Economics of individualization in comparative effectiveness research and a basis for a patient-centered health care.

Economics of individualization in comparative effectiveness research and a basis for a patient-centered health care.
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DOI:
10.1016/j.jhealeco.2011.03.004
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发表时间:
2011-05
影响因子:
3.5
通讯作者:
Basu, Anirban
Basu, Anirban
中科院分区:
经济学2区
文献类型:
--
作者:
Basu, Anirban

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美国希望利用来自比较有效性研究的信息来减少浪费和控制费用,而不建立正式的配给机制或损害病人或医生在治疗选择方面的自主权。有了这样雄心勃勃的目标,CER中使用的研究设计和分析方法的传统组合可能会导致令人失望的结果。在本文中,我研究了替代制度的比较有效性信息如何帮助塑造人口的边际效益(需求)曲线,以及这种感知的需求曲线如何影响个体患者层面的决策和社会层面的福利。我强调需要个性化的比较有效性的研究,以产生真正的(规范)的治疗需求曲线。我将讨论指导此类研究的研究设计的方法论原则。以药物滥用治疗对犯罪的比较效果为例,我使用新的计量经济学方法从现有的数据集中抢救个性化的信息。
The United States aspires to use information from comparative effectiveness research (CER) to reduce waste and contain costs without instituting a formal rationing mechanism or compromising patient or physician autonomy with regard to treatment choices. With such ambitious goals, traditional combinations of research designs and analytical methods used in CER may lead to disappointing results. In this paper, I study how alternate regimes of comparative effectiveness information help shape the marginal benefits (demand) curve in the population and how such perceived demand curves impact decision-making at the individual patient level and welfare at the societal level. I highlight the need to individualize comparative effectiveness research in order to generate the true (normative) demand curve for treatments. I discuss methodological principles that guide research designs for such studies. Using an example of the comparative effect of substance abuse treatments on crime, I use novel econometric methods to salvage individualized information from an existing dataset.
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