An article in yesterday's New York Times talks about an article that describes different results from different types of prostate surgery. A key finding is that minimally invasive surgery is associated with similar outcomes with respect to cancer, fewer short-term side effects, but more long-term side effects.
Why is this "economics"? Quite simply it demonstrates tradeoffs. A main short-term risk that is referred to is pneumonia. Main long-term risks are impotence and incontinence. This is something that society in general might have opinions about and is certainly something that individual men who are undergoing prostate cancer treatment have opinions about. This can be analyzed using a cost-effectiveness analysis to describe average results within a population and can also be analyzed at the individual level looking at a "decision support system" which is intended to provide information for an individual to make decisions What are the costs and risks associated with pneumonia? What are the costs and risks associated with incontinence and impotence? Is there specific information about these risks for men just like the patient in question?
It is also economics because a key question is why there is the demand for a service that has not been shown to be clearly superior. This is an interesting question about technology diffusion, marketing, and how hospitals make decisions about the expected return on investment from the acquisition of new technology. Hospitals that calculated a favorable return on investment invested in new technologies and now need to achieve the return on investment.
As a result, the more expensive and less invasive technology may continue to penetrate the market despite mixed clinical evidence. This is another point at which some additional regulation or oversight of investment and coverage decisions may help the market for medical care.
Lemon Zest, Turkish Apricot Scones
2 years ago