Tradeoffs from integrating diagnosis and treatment in markets for health care:
What are the important tradeoffs in consulting a single expert for both diagnosis and treatment? On one hand, an integrated diagnostician may have the incentive to recommend treatments that are not in the buyer's best interests. On the other hand, joint production of diagnosis and treatment by...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Book |
| Language: | English |
| Published: |
Cambridge, Mass.
National Bureau of Economic Research
2006
|
| Series: | Working paper series / National Bureau of Economic Research
12623 |
| Links: | http://papers.nber.org/papers/w12623.pdf |
| Summary: | What are the important tradeoffs in consulting a single expert for both diagnosis and treatment? On one hand, an integrated diagnostician may have the incentive to recommend treatments that are not in the buyer's best interests. On the other hand, joint production of diagnosis and treatment by an integrated diagnostician may be more efficient. We examine an important special case of this problem: the costs and health outcomes of elderly Medicare beneficiaries with coronary artery disease. We compare the empirical consequences of diagnosis by an "integrated" cardiologist -- one who can provide surgical treatment -- to the consequences of diagnosis by a non-integrated cardiologist. Diagnosis by an integrated cardiologist leads, on net, to higher health spending but similar health outcomes. The net effect contains three components: reduced spending and improved outcomes from better allocation of patients to surgical treatment options; increased spending conditional on treatment option; and worse outcomes from poorer provision of non-surgical care. We conclude that accounting more completely for doctors' incentives to refer patients in setting reimbursements, or in the alternative, allowing doctors more freedom to make and receive payments for referrals, could reduce spending and improve quality. |
| Item Description: | Literaturverz. S. 16 |
| Physical Description: | 18, [1] S. 22 cm |
Staff View
MARC
| LEADER | 00000nam a2200000zcb4500 | ||
|---|---|---|---|
| 001 | BV023592551 | ||
| 003 | DE-604 | ||
| 005 | 20080327000000.0 | ||
| 007 | t| | ||
| 008 | 070307s2006 xxu |||| 00||| eng d | ||
| 035 | |a (OCoLC)255697862 | ||
| 035 | |a (DE-599)BVBBV023592551 | ||
| 040 | |a DE-604 |b ger | ||
| 041 | 0 | |a eng | |
| 044 | |a xxu |c XD-US | ||
| 049 | |a DE-521 | ||
| 100 | 1 | |a Afendulis, Christopher C. |e Verfasser |0 (DE-588)132723050 |4 aut | |
| 245 | 1 | 0 | |a Tradeoffs from integrating diagnosis and treatment in markets for health care |c Christopher C. Afendulis ; Daniel P. Kessler |
| 264 | 1 | |a Cambridge, Mass. |b National Bureau of Economic Research |c 2006 | |
| 300 | |a 18, [1] S. |c 22 cm | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 490 | 1 | |a Working paper series / National Bureau of Economic Research |v 12623 | |
| 500 | |a Literaturverz. S. 16 | ||
| 520 | |a What are the important tradeoffs in consulting a single expert for both diagnosis and treatment? On one hand, an integrated diagnostician may have the incentive to recommend treatments that are not in the buyer's best interests. On the other hand, joint production of diagnosis and treatment by an integrated diagnostician may be more efficient. We examine an important special case of this problem: the costs and health outcomes of elderly Medicare beneficiaries with coronary artery disease. We compare the empirical consequences of diagnosis by an "integrated" cardiologist -- one who can provide surgical treatment -- to the consequences of diagnosis by a non-integrated cardiologist. Diagnosis by an integrated cardiologist leads, on net, to higher health spending but similar health outcomes. The net effect contains three components: reduced spending and improved outcomes from better allocation of patients to surgical treatment options; increased spending conditional on treatment option; and worse outcomes from poorer provision of non-surgical care. We conclude that accounting more completely for doctors' incentives to refer patients in setting reimbursements, or in the alternative, allowing doctors more freedom to make and receive payments for referrals, could reduce spending and improve quality. | ||
| 700 | 1 | |a Kessler, Daniel P. |d 1966- |e Verfasser |0 (DE-588)128781629 |4 aut | |
| 776 | 0 | 8 | |i Erscheint auch als |n Online-Ausgabe |
