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Why is it difficult to measure health outcomes?
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Chapter 16
Information, Risk, and Insurance
How Markets Work
Markets and Welfare
The Economics of the Public Sector
Mahler S.
March 9, 2022
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There are lots of reasons why it could be very difficult to measure health outcomes, one of the basic ones of something called survivor bias. And this is where if you were to survey a group of people and ask them, how did you fare in a certain situation? The only people available to survey are people who made it out of that situation. The famous example is, if you surveyed every soldier coming home from World War Two and ask them, Did you die in the war? Obviously, everyone says no. And then the conclusion you draw from that is well, there were no fatalities in the war. So in the same way, you can have a survivor bias, if you will. When you're trying to measure health outcomes, another one is tryingto actually develop a good way. Tohave counterfactual sze order counterfactual tze That's essentially when you ask the question What if we didn't do X? What if we did? Why, Instead, what would have happened? Well, that's essentially a guess. There's no way to prove what exactly would have been the other outcome. For example, if I can give you drug A or drug Bea and I give you drug A. We have results from that. But then I want to measure what would have happened with result be, Well, we don't know that because we didn't do it. So now we're guessing, as opposed to observing an actual fact. Another example is that everyone's different, right? So because of that, the results you have may not be the results someone else has. But both could be optimal. In other words, let's say you recover from an illness in five days, whereas I take six days to recover Now. Maybe that's because I haven't underlying health condition. Maybe that's because I'm older and I have a poor immune system. Whatever the case may be, sometimes it's a genetic difference. These facts make it very, very difficult sometimes to compare outcomes, a cost across groups. Another factor is how much money has actually spent. So what I mean by this is essentially that you may value a certain health outcome much more than I do, and you may be willing to spend more money on that than I am. However, just like an education, the actual amount of money spent isn't always a good indicator of health outcomes. because an education you have certain situations, especially in inner cities where tons, excuse me tons and tons of money is spent on education. And yet the quality is relatively poor compared to some other areas that spend very little on education and yet get higher outcomes. The other aspect is that sometimes it's just very difficult to measure quality. For example, it's often cited that we spend MAWR in the United States on health care than in the United Kingdom. Well, that's true, but we get a better quality of care. For example, in the United States, your must move much more likely in a hospital. To get a private room in the United Kingdom, you're much more likely to be placed in a ward where there's little to no privacy, so it could be very, very difficult to measure quality of care. Where is it? Could be much easier to just look at the flat number of dollars or even the per capita number of dollars, But that doesn't give a good indicator of quality
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