The Experts below are selected from a list of 199566 Experts worldwide ranked by ideXlab platform
Ali Bydon - One of the best experts on this subject based on the ideXlab platform.
-
long term back pain after a single level discectomy for radiculopathy incidence and Health Care Cost analysis
Journal of Neurosurgery, 2010Co-Authors: Scott L Parker, Risheng Xu, Matthew J Mcgirt, Timothy F Witham, Donlin M Long, Ali BydonAbstract:Object The most common spinal procedure performed in the US is lumbar discectomy for disc herniation. Longterm disc degeneration and height loss occur in many patients after lumbar discectomy. The incidence of mechanical back pain following discectomy varies widely in the literature, and its associated Health Care Costs are unknown. The authors set out to determine the incidence of and the Health Care Costs associated with mechanical back pain attributed to segmental degeneration or instability at the level of a prior discectomy performed at their institution. Methods The authors retrospectively reviewed the data for 111 patients who underwent primary, single-level lumbar hemilaminotomy and discectomy for radiculopathy. All diagnostic modalities, conservative therapies, and operative treatments used for the management of postdiscectomy back pain were recorded. Institutional billing and accounting records were reviewed to determine the billed Costs of all diagnostic and therapeutic measures. Results At a m...
Andrew Briggs - One of the best experts on this subject based on the ideXlab platform.
-
analysis of uncertainty in Health Care Cost effectiveness studies an introduction to statistical issues and methods
Statistical Methods in Medical Research, 2002Co-Authors: Bernie J Obrien, Andrew BriggsAbstract:Cost-effectiveness analysis is now an integral part of Health technology assessment and addresses the question of whether a new treatment or other Health Care program offers good value for money. In this paper we introduce the basic framework for decision making with Cost-effectiveness data and then review recent developments in statistical methods for analysis of uncertainty when Cost-effectiveness estimates are based on observed data from a clinical trial. Although much research has focused on methods for calculating confidence intervals for Cost-effectiveness ratios using bootstrapping or Fieller's method, these calculations can be problematic with a ratio-based statistic where numerator and/or denominator can be zero. We advocate plotting the joint density of Cost and effect differences, together with cumulative density plots known as Cost-effectiveness acceptability curves (CEACs) to summarize the overall value-for-money of interventions. We also outline the net-benefit formulation of the Cost-effectiveness problem and show that it has particular advantages over the standard incremental Cost-effectiveness ratio formulation.
-
the distribution of Health Care Costs and their statistical analysis for economic evaluation
Journal of Health Services Research & Policy, 1998Co-Authors: Andrew Briggs, Alastair GrayAbstract:Objective:Where patient level data are available on Health Care Costs, it is natural to use statistical analysis to describe the differences in Cost between alternative treatments. Health Care Costs are, however, commonly considered to be skewed, which could present problems for standard statistical tests. This review examines how authors report the distributional form of Health Care Cost data and how they have analysed their results.Method:A review of Cost-effectiveness studies that collected patient-level data on Health Care Costs. To supplement the review, five datasets on Health Care Costs are examined. Consideration is given to the use of parametric methods on the transformed scale and to non-parametric methods of analysing skewed Cost data.Results:Since economic analysis requires estimation in monetary units, the usefulness of transformation-based methods is limited by the inability to retransform Cost differences to the original scale. Non-parametric rank sum methods were also found to be of limite...
Russell B Korobkin - One of the best experts on this subject based on the ideXlab platform.
-
comparative effectiveness research as choice architecture the behavioral law and economics solution to the Health Care Cost crisis
Michigan Law Review, 2014Co-Authors: Russell B KorobkinAbstract:With the Patient Protection and Affordable Care Act ("ACA") set to dramatically increase access to medical Care, the problem of rising Costs will move center stage in Health law and policy discussions. "Consumer directed Health Care" proposals, which provide patients with financial incentives to equate marginal Costs and benefits of Care at the point of treatment, demand more decisionmaking ability from consumers than is plausible due to bounded rationality. Proposals that seek to change the incentives of Health Care providers threaten to create conflicts of interest between doctors and patients. New approaches are desperately needed.This Article proposes a government-facilitated but market-based approach to improving efficiency in the private market for medical Care that I call "relative value Health insurance." This approach focuses on the "choice architecture" necessary to enable even boundedly rational patients to contract for an efficient level of Health Care services through their Health insurance purchase decisions. It uses comparative effectiveness research, which the ACA funds at a significant level for the first time, to rate medical treatments on a scale of one to ten based on their relative value, taking into account expected Costs and benefits. These relative value ratings would enable consumers to contract with insurers for different levels of medical Care at different prices, reflecting different Cost-quality trade-offs.The Article describes both the benefits of relative value Health insurance and the impediments to its implementation. It concludes with a brief discussion of how relative value ratings could also help to rationalize expenditures on public Health insurance programs.IntroductionSince the 1960s, Health Care