Health Economics

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Recently Completed Projects

Obesity and Surgical Outcomes

Funded by the National Institute of Diabetes and Digestive and Kidney Diseases
Principal Investigator:  Jeffrey H. Silber, MD, PhD

Obesity has been implicated in predisposing patients to worse surgical outcomes (death and complications). However, the etiology of these outcome differences is not well understood or well defined. Developing approaches to improving outcomes in this population is therefore challenging. The aim of this study was to examine, using an efficient design that incorporated a 3 state, 50-hospital Medicare augemented claims database and nested, detailed chart abstraction using a matched cohort design, the differences in outcomes and treatments between obese and normal weight patients who underwent general, orthopedic, vascular or urological surgery.  

Evidence on the Efficacy of Inpatient Spending on Medicare Patients

Principal Investigators:  Robert Kaestner, PhD and Jeffrey H. Silber, MD, PhD

It is widely believed that a significant amount, perhaps as much as 20 to 30 percent, of health care spending in the United States is wasted, despite market forces such as managed care organizations and large, self-insured firms with a financial incentive to eliminate waste of this magnitude.  This study found that although some spending may be inefficient, the results suggest that the amount of waste is less than conventionally believed, at least for inpatient care.  

An Economic Study of Adverse Events Across Conditions

Funded by Amgen
Principal Investigator:  Jeffrey H. Silber, MD, PhD

The aim of this project was to develop a global model to estimate adverse events accounting for the distribution of cancer types. In particular, the relationship between adverse effects such as neutropenia and anemia, chemotherapy usage and cancer types was analyzed though a process of direct standardization. This work allowed for future comparisons across institutions on the management of adverse events given chemotherapy regimen and cancer types.