manager of Physiotherapy Services, Cabrini Health PhD Candidate, Physiotherapy Department, Faculty of Health Science, La Trobe University, Bundoora, Victoria, Australia MedicalResearch: What are the main findings of the study? Answer: This economic evaluation reports that providing additional Saturday rehabilitation, compared to Monday to Friday rehabilitation alone, is likely to be cost saving per quality adjusted life year gained and for a minimal clinically important difference in functional independence. This builds on previous literature that reports that additional Saturday rehabilitation can improve functional independence and health related quality of life at discharge and may reduce patient length of stay. (more…)
Author Interviews, Cost of Health Care, Pharmacology, University of Pittsburgh / 09.06.2014

MedicalResearch.com Interview with: Yuting Zhang, Ph.D. Associate professor Graduate School of Public Health Department of Health Policy and Management. University of Pittsburgh MedicalResearch: What are the main findings of the study? Dr. Zhang: Since 2006, the government has randomly assigned low-income enrollees to stand-alone Part D plans, based upon the region in which they live. If low-income Medicare Part D enrollees were assigned to the least expensive plan instead of a random plan, the government and beneficiaries could save more than $5 billion in the first year. (more…)
Author Interviews, Cancer Research, Cost of Health Care, Journal Clinical Oncology / 09.06.2014

Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MAMedicalResearch Interview with: Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MA MedicalResearch: What are the main findings of the study? Dr. Aizer: We studied Americans between the ages of 20-40 using the SEER Database (a national cancer registry) and found that patients who had insurance were more likely to present with localized (curable) versus metastatic (generally incurable) cancer. Patients with localized tumors were more likely to receive the appropriate treatment and, most importantly, survived longer than patients without insurance. Our analysis accounted for demographic and socioeconomic differences between patients who were insured versus uninsured. Our results indicate that insurance status is a powerful predictor of outcome among young adults with cancer. The Affordable Care Act, which will likely improve insurance coverage nationally, may yield improved cancer outcomes among Americans. (more…)
Author Interviews, Cost of Health Care / 07.06.2014

http://www.ncbi.nlm.nih.gov/pubmed/24889948?dopt=AbstractMedicalResearch.com Interview with Katherine Neuhausen, MD, MPH Director of Delivery System Transformation, Office of Health Innovation Clinical Assistant Professor, Department of Family Medicine and Population Health Virginia Commonwealth University MedicalResearch: What are the main findings of the study? Dr. Neuhausen: Medicaid Disproportionate Share Hospital (DSH) payments keep safety-net hospitals financially viable because these hospitals play such a critical role caring for the uninsured and Medicaid patients, providing trauma care and other vital community services, and training future health providers.  The Affordable Care Act (ACA) reduces these DSH payments because the ACA's authors assumed that safety-net hospitals would receive increased revenue from Medicaid expansion and therefore, have less need for DSH payments.  However, we found that California’s DSH need will actually increase because of medical cost inflation, low Medicaid payment rates, and the high number of people who will remain uninsured.  As a result, the DSH reductions will create funding gaps that must be filled to ensure the financial stability of safety-net hospitals.  The financial outlook for California’s safety-net hospitals is still much better under ACA than it would have been without the ACA.  In the absence of the ACA, California’s public hospitals would have had an additional $1.5 billion in costs for uncompensated care for the uninsured and would be facing a financial crisis. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Heart Disease, JACC / 22.05.2014