| 810 | 2 | |a National Bureau of Economic Research <Cambridge, Mass.> |t NBER working paper series |v 12623 |w (DE-604)BV002801238 |9 12623 | |
| 856 | 4 | 1 | |u http://papers.nber.org/papers/w12623.pdf |z kostenfrei |3 Volltext |
| 943 | 1 | |a oai:aleph.bib-bvb.de:BVB01-016907881 | |
Record in the Search Index
| _version_ | 1818965834636197888 |
|---|---|
| any_adam_object | |
| author | Afendulis, Christopher C. Kessler, Daniel P. 1966- |
| author_GND | (DE-588)132723050 (DE-588)128781629 |
| author_facet | Afendulis, Christopher C. Kessler, Daniel P. 1966- |
| author_role | aut aut |
| author_sort | Afendulis, Christopher C. |
| author_variant | c c a cc cca d p k dp dpk |
| building | Verbundindex |
| bvnumber | BV023592551 |
| ctrlnum | (OCoLC)255697862 (DE-599)BVBBV023592551 |
| format | Book |
| fullrecord | <?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>02599nam a2200337zcb4500</leader><controlfield tag="001">BV023592551</controlfield><controlfield tag="003">DE-604</controlfield><controlfield tag="005">20080327000000.0</controlfield><controlfield tag="007">t|</controlfield><controlfield tag="008">070307s2006 xxu |||| 00||| eng d</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(OCoLC)255697862</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)BVBBV023592551</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-604</subfield><subfield code="b">ger</subfield></datafield><datafield tag="041" ind1="0" ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="044" ind1=" " ind2=" "><subfield code="a">xxu</subfield><subfield code="c">XD-US</subfield></datafield><datafield tag="049" ind1=" " ind2=" "><subfield code="a">DE-521</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Afendulis, Christopher C.</subfield><subfield code="e">Verfasser</subfield><subfield code="0">(DE-588)132723050</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Tradeoffs from integrating diagnosis and treatment in markets for health care</subfield><subfield code="c">Christopher C. Afendulis ; Daniel P. Kessler</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="a">Cambridge, Mass.</subfield><subfield code="b">National Bureau of Economic Research</subfield><subfield code="c">2006</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">18, [1] S.</subfield><subfield code="c">22 cm</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="b">n</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="b">nc</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="490" ind1="1" ind2=" "><subfield code="a">Working paper series / National Bureau of Economic Research</subfield><subfield code="v">12623</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">Literaturverz. S. 16</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">What are the important tradeoffs in consulting a single expert for both diagnosis and treatment? On one hand, an integrated diagnostician may have the incentive to recommend treatments that are not in the buyer's best interests. On the other hand, joint production of diagnosis and treatment by an integrated diagnostician may be more efficient. We examine an important special case of this problem: the costs and health outcomes of elderly Medicare beneficiaries with coronary artery disease. We compare the empirical consequences of diagnosis by an "integrated" cardiologist -- one who can provide surgical treatment -- to the consequences of diagnosis by a non-integrated cardiologist. Diagnosis by an integrated cardiologist leads, on net, to higher health spending but similar health outcomes. The net effect contains three components: reduced spending and improved outcomes from better allocation of patients to surgical treatment options; increased spending conditional on treatment option; and worse outcomes from poorer provision of non-surgical care. We conclude that accounting more completely for doctors' incentives to refer patients in setting reimbursements, or in the alternative, allowing doctors more freedom to make and receive payments for referrals, could reduce spending and improve quality.</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Kessler, Daniel P.</subfield><subfield code="d">1966-</subfield><subfield code="e">Verfasser</subfield><subfield code="0">(DE-588)128781629</subfield><subfield code="4">aut</subfield></datafield><datafield tag="776" ind1="0" ind2="8"><subfield code="i">Erscheint auch als</subfield><subfield code="n">Online-Ausgabe</subfield></datafield><datafield tag="810" ind1="2" ind2=" "><subfield code="a">National Bureau of Economic Research <Cambridge, Mass.></subfield><subfield code="t">NBER working paper series</subfield><subfield code="v">12623</subfield><subfield code="w">(DE-604)BV002801238</subfield><subfield code="9">12623</subfield></datafield><datafield tag="856" ind1="4" ind2="1"><subfield code="u">http://papers.nber.org/papers/w12623.pdf</subfield><subfield code="z">kostenfrei</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="943" ind1="1" ind2=" "><subfield code="a">oai:aleph.bib-bvb.de:BVB01-016907881</subfield></datafield></record></collection> |
