Paper of the Week

10 09, 2019

Paper of the Week: 10th September 2019 – At last, value measured by the opportunity cost of an intervention

2019-09-10T09:43:21+00:00

This week’s blog is brought to you by: Professor Sir Muir Gray Full reference and title from the journal: Uterus at a price: Disability insurance and hysterectomy Fan E. (et al) Journal of Health Economics 66 (2019) 1-17 Link to Paper: https://www.sciencedirect.com/science/article/abs/pii/S0167629618308142?dgcid=rss_sd_all Authors conclusion: Taiwanese Labor, Government Employee, and Farmer Insurance programs provide 5 to 6 months of salary to enrollees who undergo hysterectomies or oophorectomies before their 45th birthday. These programs create incentives for more and earlier treatments, …..Induced hysterectomies increase benefit payments and surgical costs, at about the cost of a mammogram and 5 pap smears per enrollee. 3V bottom line: Expressing value in terms of other things that could be one with the same amount [...]

Paper of the Week: 10th September 2019 – At last, value measured by the opportunity cost of an intervention2019-09-10T09:43:21+00:00
23 08, 2019

Paper of the Week: 23rd August 2019 – Yet again, more is not always better

2019-08-23T17:59:14+00:00

Full reference and title from the journal: Intensive Glucose Control in Patients with Type 2 Diabetes — 15-Year Follow-up Reaven P.D. et al (2019) N Engl J Med 2019;380:2215-24. This week’s blog is brought to you by: Professor Sir Muir Gray WEB LINK TO PAPER Authors conclusion: “In conclusion, in this group of participants with type 2 diabetes who were at high risk for cardiovascular disease, 5.6 years of intensive glucose lowering to a glycated hemoglobin level of 6.9% did not reduce the incidence of major cardiovascular events over a follow-up of 13.6 years or reduce total mortality or improve quality of life over a total follow-up of 15 years. Although there was a significantly lower risk of [...]

Paper of the Week: 23rd August 2019 – Yet again, more is not always better2019-08-23T17:59:14+00:00
15 08, 2019

Paper of the Week: 15th August 2019 – Why productivity isn’t enough

2019-08-15T06:25:59+00:00

This week's paper of the week is brought to you by Dr Tim Wilson, Managing Director Full reference and title from the journal: Atella, V., Belotti, F., Bojke, C., Castelli, A., Grašič, K., Kopinska, J., … Street, A. (2019). How health policy shapes healthcare sector productivity? Evidence from Italy and UK. Health Policy, 123(1), 27–36. WEB LINK TO PAPER Authors conclusion Productivity growth is measured as the rate of change in outputs over the rate of change in inputs. We find that the overall NHS productivity growth index increased by 10% over the whole period, at an average of 1.39% per year, while SSN productivity increased overall by 5%, at an average of 0.73% per year. Our results [...]

Paper of the Week: 15th August 2019 – Why productivity isn’t enough2019-08-15T06:25:59+00:00
8 08, 2019

Thursday 8th August 2019 Paper of the Week: What is fair in healthcare

2019-08-08T13:29:03+00:00

This week's paper of the week is brought to you by Dr Tim Wilson, Managing Director Full reference and title from the journal: Chamberlain, C., Owen-Smith, A., MacKichan, F., Donovan, J. L., & Hollingworth, W. (2019). “What’s fair to an individual is not always fair to a population”: a qualitative study of patients and their health professionals using the Cancer Drugs Fund. Health Policy, 123(8), 706–712. WEB LINK TO PAPER Authors conclusion While patients and oncologists appreciated the drugs available through the Cancer Drugs Fund, most expressed concern about its fairness. Competing participant views about the added value of the end of life is challenging for resource allocation.   3V bottom line  Fairness in healthcare needs us to [...]

Thursday 8th August 2019 Paper of the Week: What is fair in healthcare2019-08-08T13:29:03+00:00
2 08, 2019

Paper of the Week 2nd August: Lessons on paying for value from the US health policy laboratory

2019-08-02T06:20:37+00:00

This week's blog is brought to you by Dr Tim Wilson, 3V Managing Director. Full reference: Health Care Spending, Utilization, and Quality 8 Years into Global Payment Song, Z., Ji, Y., Safran, D. G., & Chernew, M. E. (2019). Health Care Spending, Utilization, and Quality 8 Years into Global Payment. New England Journal of Medicine, 381(3), 252–263. Web Link to Paper Authors conclusion: During the first 8 years after its introduction the Alternative Quality Contract of Blue Cross Blue Shield (BCBS) of Massachusetts, a population-based payment model, was associated with slower growth in medical spending on claims, resulting in savings that over time began to exceed incentive payments. Unadjusted measures of quality under this model were higher than [...]

