Cost-Benefit Analysis

Publication Title: 
The Hastings Center Report
Author(s): 
Emery, D. D.
Schneiderman, L. J.
Publication Title: 
Medical Decision Making: An International Journal of the Society for Medical Decision Making

BACKGROUND: Although congestive heart failure (CHF) is a primary target for disease management programs, previous studies have generated mixed results regarding the effectiveness and cost savings of disease management when applied to CHF. OBJECTIVE: We estimated the long-term impact of systolic heart failure disease management from the results of an 18-month clinical trial.

Author(s): 
Miller, George
Randolph, Stephen
Forkner, Emma
Smith, Brad
Galbreath, Autumn Dawn
Publication Title: 
Coronary Artery Disease

Percutaneous pulmonary valve implantation helps in prolonging the lifespan of surgically placed right ventricle-to-pulmonary artery (RV-PA) conduits, and represents a less invasive alternative to repeat open-heart surgery. The clinical indications for treatment match those of surgery. As far as the suitability is concerned, the current ideal substrate is a degenerated RV-PA conduit, because of the presence of a certain degree of calcification that offers a safe anchoring point.

Author(s): 
Frigiola, Alessandra
Nordmeyer, Johannes
Bonhoeffer, Philipp
Publication Title: 
Community Dentistry and Oral Epidemiology

OBJECTIVE: Fluoride was first added to the Australian water supply in 1953, and by 2003, 69% of Australia's population was receiving the minimum recommended dose. Extending coverage of fluoridation to all remaining communities of at least 1000 people is a key strategy of Australia's National Oral Health Plan 2004-2013. We evaluate the cost-effectiveness of this strategy from an Australian health sector perspective. METHODS: Health gains from the prevention of caries in the Australian population are modelled over the average 15-year lifespan of a treatment plant.

Author(s): 
Cobiac, Linda J.
Vos, Theo
Publication Title: 
International Orthopaedics

Total knee replacement (TKR) achieves an immediate and exceptional restoration in the quality of life that is comparable only to a few other procedures. It has been suggested that the most common cause of revision TKR is error in surgical technique, from malpositioning of the components which results in a poorer post-operative outcome. Based on the theoretical assumption that the use of computer-assisted systems (CAS) in TKRs may improve implant alignment and thus implant longevity, the use of this technology is becoming increasingly popular.

Author(s): 
Dattani, Rupen
Patnaik, Surendra
Kantak, Avadhoot
Tselentakis, Georgis
Publication Title: 
American Journal of Public Health

OBJECTIVES: Vitamin and mineral supplementation is a common practice in the United States, yet little is known about the long-term health effects of regular supplement use. METHODS: To examine the relationship between reported use of supplements and mortality, we analyzed data from US adults 25 to 74 years of age who were examined in the First National Health and Nutrition Examination Survey (1971 to 1975), with vital status determined through 1987. RESULTS: At baseline, 22.5% of the cohort reported using supplements regularly and 10.0% reported irregular use.

Author(s): 
Kim, I.
Williamson, D. F.
Byers, T.
Koplan, J. P.
Publication Title: 
Inquiry: A Journal of Medical Care Organization, Provision and Financing

This paper applies instrumental variable (IV) techniques and estimates the average benefits of invasive surgical treatments for marginal acute myocardial infarction (AMI) patients by insurance coverage. The study uses data from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases for the state of Washington, for years 1988-1993. We observed differences in average benefits for marginal patients across insurance subpopulations that cannot be explained by differences in measured clinical circumstances.

Author(s): 
Brooks, J. M.
McClellan, M.
Wong, H. S.
Publication Title: 
The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences

OBJECTIVE: States vary greatly in their support for home- and community-based services (HCBS) that are intended to help disabled seniors live in the community. This article examines how states' generosity in providing HCBS affects the risk of nursing home admission among older Americans and how family availability moderates such effects. METHODS: We conducted discrete time survival analysis of first long-term (90 or more days) nursing home admissions that occurred between 1995 and 2002, using Health and Retirement Study panel data from respondents born in 1923 or earlier.

Author(s): 
Muramatsu, Naoko
Yin, Hongjun
Campbell, Richard T.
Hoyem, Ruby L.
Jacob, Martha A.
Ross, Christopher O.
Publication Title: 
Health Services Research

OBJECTIVE: To estimate patients' elasticity of demand, willingness to pay, and consumer surplus for five high-cost specialty medications treating metastatic disease or hematologic malignancies. DATA SOURCE/STUDY SETTING: Claims data from 71 private health plans from 1997 to 2005. STUDY DESIGN: This is a revealed preference analysis of the demand for specialty drugs among cancer patients. We exploit differences in plan generosity to examine how utilization of specialty oncology drugs varies with patient out-of-pocket costs.

Author(s): 
Goldman, Dana P.
Jena, Anupam B.
Lakdawalla, Darius N.
Malin, Jennifer L.
Malkin, Jesse D.
Sun, Eric
Publication Title: 
Journal of Dental Education

If it is not a naÔve expectation for dentists who have been beneficiaries of public generosity to share their good fortune with the public that made it possible, there may be a rational basis for enhancing the role of dental education in improving access to oral health care by promoting-but not requiring-a voluntary service commitment after graduation commensurate with the magnitude of the subsidy received.

Author(s): 
Bertolami, Charles N.
Berne, Robert

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