CoChat
Sign Up
Cited by 377

The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

Is Technological Change In Medicine Worth It?

Cutler, David M., McClellan, Mark·2001·Health Affairs
DOI 10.1377/hlthaff.20.5.11
Open this paper in CoChat — free account

Abstract

Medical technology is valuable if the benefits of medical advances exceed the costs. We analyze technological change in five conditions to determine if this is so. In four of the conditions--heart attacks, low-birthweight infants, depression, and cataracts--the estimated benefit of technological change is much greater than the cost. In the fifth condition, breast cancer, costs and benefits are about of equal magnitude. We conclude that medical spending as a whole is worth the increased cost of care. This has many implications for public policy.

Overview

Integrity signals

Registry

Crossref · 10.1377/hlthaff.20.5.11

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • For older persons, there have been fairly regular reports of improved functioning from reports of the prevalence of problems from the 1980s through the present.

    “For older persons, there have been fairly regular reports of improved functioning from reports of the prevalence of problems from the 1980s through the present (Crimmins & Saito, 2000; Cutler, 2001; Freedman & Martin, 1998, 2000; Martin, Freedman, et al., 2010; Schoeni, Freedman, & Wallace, 2001).”

    From Mortality and Morbidity Trends: Is There Compression of Morbidity? (2011) · cites this paper as Cutler, 2001

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 23

  1. K.G. Manton and X. Gu, “Changes in the Prevalence of Chronic Disability in the United States Black and Nonblack Population above Age 65 from 1982 to 1999,” Proceedings of the National Academy of Sciences (22 May 2001 ): 6354 –6359. · DOI
  2. W.K. Viscusi , “The Value of Risks to Life and Health,” Journal of Economic Literature (December 1993 ): 1912 –1946
  3. There is substantial debate about whether such costs ought to be included in the analysis or not. See Panel on Cost-Effectiveness in Health and Medicine, Cost-Effectiveness in Health and Medicine; and D. Meltzer, “Accounting for Future Costs in Medical Cost-Effectiveness Analysis,” Journal of Health Economics (Jan/Feb 1997 ): 33 –64. These two sources present opposing views. Conceptually, such costs ought to be included, but so too should the gains from extending longevity. To see why, consider the simplistic case of a medical technology that at negligible monetary cost would add one year to the life of a person just about to die. The technology will be worthwhile if the value to society of the person living a year is greater than the cost to society of having the person alive. Omitting either the costs or benefits from this equation biases the answer. The argument against including these costs and benefits has largely been based on the practical difficulty of doing so. · DOI
  4. 10.2307/3350295 · DOI
  5. D.M. Cutler et al. “Are Medical Prices Falling?” Quarterly Journal of Economics (November 1998 ): 991 –1024 · DOI
  6. J.P. Newhouse , “Medical Care Costs: How Much Welfare Loss?” Journal of Economic Perspectives (Summer 1992 ): 3 –21 · DOI
  7. ; and E.A. Peden and M.S. Freeland, “A Historical Analysis of Medical Spending Growth, 1960–1993,” Health Affairs (Summer 1995 ): 235 –247. · DOI
  8. P.A. Heidenreich and M. McClellan, “Trends in Treatment and Outcomes for Acute Myocardial Infarction: 1975–1995,” American Journal of Medicine (15 February 2001 ): 165 –174, examines trends in characteristics of heart attack patients from samples such as the Worcester Heart Attack Study and the Minnesota Heart Study. · DOI
  9. ; R.G. Frank et al. “The Value of Mental Health Care at the System Level: The Case of Treating Depression,” Health Affairs (Sep/Oct 1999 ): 71 –88 · DOI
  10. R.M. Hirschfeld et al. “The National Depressive and Manic-Depressive Association Consensus Statement on the Undertreatment of Depression,” Journal of the American Medical Association (22/29 January 1997 ): 333 –340. · DOI
  11. D.L. Sackett and G.W. Torrence, “The Utility of Different Health States as Perceived by the General Public,” Journal of Chronic Diseases (November 1978 ): 697 –704 · DOI
  12. ; D.G. Frybeck et al. “The Beaver Dam Health Outcomes Study: Initial Catalog of Health-State Quality Factors,” Medical Decision Making (April–June 1993 ): 89 –102 · DOI
  13. ; S.F. Anton and D.A. Revicki, “The Use of Decision Analysis in the Pharmacoeconomic Evaluation of an Antidepressant: A Cost-Effectiveness Study of Nefazodone,” Psychopharmacology Bulletin (Summer 1995 ): 249 –258
  14. For a discussion, see A.B. Nottinger , “Older Women, Mammography, and Mortality from Breast Cancer,” American Journal of Medicine (February 2000 ): 174 –175, and the references therein. · DOI
  15. For discussion, see D.M. Cutler and E. Richardson, “Your Money and Your Life: The Value of Health and What Affects It,” in Frontiers in Health Policy Research , vol. 2 , ed. A. Garber (Cambridge, Mass.: MIT Press, 1999 ), 99 –132.
  16. P.A. Sytkowski , W.B. Kannel, and R.B. D’Agostino, “Changes in Risk Factors and the Decline in Mortality from Cardiovascular Disease,” New England Journal of Medicine (7 June 1990 ): 1635 –1641. · DOI
  17. L. Baker and M. Brown, “The Effect of Managed Care on Health Care Providers,” RAND Journal of Economics (Summer 1999 ): 351 –374 · DOI
  18. ; M.E. Chernew et al. “Managed Care, Medical Technology, and Health Care Cost Growth: A Review of the Evidence,” Medical Care Research and Review (September 1998 ): 259 –288 · DOI
  19. ; and D. Cutler and L. Sheiner, “Managed Care and the Growth of Medical Expenditures,” in Frontiers in Health Policy Research , vol. 1 , ed. A. Garber (Cambridge, Mass.: MIT Press, 1998 ), chap, 3, 77 –115. · DOI
  20. Two studies that consider dynamic effects, at least over short time periods, are D.P. Kessler and M. McClellan, “Do Doctors Practice Defensive Medicine?” Quarterly Journal of Economics (May 1996 ): 353 –390 · DOI
  21. ; and D.P. Kessler and M. McClellan, “Is Hospital Competition Socially Wasteful?” Quarterly Journal of Economics (May 2000 ): 577 –615. These studies find one-time beneficial productivity effects of malpractice liability limits and increased competition, respectively. However, they find little evidence of dynamic effects on productivity. · DOI
  22. E. Berndt et al. “Medical Care Prices and Output,” in Handbook of Health Economics , vol. IA , ed. A.J. Culyer and J.P. Newhouse (Amsterdam: Elsevier, 2000 ), 119 –180. · DOI
  23. In other work with Joseph Newhouse, we have begun to develop evidence on this question. D.M. Cutler, M. McClellan, and J.P. Newhouse, “What Does Managed Care Do?” RAND Journal of Economics (August 2000 ): 526 –548. · DOI

Cited by

Sorted by citations

Metadata

Authors
Cutler, D. M., & McClellan, M.
Venue
Health Affairs
Publisher
Health Affairs Publishing, LLC
Published
2001-09
Volume
20
Issue
5
Pages
11-29
ISSN
  • 0278-2715
  • 1544-5208
DOI
10.1377/hlthaff.20.5.11
Cited by
377
References
1
Language
en

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review