spending in the United States has consist- ently increased-often by significant amounts-as a percentage of gross do- mestic product ("GDP").1 Accounting for 5.2% of GDP in 1960, Health Care expenditures grew to 7.2% of GDP in 1970, 9.2% in 1980, 12.5% in 1990, 13.8% in 2000, and 17.9% in 2011.2 In 2013, the Congressional Budget Of- fice predicted that without sharp, systemic change, 22% of domestic eco- nomic production will be devoted to Health Care by 2038.3As total Health Care spending has increased, so too has the Cost of private Health insurance. As of 2013, the average Cost of insurance coverage for a single adult with an employer-sponsored plan was $5,884, and a standard employer-sponsored policy for a family of four ran $16,351.4 For American families, increasing private insurance Costs have meant that workers who continue to enjoy employer-based Health insurance have seen wages stagnate and out-of-pocket Health Care Costs increase rapidly as employers have scrambled to maintain benefits. An estimated 46% of real wage increases went to employees' share of Health insurance premiums each year from 2000 to 2009.5 For the average worker with single coverage, annual contributions to premiums increased by 97% between 2003 and 2013;6 out-of-pocket de- ductibles increased from 17% to 138%, depending on the type of plan, from just 2006 to 2013;7 and the number of people with a deductible of at least $2,000 increased five-fold during the same time period.8 Public expenditures on medical Care have also increased sharply. In fiscal year 2012, MediCare, Medicaid, and the Children's Health Insurance Program ("CHIP") Cost the federal government an estimated $732 billion, 21% of its total budget.9 That number is up from less than 10% in 1985.10 Medicaid spending alone now comprises 15% of all state government spending,11 up from 10% in 1987.12The United States is a wealthy country, so it is not obvious that it should not spend such a large share of its national resources on medical Care. But rapidly increasing Costs, coupled with the well-known fact that the Health and longevity of Americans lag behind those of citizens of other developed nations that spend less of their wealth on medical Care,13 at least suggests that the nation probably allocates an inefficiently large fraction of national resources to Health Care, compared to competing goods and services. …
Russell Korobkin - One of the best experts on this subject based on the ideXlab platform.
-
comparative effectiveness research as choice architecture the behavioral law and economics solution to the Health Care Cost crisis
Michigan Law Review, 2014Co-Authors: Russell KorobkinAbstract:With the Patient Protection and Affordable Care Act ("ACA") set to dramatically increase access to medical Care, the problem of rising Costs will move center stage in Health law and policy discussions. "Consumer directed Health Care" proposals, which provide patients with financial incentives to equate marginal Costs and benefits of Care at the point of treatment, demand more decisionmaking ability from consumers than is plausible due to bounded rationality. Proposals that seek to change the incentives of Health Care providers threaten to create conflicts of interest between doctors and patients. New approaches are desperately needed. This Article proposes a government-facilitated but market-based approach to improving efficiency in the private market for medical Care that I call "relative value Health insurance." This approach focuses on the "choice architecture" necessary to enable even boundedly rational patients to contract for an efficient level of Health Care services through their Health insurance purchase decisions. It uses comparative effectiveness research, which the ACA funds at a significant level for the first time, to rate medical treatments on a scale of one to ten based on their relative value, taking into account expected Costs and benefits. These relative value ratings would enable consumers to contract with insurers for different levels of medical Care at different prices, reflecting different Cost-quality trade-offs. The Article describes both the benefits of relative value Health insurance and the impediments to its implementation. It concludes with a brief discussion of how relative value ratings could also help to rationalize expenditures on public Health insurance programs.
F Kelly - One of the best experts on this subject based on the ideXlab platform.
-
folic acid levels in some food staples in ireland are on the decline implications for passive folic acid intakes
Journal of Public Health, 2016Co-Authors: F Kelly, Eileen R Gibney, Andrew Boilson, Anthony Staines, Mary Rose SweeneyAbstract:The rapid increase of Health Care Costs in most countries resulted from higher demand for and expectations from new medical technology, expensive prescription drugs, an ageing population and a growing demand for Health and long term Care. Since Health resources available for delivery of Health Care services are limited, a number of different groups who are involved including Health service providers want to monitor value of resource used. The economic technique of Health Care Cost evaluation is one of the tools available to help Health decision makers choose wisely from a range of alternatives including use of resources and the implementation efficient programs. The economists use the concept of opportunity Cost in deciding whether the resources are efficient used. The evaluation is about Health Care Cost analysis, and involves evaluating the use of resources spent on the treatment of people with illnesses and assessing the Costs of carrying out a set of activities in order to identify ways to do the most with a limited resources. Health Care Cost analysis is a form of economic evaluation technique that can be used to assess either the Cost of a illness or the Cost of a Health Care program or interventions. Health Care activities are like other activities in the social economic that consume resources for producing goods and services. Therefore, it is necessary to understand the concepts and meanings of Cost and Health Care Costs.
