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Effects of expanding health screening on treatment – What should we expect? What can we learn?

Author

Listed:
  • Rebecca Myerson

    () (University of Southern California School of Pharmacy)

  • Darius Lakdawalla

    () (University of Southern California)

  • Lisandro D. Colantonio

    () (The University of Alabama at Birmingham)

  • Monika Safford

    () (Weill Cornell Medical College)

  • David Meltzer

    () (The University of Chicago)

Abstract

Screening interventions can produce very different treatment outcomes, depending on the reasons why patients had been unscreened in the first place. Economists have paid scant attention to these complexities and their implications for evaluating screening programs. In this paper, we propose a simple economic framework to guide policy-makers and analysts in designing and evaluating the impact of screening on treatment uptake. We apply these insights to several salient empirical examples that illustrate the different kinds of effects screening programs might produce. Our empirical examples focus on contexts relevant to the top cause of death in the United States, heart disease. We find that currently undiagnosed patients differ from currently diagnosed patients in important ways, leading to lower predicted uptake of recommended treatment if these patients were diagnosed. Additionally, changes in the composition of diagnosed patients can produce misleading conclusions during policy analysis, such as spurious reductions in measured health system performance as screening expands.

Suggested Citation

  • Rebecca Myerson & Darius Lakdawalla & Lisandro D. Colantonio & Monika Safford & David Meltzer, 2018. "Effects of expanding health screening on treatment – What should we expect? What can we learn?," Working Papers 2018-014, Human Capital and Economic Opportunity Working Group.
  • Handle: RePEc:hka:wpaper:2018-014
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    File URL: http://humcap.uchicago.edu/RePEc/hka/wpaper/Myerson_Lakdawalla_Colantonio_etal_2018_expanding_health_screening.pdf
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    File URL: http://humcap.uchicago.edu/RePEc/hka/wpaper/Myerson_Lakdawalla_Colantonio_etal_2018_expanding_health_screening_rev1.pdf
    File Function: Second version, April 26, 2018
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    References listed on IDEAS

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    Cited by:

    1. Amanda E. Kowalski, 2018. "Behavior within a Clinical Trial and Implications for Mammography Guidelines," NBER Working Papers 25049, National Bureau of Economic Research, Inc.

    More about this item

    Keywords

    diagnosis; screening; self-selection; policy analysis; quality measurement;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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