Forum for Health Economics and Policy最新文献

{"title":"The Health and Retirement Study: Contextual Data Augmentation.","authors":"Christopher Dick","doi":"10.1515/fhep-2021-0068","DOIUrl":"https://doi.org/10.1515/fhep-2021-0068","url":null,"abstract":"<p><p>The Health and Retirement Study is an amazing resource for those studying aging in the United States, and a fantastic model for other countries who have created similar longitudinal studies. The raw amount of information, from data on income, wealth, and use of health services to employment, retirement, and family connections on to the collection of clinical biomarkers can be both empowering and overwhelming to a researcher. Luckily through the process of engagement with the research community and constant improvement, these reams of data are not only consistently growing in a thoughtful and focused direction, they are also explained and summarized to increase the ease of use for all. One of the very useful areas of the HRS is the Contextual Data File (CDF), which is the focus of this review. The CDF provides access to easy-to-use helpful community-level data in a secure environment that has allowed researchers to answer questions that would have otherwise been difficult or impossible to tackle. The current CDF includes data in six categories (University of Michigan Institute for Social Research. 2017. <i>HRS Data Book: The Health and Retirement Study: Aging in the 21st Century, Challenges and Opportunities for Americans</i>. Ann Arbor: University of Michigan. Also available at https://hrs.isr.umich.edu/about/data-book, 17): 1. Socio-economic Status and Demographic Structure 2. Psychosocial Stressors 3. Health Care 4. Physical Hazards 5. Amenities 6. Land Use and the Built Environment. Each of these areas have allowed researchers to answer interesting questions such as what is the impact of air pollution on cognition in older adults (Ailshire, J., and K. M. Walsemann. 2021. \"Education Differences in the Adverse Impact of PM 2.5 on Incident Cognitive Impairment Among U.S. Older Adults.\" <i>Journal of Alzheimer's Disease</i> 79 (2): 615-25), the impact of neighborhood characteristics on obesity in older adults (Grafova, I. B., V. A. Freedman, R. Kumar, and J. Rogowski. 2008. \"Neighborhoods and Obesity in Later Life.\" <i>American Journal of Public Health</i> 98: 2065-71), or even what do we gain from introducing contextual data to a survey analysis (Wilkinson, L. R., K. F. Ferraro, and B. R. Kemp. 2017. \"Contextualization of Survey Data: What Do We Gain and Does it Matter?\" <i>Research in Human Development</i> 14 (3): 234-52)? My review focuses on the potential to expand contextual data in a few of these areas. From new data sets developed and released by the U.S. Census Bureau, to improved measurements of climate and environmental risk, there are numerous new data sources that would be a boon to the research community if they were joined together with the HRS. The following section begins by breaking down the opportunity provided by community or place-based data before moving on to specific recommendations for new data that could be included in the HRS contextual data file.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"25 1-2","pages":"29-40"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10661177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the Utility of the Health and Retirement Study (HRS) to Identify Drivers of Rising Mortality Rates in the United States.","authors":"Shannon M Monnat,&nbsp;Irma T Elo","doi":"10.1515/fhep-2021-0058","DOIUrl":"https://doi.org/10.1515/fhep-2021-0058","url":null,"abstract":"<p><p>A recent report from the National Academies of Sciences, Engineering, and Medicine (NASEM) highlights rising rates of working-age mortality in the United States, portending troubling population health trends for this group as they age. The Health and Retirement Study (HRS) is an invaluable resource for researchers studying health and aging dynamics among Americans ages 50 and above and has strong potential to be used by researchers to provide insights about the drivers of rising U.S. mortality rates. This paper assesses the strengths and limitations of HRS data for identifying drivers of rising mortality rates in the U.S. and provides recommendations to enhance the utility of the HRS in this regard. Among our many recommendations, we encourage the HRS to prioritize the following: link cause of death information to respondents; reduce the age of eligibility for inclusion in the sample; increase the rural sample size; enhance the existing <i>HRS Contextual Data Resource</i> by incorporating longitudinal measures of structural determinants of health; develop additional data linkages to capture residential settings and characteristics across the life course; and add measures that capture drug use, gun ownership, and social media use.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"25 1-2","pages":"57-84"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448826/pdf/fhep-25-1-fhep-2021-0058.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9901628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Nonresponse and Data Linkage Consent Bias in Large-Scale Panel Surveys.","authors":"Joseph W Sakshaug","doi":"10.1515/fhep-2021-0060","DOIUrl":"https://doi.org/10.1515/fhep-2021-0060","url":null,"abstract":"<p><p>Selection bias is an ongoing concern in large-scale panel surveys where the cumulative effects of unit nonresponse increase at each subsequent wave of data collection. A second source of selection bias in panel studies is the inability to link respondents to supplementary administrative records, either because respondents do not consent to link or the matching algorithm fails to locate their administrative records. Both sources of selection bias can affect the validity of conclusions drawn from these data sources. In this article, I discuss recently proposed methods of reducing both sources of selection bias in panel studies, with a special emphasis on reducing selection bias in the US Health and Retirement Study.