A framework to evaluate the effects of small area variations in healthcare infrastructure on diagnostics and patient outcomes of rare diseases based on administrative data

Health Policy
Tom Stargardt, Jonas Schreyögg

Abstract

Small area variations in healthcare infrastructure may result in differences in early detection and outcomes for patients with rare diseases. It is our aim to provide a framework for evaluating small area variations in healthcare infrastructure on the diagnostics and health outcomes of rare diseases. We focus on administrative data as it allows (a) for relatively large sample sizes even though the prevalence of rare diseases is very low, and (b) makes it possible to link information on healthcare infrastructure to morbidity, mortality, and utilization. For identifying patients with a rare disease in a database, a combination of different classification systems has to be used due to usually multiple diseases sharing one ICD code. Outcomes should be chosen that are (a) appropriate for the disease, (b) identifiable and reliably coded in the administrative database, and (c) observable during the limited time period of the follow-up. Risk adjustment using summary scores of disease-specific or comprehensive risk adjustment instruments might be preferable over empirical weights because of the lower number of variables needed. The proposed framework will help to identify differences in time to diagnosis and treatment outcomes across ar...Continue Reading

References

Jun 1, 1992·Journal of Clinical Epidemiology·R A DeyoM A Ciol
Dec 1, 1988·Controlled Clinical Trials·J M Lachin
Dec 14, 1973·Science·J Wennberg, Gittelsohn
Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
May 8, 1995·Journal of Health Economics·C E Phelps
Mar 27, 2001·Journal of the American College of Cardiology·J V TuK M McDonald
Jul 27, 2001·Journal of Health Economics·W G Manning, J Mullahy
Jan 30, 2004·Statistics in Medicine·David V Glidden, Eric Vittinghoff
Aug 24, 2004·Health Economics·Anirban BasuJohn Mullahy
Dec 25, 2004·Journal of Clinical Epidemiology·Vijaya SundararajanWilliam A Ghali
Jan 16, 2008·BMC Public Health·Dag Gundersen StorlaGunnar Aksel Bjune
Mar 18, 2009·Nursing Research·Suzanne AmeringerSandra Ward
Jun 19, 2009·Arthritis Research & Therapy·Steven C VladDonald R Miller
Oct 21, 2009·BMC Health Services Research·Rikke Sand AndersenJens Søndergaard
Jan 19, 2010·British Journal of Clinical Pharmacology·Emily HerrettAndrew J Hall
Mar 6, 2010·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Nada F KhanPeter W Rose
Sep 18, 2010·Das Gesundheitswesen·K RollJ Schreyögg
Mar 8, 2011·Annals of Epidemiology·Amy E KalkbrennerJiu-Chiuan Chen
Apr 26, 2011·International Journal of Medical Informatics·Nhi-Ha T TrinhAlbert Yeung
Jul 28, 2011·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Mai Partridge VandborgOle Mogensen

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Citations

Apr 4, 2012·Health Policy·Carsten SchultzReinhard Busse
May 28, 2013·Health Policy·Peter Eibich, Nicolas R Ziebarth
Sep 23, 2016·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Caroline E WalkerTarun S Weeramanthri

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