Paper of the Week 2nd August: Lessons on paying for value from the US health policy laboratory2019-08-02T06:20:37+00:00
26 07, 2019

Paper of the Week: 26th July – Clinicians belief drives variation

2019-07-26T13:02:01+00:00

This week's paper is brought to you by: Dr Tim Wilson, Managing Director Full reference and title from the journal: Cutler, David, Jonathan S. Skinner, Ariel Dora Stern, and David Wennberg. 2019. "Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending." American Economic Journal: Economic Policy, 11 (1): 192-221. WEB LINK TO PAPER Authors conclusion There is considerable controversy about the causes of regional variations in health care expenditures. Using vignettes from patient and physician surveys linked to fee-for-service Medicare expenditures, this study asks whether patient demand-side factors or physician supply-side factors explain these variations. The results indicate that patient demand is relatively unimportant in explaining variations. Physician organizational factors matter, but the most [...]

Paper of the Week: 26th July – Clinicians belief drives variation2019-07-26T13:02:01+00:00
22 07, 2019

Paper of the Week – 22nd July 2019: The 7 Habits of Highly Effective Cost-of-Care Conversations

2019-07-22T06:46:10+00:00

  This weeks blog is brought to you by: Professor Sir Muir Gray, Founding Director. Authors conclusion Cost-conversation practice certainly will not make us perfect, given the logistical and informational barriers that exist. However, it will move us closer to the kind of patient-centered care that characterizes the ideals of our profession.   Text from the paper chosen by 3VH (this may, or may not be the ‘conclusion’) Out-of-pocket expenditures have increased rapidly in the United States over the past decade. In 2018, 29% of people with private insurance were enrolled in high-deductible health plans, compared with just 4% in 2006. Out-of-pocket costs are high for many publicly insured people, too. Medicare beneficiaries with cancer who do not [...]

Paper of the Week – 22nd July 2019: The 7 Habits of Highly Effective Cost-of-Care Conversations2019-07-22T06:46:10+00:00
12 07, 2019

Paper of the Week 12th July 2019: Why are we wasting precious resources to deliver low value at the end of life?

2019-07-12T10:02:02+00:00

Warraich, H. J., & Meier, D. E. (2019). Serious-Illness Care 2.0 — Meeting the Needs of Patients with Heart Failure. New England Journal of Medicine, 380(26), 2492–2494. https://doi.org/10.1056/NEJMp1900584 WEB LINK TO PAPER   This week's paper of the week is brought to you by Dr Tim Wilson, Managing Director   Authors conclusion Heart failure is the most common cause of hospitalizations among elderly Americans, and despite much medical and scientific progress, it remains a source of substantial suffering, expense, and caregiver burden. Palliative care can improve quality of life, symptoms, and functioning for people with serious illnesses, and a recent observational study in patients with heart failure showed that enrollment in home hospice was associated with fewer emergency [...]

Paper of the Week 12th July 2019: Why are we wasting precious resources to deliver low value at the end of life?2019-07-12T10:02:02+00:00
5 07, 2019

Paper of the Week 5th July 2019: The inverse care law continues to thrive in the NHS for vascular surgery (and probably more)

2019-07-05T17:19:32+00:00

Giuseppe Moscelli, Luigi Siciliani, Nils Gutacker, Richard Cookson (2018) Socioeconomic inequality of access to healthcare: Does choice explain the gradient? Journal of Health Economics, 57, 290–314.   This week's blog is brought to you by: Dr Tim Wilson   Bottom Line For planned vascular surgery, there is inequity in NHS provision for people living in the poorest and wealthiest neighbourhoods, representing an addressable cause of lower value.   Authors conclusion Equity of access is a key policy objective in publicly-funded healthcare systems. However, observed inequalities of access by socioeconomic status may result from differences in patients’ choices. Using data on non-emergency coronary revascularisation procedures in the English National Health Service, we found substantive differences in waiting times within [...]

Paper of the Week 5th July 2019: The inverse care law continues to thrive in the NHS for vascular surgery (and probably more)2019-07-05T17:19:32+00:00
28 06, 2019

Paper of the Week 28th June 2019: The Precision of Evidence Needed to Practice “Precision Medicine”

2019-06-28T12:29:34+00:00

    This weeks Paper of the Week is brought to you by: Professor Sir Muir Gray   Author’s Conclusion “In July 2018, the Journal published the results of TAILORx (Trial Assigning Individualized Option for Treatment).1 This randomized trial conducted by Sparano et al. showed the noninferiority of endocrine therapy to chemoendocrine therapy with respect to invasive disease–free survival among women with hormone-receptor–positive, human epidermal growth factor receptor 2 (HER2)–negative, axillary node–negative breast cancer who had a recurrence score (based on a 21-gene assay) of 11 to 25 (scores range from 0 to 100, with higher scores predicting a higher risk of distant recurrence)… Less than a year later, we are publishing additional results from the same data [...]

Paper of the Week 28th June 2019: The Precision of Evidence Needed to Practice “Precision Medicine”2019-06-28T12:29:34+00:00