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"25 1-2","pages":"41-55"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10655760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preface: Expert Advice to Enhance Aging Research and the Health and Retirement Study.","authors":"Terrie E Moffitt,&nbsp;John W R Phillips","doi":"10.1515/fhep-2022-0021","DOIUrl":"https://doi.org/10.1515/fhep-2022-0021","url":null,"abstract":"This new issue of Forum for Health Economics & Policy brings fi ve peer-reviewed articles that were commissioned in 2021 to shape the future of the Health and Retirement Study (HRS), a longitudinal panel study that surveys a nationally representative sample of approximately 20,000 people in America aged 50 and older, supported by the National Institute on Aging and the Social Security Administration. 1 Each article contains thoughtful recommendations from subject matter experts for the HRS team to consider as they develop plans for future data collection efforts","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"25 1-2","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10473961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Outcomes, Income and Income Inequality: Revisiting the Empirical Relationship.","authors":"Constantinos Alexiou,&nbsp;Emmanouil Trachanas","doi":"10.1515/fhep-2021-0042","DOIUrl":"https://doi.org/10.1515/fhep-2021-0042","url":null,"abstract":"<p><p>In this paper we revisit the relationship between health outcomes, income, and income inequality by applying alternative panel methodologies to a dataset of high-income countries spanning the time period 1980-2017. In this direction, we adopt alternative methodological frameworks in order to provide a) meaningful results by taking into account standard errors that alleviate problems of cross-sectional (spatial) and temporal dependence, and b) insights into the underlying relationships at several points of the conditional distribution of the health outcomes dependent variables. The evidence strongly supports the significant role that income plays in determining health outcomes. The findings relating to income inequality and nonlinear terms are more fragmented in that their significance and sign-direction depend on the functional form and the respective quantiles of the distribution the relationships are evaluated.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"24 2","pages":"75-100"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10654223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Economic Growth, Mortality, and Healthcare Spending in 31 High-Income Countries.","authors":"Francesco Sanmarchi,&nbsp;Francesco Esposito,&nbsp;Andrea Bucci,&nbsp;Fabrizio Toscano,&nbsp;Davide Golinelli","doi":"10.1515/fhep-2021-0035","DOIUrl":"https://doi.org/10.1515/fhep-2021-0035","url":null,"abstract":"<p><p>This study aims to investigate the association between gross domestic product (GDP), mortality rate (MR) and current healthcare expenditure (CHE) in 31 high-income countries. We used panel data from 2000 to 2017 collected from WHO and OECD databases. The association between CHE, GDP and MR was investigated through a random-effects model. To control for reverse causality, we adopted a test of Granger causality. The model shows that the MR has a statistically significant and negative effect on CHE and that an increase in GDP is associated with an increase of CHE (<i>p</i> < 0.001). The Granger causality analysis shows that all the variables exhibit a bidirectional causality. We found a two-way relationship between GDP and CHE. Our analysis highlights the economic multiplier effect of CHE. In the debate on the optimal allocation of resources, this evidence should be taken into due consideration.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"24 2","pages":"101-118"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10662493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Biopharmaceutical Innovation on Disability, Social Security Recipiency, and Use of Medical Care of U.S. Community Residents, 1998-2015.","authors":"Frank R Lichtenberg","doi":"10.1515/fhep-2021-0050","DOIUrl":"https://doi.org/10.1515/fhep-2021-0050","url":null,"abstract":"<p><p>This study seeks to analyze the overall impact that biopharmaceutical innovation had on disability, Social Security recipiency, and the use of medical services of U.S. community residents during the period 1998-2015. We test the hypothesis that the probability of disability, Social Security recipiency, and medical care utilization associated with a medical condition is inversely related to the number of drug classes previously approved for that condition. We use data from the 1998-2015 waves of the Medical Expenditure Panel Survey and other sources to estimate probit models of an individual's probability of disability, Social Security recipiency, and medical care utilization. The effect of biopharmaceutical innovation is identified by differences across over 200 medical conditions in the growth in the lagged number of drug classes ever approved. 