MedicalResearch.com Interview with: Nileshkumar J. Patel MD Staten Island University Hospital Staten Island, NY, 10304 and Abhishek J. Deshmukh MD University of Arkansas Little Rock, AR MedicalResearch: What are the main findings of the study? Answer: We analyzed data from almost 4 million hospitalizations for atrial fibrillation (AF) from more than 1,200 hospitals across 45 states in last decade, and found that -   Hospitalization rates for atrial fibrillation have increased exponentially among US adults during the past 10 years, particularly in those 65 years or older. -   The most frequent coexisting conditions were hypertension (59.99%), diabetes (21.47%) and chronic pulmonary disease (20.01%). -   In terms of geographic distribution of admissions, the hospitals in the South constitute (38.5%) the highest percentage of atrial fibrillation hospitalizations, followed by Midwest (24.9%), Northeast (22.2%) and West (14.4%). -   Overall in-hospital mortality was 1%. The mortality rate was highest in >80 years age group (1.93%) and patients with concomitant heart failure (8.2%). -   The percentage of patients discharged to nursing facility increased from 8.1% in 2000 to 11.5% in 2010 and need for home health care increased from 6.7% to 13.1%. Approximately one fourth of the patients (25.83%) were discharged to long-term care institution if atrial fibrillation hospitalization was complicated by acute ischemic stroke. -   Mean cost of AF hospitalization increased significantly from $6,410 in 2001 to $8,439 in 2010 (24.04% increase, p <0.001) even after adjusting for inflation. This represents an absolute increment in annual national cost from approximate 2.15 billion dollars in 2001 to 3.46 billion dollars in 2010. The mean cost of care was highest if AF hospitalization was associated with heart failure ($33,161) and valvular disorders ($28,030). (more…)
Asthma, Author Interviews, Cost of Health Care / 21.05.2014

dr_vicki_fung MedicalResearch.com Interview with: Vicki Fung, Ph.D. Assistant Professor Department of Medicine, Harvard Medical School Mongan Institute for Health Policy, Massachusetts General Hospital   MedicalResearch: What are the main findings of the study? Dr. Fung: We found that lower income parents of children with asthma were more likely to delay or avoid taking their children to a doctor's office visit or to the emergency room if they had to pay higher out-of-pocket costs for care; they were also more likely to report borrowing money to pay for asthma care. (more…)
Author Interviews, Cost of Health Care / 15.05.2014

MedicalResearch.com Interview with: David Lassman Statistician in the National Health Statistics Group, Office of the Actuary Centers for Medicare and Medicaid Services (CMS) Baltimore, Maryland. MedicalResearch: What types of health care spending are included in this report?  Answer: In the past, the CMS Office of the Actuary provided periodic updates of health care spending by age and more recently by gender. This report, for the first time, provides a time series of spending by age (five categories – 0-18, 19-44, 45-64, 65-84, and 85+) and gender. We also show spending by three major age categories – children (0-18), working age adults (19-64), and the elderly (age 65 and over). We present data for personal health care only which consists of all the medical goods and services used to treat or prevent a specific disease or condition in a specific person. We provide estimates for the even years between 2002 and 2010. These age and gender estimates are controlled to the most recent Historical National Health Expenditure Accounts. (more…)
AHA Journals, Author Interviews, Health Care Systems, Hospital Readmissions, Medicare / 13.05.2014

Alex Blum, MD MPH FAAP Chief Medical Officer Evergreen Health, Baltimore MD 21211MedicalResearch.com Interview with: Alex Blum, MD MPH FAAP Chief Medical Officer Evergreen Health, Baltimore MD 21211 MedicalResearch.com: What are the main findings of the study? Dr. Blum: Accounting for the social risk of patients using a measure of neighborhood socioeconomic status (SES), did not alter the hospital rankings for congestive heart failure (CHF) readmission rates. (more…)
Annals Internal Medicine, Author Interviews, Cost of Health Care, Health Care Systems / 07.05.2014

