NBER Working Paper
Lancet Global Health
Medical boards and other practitioner boards aim to protect the public from unsafe practice. Previous research has examined disciplinary actions against doctors, but other professions (e.g., nurses and midwives, dentists, psychologists, pharmacists) remain understudied.
Importance Elevations in levels of total, low-density lipoprotein, and non–high-density lipoprotein cholesterol; lower levels of high-density lipoprotein cholesterol; and, to a lesser extent, elevated triglyceride levels are associated with risk of cardiovascular disease in adults.
Objective To update the 2007 US Preventive Services Task Force (USPSTF) recommendation on screening for lipid disorders in children, adolescents, and young adults.
During a fatal Nipah virus (NiV) outbreak in Bangladesh, residents rejected biomedical explanations of NiV transmission and treatment and lost trust in the public healthcare system. Field anthropologists developed and communicated a prevention strategy to bridge the gap between the biomedical and local explanation of the outbreak.
Clinical decision support (CDS) systems with complex logic are being developed. Ensuring the quality of CDS is imperative, but there is no consensus on testing standards. We tested ATHENA-HTN CDS after encoding updated hypertension guidelines into the system. A logic flow and a complexity analysis of the encoding were performed to guide testing. 100 test cases were selected to test the major pathways in the CDS logic flow, and the effectiveness of the testing was analyzed. The encoding contained 26 decision points and 3120 possible output combinations.
Abstract: Conventional wisdom suggests that if private health insurance plans compete alongside a public option, they may endanger the latter's financial stability by cream-skimming good risks. This paper argues that two factors may contribute to the extent of cream-skimming: (i) degree of horizontal differentiation between public and private options when preferences are heterogeneous; (ii) whether contract design encourages choice of private insurance before information about risk is revealed.
Background: The total population health benefits and costs of HIV preexposure prophylaxis (PrEP) for people who inject drugs (PWID) in the United States are unclear.
Objective: To evaluate the cost-effectiveness and optimal delivery conditions of PrEP for PWID.
Design: Empirically calibrated dynamic compartmental model.
Data Sources: Published literature and expert opinion.
Target Population: Adult U.S. PWID.
Time Horizon: 20 years and lifetime.
Rationale: Although lung transplant recipient survival is better at higher volume centers, the effect of center volume on admission cost and early hospital readmission is unknown.
Objectives: To understand the association between transplant center volume and recipient risk-adjusted transplant admission cost, in-hospital mortality, and early hospital readmission in lung transplant recipients.
Extensive variation exists in the follow-up of positive screens for sickle cell disease. Limited quality indicators exist to measure if the public health goals of screening—early initiation of treatment and enrollment to care—are being achieved. This manuscript focuses on the development of quality indicators related to the follow-up care for individuals identified with sickle cell disease and trait through screening processes. The authors used a modified Delphi method to develop the indicators.
Abstract: How does teamwork increase productivity? Considering teamwork as joint monitoring and management, I investigate this question by studying the same emergency physicians working in two organizational systems differing in the team-management of work: Physicians are assigned patients in a "nurse-managed" system but divide patients between themselves in a "self-managed" system. The self-managed system increases throughput productivity by reducing a "foot-dragging" moral hazard, in which physicians prolong patient stays with expected future work.
A large-scale review is needed to characterize the rates of airway, respiratory, and cardiovascular complications after pediatric tonsillectomy and adenoidectomy (T&A) for inpatient and ambulatory cohorts.
To identify risk factors for postoperative complications stratified by age and operative facility type among children undergoing T&A.
Design, Setting, and Participants
The effect of child poverty and related early life experiences on adult health outcomes and patterns of aging has become a central focus of child health research and advocacy. In this article a critical review of this proliferating literature and its relevance to child health programs and policy are presented. This literature review focused on evidence of the influence of child poverty on the major contributors to adult morbidity and mortality in the United States, the mechanisms by which these associations operate, and the implications for reforming child health programs and policies.
This chapter highlights evidence that links women’s health challenges in LMICs to economics at every stage of life. It advances the notion that discrimination against women persists for sociocultural and economic reasons and is embodied in ill health and disability across the life span.
There is longstanding debate in population policy about the relationship between modern contraception and abortion. Although theory predicts that they should be substitutes, the existing body of empirical evidence is difficult to interpret. What is required is a large-scale intervention that alters the supply (or full price) of one or the other – and importantly, does so in isolation (reproductive health programs
How health technology interacts with underlying cultural norms may have unanticipated consequences for development. Recent policy debates on closing the gender gap in developing countries have focused on affirmative action and economic growth, but there are reasons to expect that policies targeting the health of young children might also be effective.
Twenty years ago, few systematic efforts to make health care safer existed. Today, patient safety is a priority for patients, providers, payers, and policy makers. The Institute of Medicine’s 1999 report on medical error prompted a flurry of activity, including widespread adoption of error detection and reporting programs, movement toward systems approaches for addressing error, development of new clinical interventions to reduce error, and efforts to foster stronger safety cultures within healthcare organizations.
Abstract: Objectives To describe hospital utilization and costs associated with preterm or low birth weight births (preterm/LBW) by payer prior to implementation of the Affordable Care Act and to identify areas for improvement in the quality of care received among preterm/LBW infants.
For adolescent patients with end-stage hip disease, the choice between total hip arthroplasty (THA) and arthrodesis is complex; the clinical evidence is not definitive, and there are difficult trade-offs between clear short-term benefits from THA and uncertain long-term risks. We surveyed nearly 700 members of the Pediatric Orthopedic Society of North America and the American Association of Hip and Knee Surgeons. Respondents chose between a recommendation of THA or arthrodesis in four clinical vignettes.