Getting Past Denial - The High Cost of Health Care in the United States

Dartmouth Institute for Health Policy and Clinical , Lebanon, NH, USA.
New England Journal of Medicine (Impact Factor: 54.42). 10/2009; 361(13):1227-30. DOI: 10.1056/NEJMp0907172
Source: PubMed
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    • "It is less well tested in respect of diagnostic procedures, and the area requires further discussion, reflection, and ethical/legal consideration. Each person is entitled to a reasonable expectation of health and equal access to health care (Durand-Zaleski, 2009; Sutherland, Fisher, & Skinner, 2009; Wennberg et al., 2008). There are many factors that complicate availability and access to radiological procedures that result in favor of one region, one individual, or one group over others. "
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    ABSTRACT: Chapter Outline 7.1 Introduction 107 7.2 Ethics in Medical Radiology 109 7.2.1 Core Principles in Medical Ethics 109 7.2.2 A Basic Analysis 111 7.3 Medical, Social, and Legal Context for Radiology 114 7.3.1 Overutilization and Health Economics 116 7.4 Risk, Uncertainty,Communication, and Skeptical Doctors 116 7.5 Justification Issues 118 7.5.1 Awareness 119 7.5.2 Appropriateness and Referral Guidelines 120 7.5.3 Audit (Clinical) 121 7.5.4 Some Reasons for Failure of Justification 121 7.6 Some Special Concerns 121 7.6.1 Nonmedical Exposures 121 7.6.2 Regulatory Framework 122 7.6.3 Some Pregnancy Issues 123 7.7 Conclusions 124
    Social and Ethical Aspects of Radiation Risk Management, First edited by D. Oughton & S. Ove Hansson, 09/2013: chapter 7: pages 105-130; Elsevier Science., ISBN: 9780080450155
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    • "Our findings also potentially have implications for health policy debates about whether to try to equalize health spending across areas. Previous studies have shown, for example, that a family's own income helps explain some – but only some – of the variation across areas in health expenditures (Sutherland, Fisher, and Skinner, 2009). Our results suggest that the geographic concentration of poverty within an area may also matter for health beyond each family's own individual poverty status. "
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    ABSTRACT: In this paper we estimate the causal effects on child mortality from moving into less distressed neighborhood environments. We match mortality data covering the period from 1997 to 2009 with information on every child in public housing that applied for a housing voucher in Chicago in 1997 (N=11,680). Families were randomly assigned to the voucher wait list, and only some families were offered vouchers. The odds ratio for the effects of being offered a housing voucher on overall mortality rates is equal to 1.13 for all children (95% CI 0.73-1.70), 1.34 for boys (95% CI 0.85-2.05) and 0.21 for girls (95% CI 0.01-1.04).
    Journal of Health Economics 10/2012; 32(1):195-206. DOI:10.1016/j.jhealeco.2012.10.008 · 2.25 Impact Factor
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    • "Another strand of the literature follows Wennberg and Gittelsohn (1973) and examines " small area variations " in the utilization of medical procedures. It has been shown that there are large variations in the use of some procedures, and that these variations are unrelated to average patient health outcomes (Sutherland, Fischer, and Skinner. 2009). These variations have been widely interpreted as evidence of excessive provision of medical care (e.g. Fuchs, 2004). However, Chandra and Staiger (2007) argue that the true picture is more complex since patients in high spending areas who need high-tech care are better off in those areas, while patients who would benefit from lower te"
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    ABSTRACT: We conduct an audit study in which a pair of simulated patients with identical flu-like complaints visits the same physician. Simulated patient A is instructed to ask a question that showcases his/her knowledge of appropriate antibiotic use, whereas patient B is instructed to say nothing beyond describing his/her symptoms. We find that a patient who displays knowledge of appropriate antibiotics use reduces both antibiotic prescription rates and drug expenditures. Such knowledge also increases physicians' information provision about possible side effects, but has a negative impact on the quality of the physician-patient interactions. Our results suggest that antibiotics abuse in China is not driven by patients actively demanding antibiotics, but is largely a supply-side phenomenon.
    Journal of Health Economics 06/2011; 30(5):933-49. DOI:10.1016/j.jhealeco.2011.05.009 · 2.25 Impact Factor
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