MedicalResearch.com Interview with: Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard School of Public Health / Brigham & Women's Hospital Boston, MA 02115MedicalResearch.com Interview with: Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard School of Public Health / Brigham & Women's Hospital Boston, MA 02115   MedicalResearch.com: What are the main findings of the study? Dr. Sommers: We find that over the first four years since Massachusetts' 2006 comprehensive health reform law, all-cause mortality in the state fell by 2.9%, compared to a similar population of adults living in counties outside Massachusetts that did not expand insurance during this period.  We also found that the law reduced the number of adults in Massachusetts without insurance, reduced cost-related barriers to care, increased use of outpatient visits, and led to improvement in self-reported health.  Overall, we estimate that the health reform law prevented over 320 deaths per year in the state - or one life saved per 830 adults gaining health insurance.  Mortality rates declined primarily due to fewer deaths from causes amenable to health care, such as cancer, infections, and heart disease.  We also found that the health benefits were largest for people living in poor counties in the state, areas with higher percentage of uninsured adults before the law was passed, and for minorities. (more…)
Annals Thoracic Surgery, Author Interviews, Cost of Health Care, Hospital Readmissions, Pharmacology / 02.05.2014

Michael H. Hall, MD North Shore-LIJ Health SystemMedicalResearch.com Interview with: Michael H. Hall, MD North Shore-LIJ Health System MedicalResearch: What are the key points of your research? Dr. Hall: Our study was designed to improve care transition from the hospital to home after coronary bypass surgery. The innovative program (Follow Your Heart), implemented at one of our system hospitals, involves sending cardiac surgery nurse practitioners (NPs) who cared for the patients in the hospital to the homes of discharged patients for at least two visits in the first two weeks after discharge. Their goal is to provide continuity of care for patients that they know from the hospital setting and to provide robust medication management, coordinate community services, and be a communications hub for hospital and community providers (primary care, cardiology, and community nurse home visit services). The  nurse practitioners interact with community resources to ensure understanding and satisfaction of the patients’ needs prior to hand-off to those resources after two weeks. Our  nurse practitioners utilize encrypted smart phones to provide reports to all appropriate providers and can even send pictures of incisions to the surgeon when necessary. (more…)
Author Interviews, Cost of Health Care, Diabetes, JAMA / 28.04.2014

Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong.MedicalResearch.com Interview with: Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong. MedicalResearch.com: What are the main findings of the study? Dr. Chan: In this 1-year randomized study, we asked the question whether type 2 diabetic patients receiving team-based integrated care augmented by information technology would further improve in their glycemic control if given additional peer support through the telephone. All patients underwent comprehensive risk assessment guided by the web-based JADE portal which generated personalized risk report with attained treatment targets and decision support. After 1 year, all patients improved significantly in all risk factors including A1c with improved treatment adherence, self efficacy and psychological wellbeing. Although the peer support group did not further improve in A1c, short-stay hospitalization rates were substantially reduced by 50% , especially amongst those with emotional distress. These patients accounted for 20% of the intervention group, in whom peer support further reduced psychological distress and treatment non-adherence. (more…)
Author Interviews, CMAJ, Cost of Health Care, Prostate Cancer / 26.04.2014

MedicalResearch.com Interview with: Alice Dragomir, MSc, PhD Assistant Professor, Urology/Surgery, McGill University Scientist, RI-MUHC MedicalResearch.com: What are the main findings of the study? Authors’ response: Our study demonstrates that for eligible patients, active surveillance could offer not only the known clinical advantages from the patient’s perspective, but also economic benefits from the health care system’s perspective. At the national level, the cost savings of an annual cohort of incident prostate cancers managed with active surveillance over a first year and 5 years of follow-up could be substantial. These are estimated at $96 million. (more…)
Author Interviews, CMAJ, Cost of Health Care, Orthopedics / 23.04.2014

