Pay for performance penalties fail again

The Incidental Economist astutely deconstructs the assumptions leading to the failure of the nationwide Hospital-Based Purchasing Program’s pay-for-performance penalties to reduce 30-day mortality.  These assumptions include: 30-day mortality is the right outcome measure because it is feasible to measure 30-day mortality is a valid proxy for the quality of inpatient care delivered. As shown with readmissions based penalties and with other payContinue reading “Pay for performance penalties fail again”

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The Minimum Wage and the Social Determinants of Mental Health

A new study in Health Economics shows a temporal association between Britain’s minimum wage law and substantially improved mental health of the low wage workers benefitting from the policy. Source: The Minimum Wage and the Social Determinants of Mental Health

Should Doctors Undergo Opioid Prescribing Risk Training?

Earlier this week, an advisory panel recommended that the Food and Drug Administration require doctors who prescribe painkillers s to undergo training aimed at reducing misuse and abuse of the medications. The New York Times notes: It is the second time since 2010 that an F.D.A. panel has recommended expanding safety measures for painkillers. But the trainingContinue reading “Should Doctors Undergo Opioid Prescribing Risk Training?”

What are the priority Emergency Department (ED) presenting conditions for which ED-based Shared Decision-Making should be most urgently developed?

An article in this week’s Wall Street Journal focused on the development and use of shared decision-making (SDM) tools in the emergency department (ED).  Decision tools can help engage patients in making decisions about their care, including decisions about which tests and treatments to pursue.  In the ED, relevant decisions are (1) decisions involving two similarly reasonable optionsContinue reading “What are the priority Emergency Department (ED) presenting conditions for which ED-based Shared Decision-Making should be most urgently developed?”

Fall in life expectancy for white Americans

Newly released 2014 data from the National Center for Health Statistics on life expectancy showed a worrisome decline in life expectancy for whites in the US, to 78.8 years in 2014 from 78.9 in 2013. The good news is that, in contrast, life expectancy increased by 0.2 years for the Hispanic population (from 81.6 toContinue reading “Fall in life expectancy for white Americans”

April no-fooling!

This week’s NY Times science section debunks several common misconceptions.  All are interesting reads: Misconception: Baby teeth don’t matter. I am leading with the one I hear most often at work. Dental caries (cavities) is the most common chronic illness of childhood, and this misconception is one reason why. (Actually: Neglecting baby teeth can set a childContinue reading “April no-fooling!”

More evidence-concordant FDA guidelines increase access to mifepristone

As covered in the New York Times, this week the Food and Drug Administration relaxed the guidelines for taking mifepristone (Mifiprex, formerly RU-486), a pill that induces abortion, reviving one of the most contentious issues of the abortion debate. The change brings the directions for taking the drug, mifepristone, in line with what has become standard medical practice in most states: reducing the dosageContinue reading “More evidence-concordant FDA guidelines increase access to mifepristone”

Sitting is the new smoking

Alternatives to the traditional desk chair have become popular as increasing evidence shows that prolonged sitting increases heart failure risk and disability risk and shortens life expectancy. A review found that sitting time was independently associated with poor health outcomes regardless of physical activity. Alternatives to sitting have become a new industry: A new Cochrane review of 20 studies of sitting-alternatives showedContinue reading “Sitting is the new smoking”

The difference between the parties’ health care proposals boils down to how they distribute risk

In a Health Affairs blog post today, two Urban Institute scholars–economist Linda Blumberg and policy fellow John Holahan–state that the fundamental difference between the two parties’ health care proposals is how they propose to share health care expenditures between those currently healthy and those with costly health care needs. The health policies of the two political parties and theirContinue reading “The difference between the parties’ health care proposals boils down to how they distribute risk”

Talking with children about political bullies

Columns on “talking to your children about XXX” appear after mass shootings, natural disasters and other disturbing news events. This election cycle’s extreme levels of bullying have inspired columns on talking with your children about Trump. These include The Parent-Child Discussion That So Many Dread: Donald Trump (New York Times) Telling our kids not toContinue reading “Talking with children about political bullies”