The lifetime costs and benefits of medical technology
The lifetime costs and benefits of medical technology
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DOI：
10.1016/j.jhealeco.2007.09.003
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发表时间：
2007-12-01
影响因子：
3.5
通讯作者：
Cutler, David M.
中科院分区：
文献类型：
--
作者：
Cutler, David M.
衡量医疗技术的生命周期成本和效益对于评估技术变革和确定医疗保健的生产力至关重要。我利用 20 世纪 80 年代末心脏病发作的医疗保险受益人的数据以及 17 年的随访数据，评估了心脏病发作后血运重建的长期成本和收益。我用工具变量解释了治疗的非随机选择；继麦克莱伦、麦克尼尔和纽豪斯之后，该工具是到能够提供血运重建的医院的差异距离。结果表明，血运重建可延长一年以上的预期寿命，但费用约为 40,000 美元。血运重建或与之相关的其他治疗似乎具有很高的成本效益。 (c) 2007 年 Elsevier B.V. 出版
Measuring the lifetime costs and benefits of medical technologies is essential in evaluating technological change and determining the productivity of medical care. Using data on Medicare beneficiaries with a heart attack in the late 1980s and 17 years of follow up data, I evaluate the long-term costs and benefits of revascularization after a heart attack. I account for non-random selection into treatment with instrumental variables; following McClellan, McNeil, and Newhouse, the instrument is the differential distance to a hospital capable of providing revascularization. The results show that revascularization is associated with over I year of additional life expectancy, at a cost of about $40,000. Revascularization, or other treatments correlated with it, appears to be highly cost-effective. (c) 2007 Published by Elsevier B.V.