Stanford University

Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

Global Healthcare Productivity Project (GHP)

The Global Health Productivity project is a Stanford-led network of collaborators from 20 developed nations organized to assess the impact of healthcare regulation, financing and organization on healthcare delivery and health system performance. The project studies diverse issues of global interest, including pharmaceutical regulation, policies regarding financing the care of elderly individuals with dementia, and approaches to managing common clinical problems such as congestive heart failure.

Margaret L. Brandeau

Department of Management Science and Engineering
Stanford University
Huang Building, #262
Stanford, CA 94305-4026

(650) 725-1623 (650) 723-1614
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Coleman F. Fung Professor of Engineering and Professor, by courtesy, of Health Policy
brandeau.jpg PhD

Margaret Brandeau is the Coleman F. Fung Professor in the School of Engineering at Stanford and a Professor of Medicine (by courtesy) at the Stanford University School of Medicine. Her research focuses on the development of applied mathematical and economic models to support health policy decisions.

She has published cost-effectiveness analyses of a variety of HIV and drug-abuse interventions including methadone maintenance, buprenorphine maintenance, HIV testing and counseling programs targeted to women of childbearing age, and HIV pre-exposure prophylaxis for key populations. She has also published a number of studies on effective allocation of HIV prevention resources. In addition, she co-edited the books Operations Research and Health Care: A Handbook of Methods and Applications (with Francois Sainfort and William Pierskalla, Kluwer Publishers, 2004) and Modeling the AIDS Epidemic: Planning, Policy, and Prediction (with Edward Kaplan, Raven Press, 1994). She has been a Principal Investigator and co-Principal Investigator on four sequential five-year NIDA-funded projects entitled "AIDS and Drug Abuse: Policy Modeling for Better Decisions" that have led to numerous publications and presentations. Recently she has also worked in the area of bioterrorism preparedness planning, and on hepatitis B prevention and control.

She is a Fellow of the Institute for Operations Research and Management Science (INFORMS) and a member of the Omega Rho International Honor Society for Operations Research and Management Science. From INFORMS she has received the President’s Award (recognizing important contributions to the welfare of society), the Pierskalla Prize (for research excellence in health care management science), the Philip McCord Morse Lectureship Award, and the Award for the Advancement of Women in Operations Research and the Management Sciences. She has also received the Award for Excellence in Application of Pharmacoeconomics and Health Outcomes Research from the International Society for Pharmacoeconomics and Outcomes Research, and a Presidential Young Investigator Award from the National Science Foundation, among other awards.  Professor Brandeau earned a BS in Mathematics and an MS in Operations Research from MIT, and a PhD in Engineering-Economic Systems from Stanford University.

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Short Term Health and Economic Benefits Smoking Cessation: Low Birth Weight

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Objective: To estimate excess direct medical costs of low birth weight from maternal smoking and short-term cost savings from smoking cessation programs before or during the first trimester of pregnancy.

Methods: Simulations using data on neonatal costs per live birth. Outcome measures are mean US excess direct medical cost per live birth, total excess direct medical cost, reductions in low birth weight, and savings in medical costs from an annual 1 percentage point drop in smoking prevalence among pregnant women.

Results: Mean average excess direct medical cost per live birth for each pregnant smoker (in 1995 dollars) was $511; total cost was $263 million. An annual drop of 1 percentage point in smoking prevalence would prevent 1300 low birth weight live births and save $21 million in direct medical costs in the first year of the program; it would prevent 57,200 low birth weight infants and save $572 million in direct medical costs in 7 years.

Conclusions: Smoking cessation before the end of the first trimester produces significant cost savings from the prevention of low birth weight.

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Pediatrics
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Ciaran S. Phibbs
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Intergenerational Equity and the Rate of Discount in Long-Term Social Investment

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Basingstoke and Macmillan (New York) and St Martin's Press in association with the International Economic Association in "Contemporary Economic Issues: Economic Behavior and Design" (Chapter Five), M Sertel (ed).
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Discounting, Morality, and Gaming

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The full effects of decisions made today about many environmental policies -including climate change and nuclear waste- will not be felt for many years. For issues with long-term ramifications, analysts often employ discount rates to compare present and future costs and benefits. This is reasonable, and discounting has become a procedure that raises few objections. But are the methods appropriate for measuring costs and benefits for decisions that will have impacts 20 to 30 years from now the right ones to employ for a future that lies 200 to 300 years in the future?

Rather than simply disassemble current methodologies, the contributors examine innovations that will make discounting a more compelling tool for policy choices that influence the distant future. They discuss the combination of a high shout-term with a low long-term diescount rate, explore discounting according to more than one set of anticipated preferences for the future, and outline alternatives involving simultaneous consideration of valuation, discounting and political acceptability.

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RFF Press (Washington) in "Discounting and Intergenerational Equity"
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Evidence Suggesting That a Chronic Disease Self-Management Program Can Improve Health Status While Reducing Health Care Utilization and Costs: A Randomized Trial

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Medical Care
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Halsted Holman
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