What you don ' t know can certainly hurt you

I ' m going to defer any comment on the raging insanity around us and discuss a matter of direct importance to me. AsAustin Frakt discusses in the (highly successful) New York Times government -- at all levels really -- has an allergy to any rigorous investigation of whether policies actually work as intended. (Sorry if you ' ve spent your free NYT chits for the month, I ' ll summarize a bit of it.) Health policy is part of my portfolio, and it ' s undergoing massive experimentation and innovation. Policy makers are struggling to address the rising cost of health care, the fragmentation of services, and the gaps in coverage, financial burdens and complexity faced by most of us.Many ideas to improve health care organization and finance seem intuitively compelling, you never know what ' s really going to happen till it happens; and drawing causal inferences can still be difficult. If a change in payment policy is followed by reduced billings, is that because we ' re reducing unnecessary services, or people aren ' t getting care from which they would actually benefit? Or does it really have nothing to do with the policy change at all, but something else that just coincidentally happened at the same time?So the best way to really study the effects of policies is with some form of randomized controlled trial. There are difficulties in doing these cost effectively and ethically, but cluster randomized trials -- i.e. policies that are implemented with some institutions or communitie...
Source: Stayin' Alive - Category: American Health Source Type: blogs