MedicalResearch.com Interview with: Susan Jaglal, PhD Senior Scientist Toronto Rehabilitation Institute University of Toronto, Toronto, Ontario MedicalResearch.com: What are the main findings of the study? Dr. Jaglal: Bone Mineral Density (BMD) tests are used to both diagnose osteoporosis and assess and individual’s risk of fracture. While the tests play an important role in bone health, they are sometimes ordered inappropriately. For example, while women age 40-44 are typically not at risk of fragility fracture or in need of Bone Mineral Density testing, these individuals received almost half the Bone Mineral Density tests performed in Ontario in 2007/2008. Policy changes have been made in recent years in an effort to curb unnecessary testing of low risk individuals in both the United States and Canada. Policy efforts in Ontario included a 2008 fee schedule change that limited repeated testing among low-risk patients and included a new fee code for a “baseline” tests. Patients were limited to 1 baseline test in their lifetime. The goal of the present study was to determine the impact of this fee schedule change on Bone Mineral Density testing rates. The study was based on an analysis of provincial administrative data including physician billings, hospital discharges, and emergency department visits. Results demonstrated that while fee schedule changes were associated with a decrease in BMD testing rates, the decreases affected both low and high-risk patients. Most decreases were seen in testing rates of low-risk women. However, the associated decrease in testing among high-risk patients (e.g., those over 65 or with a recent fracture) is concerning, as high-risk patients benefit from screening and monitoring of Bone Mineral Density. (more…)
Author Interviews, Cost of Health Care, Medical Imaging, NIH / 11.04.2014

Jamie Hui, MD Center for Health Services Research Virginia Mason Medical Center Seattle, WashingtonMedicalResearch.com Interview with: Jamie Hui, MD Center for Health Services Research Virginia Mason Medical Center Seattle, Washington MedicalResearch.com: What are the main findings of the study? Dr. Hui: Through a quality improvement intervention aimed at how radiologists report on findings in female pelvic ultrasound examinations, we were able to decrease the number of unnecessary recommendations for follow-up imaging of benign adnexal cysts, preventing duress for these women. (more…)
Annals Internal Medicine, Author Interviews, Compliance, Cost of Health Care, McGill, Pharmacology / 09.04.2014

Robyn Tamblyn BScN Msc PhD James McGill Chair Departments of Medicine and Epidemiology and Biostatistics McGill University Scientific Director Institute of Health Services and Policy Research Canadian Institutes of Health Research MedicalResearch.com Interview with: Robyn Tamblyn BScN Msc PhD James McGill Chair Departments of Medicine and Epidemiology and Biostatistics McGill University and Scientific Director Institute of Health Services and Policy Research Canadian Institutes of Health Research MedicalResearch.com: What are the main findings of the study? Dr. Tamblyn: Higher drug costs are associated with a higher probability of primary non-adherence, whereas better follow-up by the prescribing physician, and a policy to provide medication at no cost for the very poor increase the likelihood of adherence (more…)
Author Interviews, CDC, Cost of Health Care, Diabetes, Diabetes Care / 08.04.2014

MedicalResearch.com Interview with: Dr. Rui Li Division of Diabetes Translation Centers for Disease Control and Prevention Atlanta, GA MedicalResearch.com: What are the main findings of the study? Answer: The proportion of people with diabetes facing high out-of-pocket (OOP) burden declined between 2001 and 2011. Although insurance and income related disparities have declined, almost one-fourth of all people with diabetes still face a high out-of-pocket burden. (more…)
Author Interviews, Cost of Health Care, JAMA / 07.04.2014

dr_sandra_l_deckerMedicalResearch.com Interview Sandra L. Decker, Ph.D. Distinguished Consultant Centers for Disease Control and Prevention National Center for Health Statistics Hyattsville, MD 20782   MedicalResearch.com: What are the main findings of the study? Dr. Decker: One of the main findings is that the percent of the low income population that is uninsured is higher in states not expanding Medicaid than those expanding.  The low income uninsured in non-expansion states are more likely to report having or having had certain health conditions such as hypertension, cancer, stroke, emphysema, or a heart condition than those in expansion states.  (more…)
Author Interviews, Cost of Health Care, JAMA / 02.04.2014

