全球智库信息集成服务系统(G2TT): Personalized Medicine When Physicians Induce Demand

G2TT

来源类型	Working Paper
规范类型	报告
DOI	10.3386/w24054
来源ID	Working Paper 24054
	Personalized Medicine When Physicians Induce Demand
	David H. Howard; Jason Hockenberry; Guy David
发表日期	2017-11-27
出版年	2017
语种	英语
摘要	Advocates for “personalized medicine” tests claim they can reduce health care spending by identifying patients unlikely to benefit from costly treatments. But most tests are imperfect, and so physicians have considerable discretion in how they use the results. We show that when physicians face incentives to provide a treatment, the introduction of an imperfect prognostic test will increase treatment rates. We study the interaction of incentives and information in physicians’ choice between conventional radiotherapy and intensity modulated radiation therapy (IMRT) for Medicare patients with breast cancer. IMRT is far more costly. Patients with left-side tumors are more likely to benefit from IMRT, though it is unnecessary for the vast majority of patients. IMRT use is 18 percentage points higher in freestanding clinics, where physician-owners share in the lucrative fees generated by IMRT, than in hospital-based clinics. Patients with left-side tumors are more likely to receive IMRT in both types of clinics. However, IMRT use in patients with right-side tumors (the low benefit group) treated in freestanding clinics is actually higher than use in patients with left-side tumors (high benefit group) treated in hospital-based clinics. Prognostic information affects use but does nothing to counter incentives to overuse IMRT.
主题	Health, Education, and Welfare ; Health
URL	https://www.nber.org/papers/w24054
来源智库	National Bureau of Economic Research (United States)
引用统计
资源类型	智库出版物
条目标识符	http://119.78.100.153/handle/2XGU8XDN/581728
推荐引用方式 GB/T 7714	David H. Howard,Jason Hockenberry,Guy David. Personalized Medicine When Physicians Induce Demand. 2017.

条目包含的文件
文件名称/大小	资源类型	版本类型	开放类型	使用许可
w24054.pdf（192KB）	智库出版物		限制开放	CC BY-NC-SA	浏览