18 years of previous biopharmaceutical innovation is estimated to have reduced: the number of people who were completely unable to work at a job, do housework, or go to school in 2015 by 4.5%; the number of people with cognitive limitations by 3.2%; the number of people receiving SSI in 2015 by 247 thousand (3.1%); and the number of people receiving Social Security by 984 thousand (2.0%). Previous innovation is also estimated to have caused reductions in home health visits (9.2%), inpatient events (5.7%), missed school days (5.1%), and outpatient events (4.1%). The estimated value in 2015 of some of the reductions in disability, Social Security recipiency, and use of medical care attributable to previous biopharmaceutical innovation ($115 billion) is fairly close to 2015 expenditure on drug classes that were first approved by the FDA during 1989-2006 ($127 billion). However, for a number of reasons, the costs are likely to be lower, and the benefits are likely to be larger, than these figures.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"24 1","pages":"35-74"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10839169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization Management in the Medicare Part D Program and Prescription Drug Utilization.","authors":"Martin S Andersen","doi":"10.1515/fhep-2022-0007","DOIUrl":"https://doi.org/10.1515/fhep-2022-0007","url":null,"abstract":"<p><p>Medicare Part D has significantly enhanced access to prescription drugs among Medicare beneficiaries. However, the recent rapid rise of utilization management policies in the Medicare Part D program may have adversely affected access to prescription drugs. I study the effects of expected and observed exposure to utilization management in prescription drug utilization using Medicare Part D claims data from 2009 to 2016 and an instrumental variables strategy based on the interaction of lagged health status and the set of plans available to each beneficiary. I find that the expected share of spending subject to utilization management increases the observed share, with the smallest effect for prior authorization. Increases in the expected share of drug spending subject to prior authorization increases Part D spending by $122.27 per percentage point, with almost three-quarters of this increase being paid by the Medicare program, rather than beneficiaries or plans. Comparable increases in step therapy and quantity limit exposure increase spending by $46 and decrease spending by $31, respectively. Interestingly, increased exposure to prior authorization and quantity limits increases the average price per 30-day prescription.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"24 1","pages":"1-34"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10473263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontmatter","authors":"","doi":"10.1515/fhep-2020-frontmatter2","DOIUrl":"https://doi.org/10.1515/fhep-2020-frontmatter2","url":null,"abstract":"","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91307434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Social Value of Improvement in Activities of Daily Living among the Advanced Parkinson's Disease Population.","authors":"Jeffrey Sullivan,&nbsp;Tiffany M Shih,&nbsp;Emma van Eijndhoven,&nbsp;Yash J Jalundhwala,&nbsp;Darius N Lakdawalla,&nbsp;Cindy Zadikoff,&nbsp;Jennifer Benner,&nbsp;Thomas S Marshall,&nbsp;Kavita R Sail","doi":"10.1515/fhep-2019-0021","DOIUrl":"https://doi.org/10.1515/fhep-2019-0021","url":null,"abstract":"<p><strong>Objectives: </strong>Quantify the value of functional status (FS) improvements consistent in magnitude with improvements due to levodopa-carbidopa intestinal gel (LCIG) treatment, among the advanced Parkinson's disease (APD) population.</p><p><strong>Methods: </strong>The Health Economic Medical Innovation Simulation (THEMIS), a microsimulation that estimates future health conditions and medical spending, was used to quantify the health and cost burden of disability among the APD population, and the value of quality-adjusted life-years gained from FS improvement due to LCIG treatment compared to standard of care (SoC). A US-representative Parkinson's disease (PD)-comparable cohort was constructed in THEMIS based on observed PD patient characteristics in a nationally representative dataset. APD was defined from the literature and clinical expert input. The PD and APD cohorts were followed from 2010 over their remaining lifetimes. All individuals were ages 65 and over at the start of the simulation. To estimate the value of FS improvement due to LCIG treatment, decreases in activities of daily living (ADL) limitations caused by LCIG treatment were calculated using data from a randomized, controlled, double-blind, double-dummy clinical trial and applied to the APD population in THEMIS.</p><p><strong>Results: </strong>Total burden of disability associated with APD was $17.7 billion (B). From clinical trial data, LCIG treatment versus SoC lowers the odds of difficulties in walking, dressing, and bathing by 76%, 42% and 39%, respectively. Among the APD population, these reductions generated $2.6B in value to patients and cost savings to payers. The added value was 15% of the burden of disability associated with APD and offsets 15% of the cost of LCIG treatment.</p><p><strong>Conclusions: </strong>FS improvements, consistent with improvements due to LCIG treatment, in the APD population created health benefits and reduced healthcare costs in the US.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"23 2","pages":"1-23"},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fhep-2019-0021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}