Distributionally sensitive measurement and valuation of population health.

We introduce a measure of population health that is sensitive to inequality in both age-specific health and lifespan and can be calculated from a health-extended period life table. By allowing for inequality aversion, the measure generalises health-adjusted life expectancy without requiring more data. A transformation of change in the (life-years) measure gives a distributionally sensitive monetary valuation of change in population health and disease burden.

Childhood Immunization and Competing Mortality Risks in Kenya: A Longitudinal Analysis for Multiparous Mothers.

Objective: To assess the relationship between childhood immunization and mortality risks for nonvaccine-preventable diseases (competing mortality risks, or CMR) in Kenya.

Study Design: A combination of the Global Burden of Disease and Demographic Health Survey data was used to measure basic vaccination status, CMR, and control variables for each child in the Demographic Health Survey data. A longitudinal analysis was performed.

Surgeon supply and healthcare quality: Are revision rates for hip and knee replacements lower in hospitals that employ more surgeons?

We study the link between department-wide surgeon supply and quality of care for two major elective medical procedures. Several countries have adopted policies to concentrate medical procedures in high-volume hospitals. While higher patient volumes might translate to higher quality, we provide evidence for a positive relationship between surgeon supply and hospital revision rates for hip and knee replacement surgery.

The relative importance and stability of disease burden causes over time: summarizing regional trends on disease burden for 290 causes over 28 years.

Background: Since the Global Burden of Disease study (GBD) has become more comprehensive, data for hundreds of causes of disease burden, measured using Disability Adjusted Life Years (DALYs), have become increasingly available for almost every part of the world. However, undergoing any systematic comparative analysis of the trends can be challenging given the quantity of data that must be presented.

Methods: We use the GBD data to describe trends in cause-specific DALY rates for eight regions.

Does price deregulation in a competitive hospital market damage quality?

Regulators may be hesitant to permit price competition in healthcare markets because of its potential to damage quality. We assess whether this fear is well founded by examining a reform that permitted Dutch health insurers to freely negotiate prices with hospitals. Unlike previous research on hospital competition that has relied on quality indicators for urgent treatments, we take advantage of a plausible absence of selection bias to identify the effect on the quality of elective procedures that should be more price responsive.

Learning from failure in healthcare: Dynamic panel evidence of a physician shock effect.

Procedural failures of physicians or teams in interventional healthcare may positively or negatively predict subsequent patient outcomes. We identify this effect by applying (non)linear dynamic panel methods to data from the Belgian transcatheter aorta valve implantation registry containing information on the first 860 transcatheter aorta valve implantation procedures in Belgium. We find that a previous death of a patient positively and significantly predicts subsequent survival of the succeeding patient.

Does my high blood pressure improve your survival? Overall and subgroup learning curves in health.

Learning curves in health are of interest for a wide range of medical disciplines, healthcare providers, and policy makers. In this paper, we distinguish between three types of learning when identifying overall learning curves: economies of scale, learning from cumulative experience, and human capital depreciation. In addition, we approach the question of how treating more patients with specific characteristics predicts provider performance.

Hospitalization costs ofTAVI in one Belgian university hospital.

Objective: Considering the sizeable cost of transcatheter aortic valve implantation (TAVI) and conflicting cost-effectiveness studies, it is useful to gain more insight into the cost structure of the TAVI hospitalization. This study provides such a cost analysis and starts to evaluate options to soften the hospitalization cost burden in order to make TAVI economically more feasible.

Methods: Costs forTAVI hospitalization in the University Hospital of Antwerp were analysed uni- and bivariately.