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The Costs and Benefits of Intensive Treatment for Cardiovascular Disease

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  • David Cutler
  • Mark McClellan
  • Joseph Newhouse

Abstract

This paper examines the causes and consequences of reductions in cardiovascular disease mortality, and in particular heart attack mortality, over the past several decades. Analysis of data from Medicare and review of the clinical literature indicate that a large share of the recent decline in heart attack mortality is a result of new medical interventions and increased use of existing interventions. Much of the mortality improvement appears to be the result of changes in the use of pharmaceuticals such as aspirin and clot-busting (thrombolytic) drugs. Greater use of these and other intensive medical procedures have increased the cost of treating heart attacks but have also lead to health improvements. We estimate that the value of improved health is greater than the increased cost of heart attack care, so that the cost of living for people with a heart attack is falling. We present preliminary evidence that patients in managed care receive nearly similar treatment for heart attacks compared to patients with traditional indemnity insurance, but that managed care insurers pay less for the same treatments than do traditional insurers.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 6514.

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Date of creation: Apr 1998
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Publication status: published as Triplett, Jack (ed.) Measuring the Prices of Medical Treatments. Washington, D.C.: The Brookings Institution, 1999.
Handle: RePEc:nbr:nberwo:6514

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Cited by:
  1. Robert J. Gordon, 2006. "The Boskin Commission Report: A Retrospective One Decade Later," International Productivity Monitor, Centre for the Study of Living Standards, vol. 12, pages 7-22, Spring.
  2. Dora L. Costa, 1998. "Understanding the Twentieth Century Decline in Chronic Conditions Among Older Men," NBER Working Papers 6859, National Bureau of Economic Research, Inc.
  3. Adriana Lleras-Muney, 2002. "The Relationship Between Education and Adult Mortality in the United States," NBER Working Papers 8986, National Bureau of Economic Research, Inc.
  4. John A. Romley & Dana Goldman, 2008. "How Costly Is Hospital Quality? A Revealed-Preference Approach," NBER Working Papers 13730, National Bureau of Economic Research, Inc.
  5. David M. Cutler & Arnold M. Epstein & Richard G. Frank & Raymond Hartman & Charles King III & Joseph P. Newhouse & Meredith B. Rosenthal & Elizabeth Richardson Vigdor, 2000. "How Good a Deal Was the Tobacco Settlement?: Assessing Payments to Massachusetts," NBER Working Papers 7747, National Bureau of Economic Research, Inc.
  6. Cutler, David M. & Mas, Nuria, 2003. "Comparing non-fatal health across countries: Is the US medical system better?," IESE Research Papers D/525, IESE Business School.
  7. Jeffrey S. McCullough, 2008. "The adoption of hospital information systems," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 649-664.
  8. Darby, Julia & Hart, Robert A. & Vecchi, Michela, 2001. "Labour force participation and the business cycle: a comparative analysis of France, Japan, Sweden and the United States," Japan and the World Economy, Elsevier, vol. 13(2), pages 113-133, April.
  9. Gianluca Baio & Laura Magazzini & Claudia Oglialoro & Fabio Pammolli & Massimo Riccaboni, 2005. "Medical Devices: Competitiveness and Impact on Public Health Expenditure," Working Papers 05-2005, Competitività Regole Mecati (CERM).
  10. David Card & Carlos Dobkin & Nicole Maestas, 2007. "Does Medicare Save Lives?," NBER Working Papers 13668, National Bureau of Economic Research, Inc.
  11. Laurence C. Baker & Ciaran S. Phibbs, 2000. "Managed Care, Technology Adoption, and Health Care: The Adoption of Neonatal Intensive Care," NBER Working Papers 7883, National Bureau of Economic Research, Inc.
  12. Robert J. Gordon, 2000. "The Boskin Commission Report and its Aftermath," NBER Working Papers 7759, National Bureau of Economic Research, Inc.
  13. Dora L. Costa & Joanna Lahey, 2003. "Becoming Oldest-Old: Evidence from Historical U.S. Data," NBER Working Papers 9933, National Bureau of Economic Research, Inc.
  14. Richard G. Frank & Ernst R. Berndt & Susan H. Busch, 1998. "Price Indexes for the Treatment of Depression," NBER Working Papers 6417, National Bureau of Economic Research, Inc.

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