| id | DE-604.BV023592551 |
| illustrated | Not Illustrated |
| indexdate | 2024-12-20T13:23:18Z |
| institution | BVB |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-016907881 |
| oclc_num | 255697862 |
| open_access_boolean | 1 |
| owner | DE-521 |
| owner_facet | DE-521 |
| physical | 18, [1] S. 22 cm |
| publishDate | 2006 |
| publishDateSearch | 2006 |
| publishDateSort | 2006 |
| publisher | National Bureau of Economic Research |
| record_format | marc |
| series2 | Working paper series / National Bureau of Economic Research |
| spelling | Afendulis, Christopher C. Verfasser (DE-588)132723050 aut Tradeoffs from integrating diagnosis and treatment in markets for health care Christopher C. Afendulis ; Daniel P. Kessler Cambridge, Mass. National Bureau of Economic Research 2006 18, [1] S. 22 cm txt rdacontent n rdamedia nc rdacarrier Working paper series / National Bureau of Economic Research 12623 Literaturverz. S. 16 What are the important tradeoffs in consulting a single expert for both diagnosis and treatment? On one hand, an integrated diagnostician may have the incentive to recommend treatments that are not in the buyer's best interests. On the other hand, joint production of diagnosis and treatment by an integrated diagnostician may be more efficient. We examine an important special case of this problem: the costs and health outcomes of elderly Medicare beneficiaries with coronary artery disease. We compare the empirical consequences of diagnosis by an "integrated" cardiologist -- one who can provide surgical treatment -- to the consequences of diagnosis by a non-integrated cardiologist. Diagnosis by an integrated cardiologist leads, on net, to higher health spending but similar health outcomes. The net effect contains three components: reduced spending and improved outcomes from better allocation of patients to surgical treatment options; increased spending conditional on treatment option; and worse outcomes from poorer provision of non-surgical care. We conclude that accounting more completely for doctors' incentives to refer patients in setting reimbursements, or in the alternative, allowing doctors more freedom to make and receive payments for referrals, could reduce spending and improve quality. Kessler, Daniel P. 1966- Verfasser (DE-588)128781629 aut Erscheint auch als Online-Ausgabe National Bureau of Economic Research <Cambridge, Mass.> NBER working paper series 12623 (DE-604)BV002801238 12623 http://papers.nber.org/papers/w12623.pdf kostenfrei Volltext |
| spellingShingle | Afendulis, Christopher C. Kessler, Daniel P. 1966- Tradeoffs from integrating diagnosis and treatment in markets for health care |
| title | Tradeoffs from integrating diagnosis and treatment in markets for health care |
| title_auth | Tradeoffs from integrating diagnosis and treatment in markets for health care |
| title_exact_search | Tradeoffs from integrating diagnosis and treatment in markets for health care |
| title_full | Tradeoffs from integrating diagnosis and treatment in markets for health care Christopher C. Afendulis ; Daniel P. Kessler |
| title_fullStr | Tradeoffs from integrating diagnosis and treatment in markets for health care Christopher C. Afendulis ; Daniel P. Kessler |
| title_full_unstemmed | Tradeoffs from integrating diagnosis and treatment in markets for health care Christopher C. Afendulis ; Daniel P. Kessler |
| title_short | Tradeoffs from integrating diagnosis and treatment in markets for health care |
| title_sort | tradeoffs from integrating diagnosis and treatment in markets for health care |
| url | http://papers.nber.org/papers/w12623.pdf |
| volume_link | (DE-604)BV002801238 |
| work_keys_str_mv | AT afendulischristopherc tradeoffsfromintegratingdiagnosisandtreatmentinmarketsforhealthcare AT kesslerdanielp tradeoffsfromintegratingdiagnosisandtreatmentinmarketsforhealthcare |