variation

  This weeks blog is brought to you by: Professor Sir Muir Gray, Founding Director. Authors conclusion Cost-conversation practice certainly will not make us perfect, given the logistical and informational barriers that exist. However, it will move us closer to the kind of patient-centered care that characterizes the ideals of our profession.   Text from the paper chosen by 3VH (this may, or may not be the ‘conclusion’) Out-of-pocket expenditures have increased rapidly in the United States over the past decade. In 2018, 29% of people with private insurance were enrolled in high-deductible health plans, compared with just 4% in 2006. Out-of-pocket costs are high for many publicly insured people, too. Medicare beneficiaries with cancer who do not [...]

Giuseppe Moscelli, Luigi Siciliani, Nils Gutacker, Richard Cookson (2018) Socioeconomic inequality of access to healthcare: Does choice explain the gradient? Journal of Health Economics, 57, 290–314.   This week's blog is brought to you by: Dr Tim Wilson   Bottom Line For planned vascular surgery, there is inequity in NHS provision for people living in the poorest and wealthiest neighbourhoods, representing an addressable cause of lower value.   Authors conclusion Equity of access is a key policy objective in publicly-funded healthcare systems. However, observed inequalities of access by socioeconomic status may result from differences in patients’ choices. Using data on non-emergency coronary revascularisation procedures in the English National Health Service, we found substantive differences in waiting times within [...]

Full reference: Sugrue L.P. and Rahul S. Desikan, R.S JAMA May 14, 2019 Volume 321, Number 18 1820 -1821 This weeks blog is brought to you by: Professor Sir Muir Gray WEB LINK TO PAPER Authors conclusion - Text from the paper chosen by 3VH Value “The value of polygenic risk scores cannot be assessed until the clinical utility has been established through research studies that evaluate their use in clinical practice and therapeutic trials. Companies are already offering these tests directly to consumers at costs ranging from one to a few hundred dollars. As whole-exomesequencing and whole genomesequencing become less expensive and more widely available, it should be possible to compute any polygenic score from an individual’s [...]

Full reference: Dover D.C. and Belon A.P.(2019) International Journal for Equity in Health 18;36 WEB LINK TO PAPER   This weeks blog is brought to you by: Professor Sir Muir Gray, Founding Director   Authors conclusion; Text from the paper chosen by 3VH. This paper presented a complex, overarching measurement framework for health equity.  The HEMF is a synthesis of existing SDOH (Social Determinants of Health) and health system utilisation frameworks and current literature.  Yet, its purpose extends to focus on measurement. It is specifically designed to help identify and measure the interrelationships between political and socio-cultural context, health system-related policies and programs, material and social circumstances, environment, biological and psychosocial factors, perceived and evaluated needs, social location, [...]