Daniel J. Elliott, M.D., MSCE, FACP Associate Chair of Research Department of Medicine and Research Scholar Value Institute, Christiana Care Health SystemMedicalResearch.com Interview with: Daniel J. Elliott, M.D., MSCE, FACP Associate Chair of Research Department of Medicine and Research Scholar Value Institute, Christiana Care Health System MedicalResearch.com: What are the main findings of the study? Dr. Elliott: The optimal workload for hospitalists has been a question since the earliest days of hospital medicine. However there has been very little empirical evidence to understand the relationship between workload and outcomes. The objective of our study was to determine the association of daily workload for hospitalists on the efficiency, quality, and cost of care.  We analyzed data from a single private practice hospitalist group at a community-based health system between February 2008 and January 2011. Our research showed that both length of stay and cost increased for patients as hospitalist workload increased. At the same time, our research showed that workload did not affect patient satisfaction as measured by HCAHPS scores or quality and safety outcomes including admissions, rapid response team activation and mortality. (more…)
Author Interviews, Cost of Health Care, JAMA, Pain Research, Pharmacology, Radiology, University of Michigan / 17.03.2014

Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann ArborMedicalResearch.com Interview Invitation with: Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann Arbor MedicalResearch.com: What are the main findings of the study? Dr. Callaghan:  The main findings are that we order headache neuroimaging (MRIs and CTs) frequently, this accounts for approximately $1 billion dollars annually, and the number of tests ordered is only increasing with time. (more…)
Author Interviews, Cost of Health Care, Health Care Systems / 12.03.2014

MedicalResearch.com Interview with: Liane J. Tinsley, MPH Associate Research Scientist Department of Epidemiology New England Research Institutes, Inc. Watertown, MA 02472 MedicalResearch.com: What are the main findings of the study? Answer: For this study, we analyzed health insurance data from a cohort of community-dwelling individuals between the ages of 30-79 at baseline, in Boston, MA. Massachusetts health care reform legislation, including the expansion of Medicaid, resulted in substantial overall gains in coverage in our study population. Despite being targeted by the law, the working poor (those currently working for pay, either part- or full-time and earning less than 200% of the US federal poverty threshold for household size) continued to report lower rates of insurance coverage following reform (13.3% without insurance), compared to the both non-working poor (4.7% without insurance) and the not poor (5.0% without insurance). (more…)
Annals Internal Medicine, Author Interviews, Cost of Health Care, Heart Disease, UCSF / 25.02.2014

Dhruv S. Kazi, MD, MSc, MS Assistant Adjunct Professor Division of Cardiology San Francisco General Hospital Department of Medicine, and Department of Epidemiology and Biostatistics University of California San FranciscoMedicalResearch.com Interview with: Dhruv S. Kazi, MD, MSc, MS Assistant Adjunct Professor Division of Cardiology San Francisco General Hospital Department of Medicine, and Department of Epidemiology and Biostatistics University of California San Francisco MedicalResearch.com: What is the background of your study? Dr. Kazi: When we first asked the research question -what is the role of genotyping among patients receiving a stent for ACS, we quickly realized that there were no RCTs that had directly compared ticagrelor with prasugrel. But in our opinion, that was precisely the reason to build a model and systematically synthesize the available literature. There are nearly half a million PCIs for ACS in the US each year, and each time, the physician and patients have to examine the trade-offs between the various alternatives. What our model does is that it explicates the trade-offs - makes them transparent, and quantifies them.  So patients and physicians can make an informed decision on what is the optimal therapy for them. (more…)
Cost of Health Care, Dartmouth, Health Care Systems, Mental Health Research, Yale / 18.02.2014

MedicalResearch.com Interview with: Ellen R. Meara Associate Professor of The Dartmouth Institute Adjunct Associate Professor in Economics & Nelson A. Rockefeller Center for Public Policy, Dartmouth College Ellen R. Meara Associate Professor of The Dartmouth Institute Adjunct Associate Professor in Economics & Nelson A. Rockefeller Center for Public Policy, Dartmouth College MedicalResearch.com: What are the main findings of this study? Answer: When insurance coverage for young adults rose by over 15 percentage points following Massachusetts' 2006 health reform, use of inpatient care for mental illness and substance use disorders fell and emergency department visits for these conditions grew more slowly for 19 to 25 year olds in Massachusetts relative to other states. Also, their care was much more likely to be paid for by private or public insurance insurers. (more…)