2011年12月21日
凹函数
2011年12月16日
The Combination of Market Prices and Public Health-Insurance [HT]
The book Bring Market Prices to Medicare argues that it can through a competitive bidding process to improve health care. The authors want beneficiaries to face the true price differentials between the lowest cost plans and less efficient plans, regardless if the plan is Medicare FFS or an MA plan. Another issue focuses on regional adjustments. Living in New York is expensive and health care is more expensive in New York than in rural Mississippi. However, should Medicare subsidize New Yorkers because their health care is more expensive. The authors argue no. [HT]
● Bring Market Prices to Medicare: Essential Reform at a Time of Fiscal Crisis (AEI Studies on Medicare Reform), Robert F. Coulam, Roger Feldman, Bryan E. Dowd
2011年11月3日
The Effects of Entry and Exit (Turnover)
The dynamics of firms' entry and exit (if turnover rate and retention rate can be calculated like in a firm) will influence the competition, innovation, diffusion of advanced technology, and productivity. However, "The health care market exhibits important differences as compared to other markets, including various forms of market failure and, as a consequence, extensive market regulation. Thus, the economic effects of entries and exits in health care markets are less obvious. "
It is a very interesting topic to examine the economic effects of entry and exit in health care market. Martin in this paper attempted to establish a framework to study the impacts on the public-private and GP-specialists relationships.
预防医疗不省钱
It is well established that preventive care reduces the prevalence of disease and helps people live longer, healthier lives. Analysis of the cost-effectiveness of preventive care can guide policy-makers to allocate scarce resources. This synthesis reviews the evidence on the cost-effectiveness of clinical preventive care. Key findings include: although many preventive services are a good value (defined as costing less than $50,000 to $100,000 per Quality Adjusted Life Year), only a few, such as childhood immunizations and counseling adults on the use of low-dose aspirin are widely regarded as cost-saving. Costs to reduce risk factors, screening costs, and the cost of treatment when disease is found can offset any savings from preventive care. Prevention can reduce the incidence of disease, but savings may be partially offset by health care costs associated with increased longevity. Whether these additional competing risk costs outweigh the savings from avoiding the targeted disease depends on how healthy people are during the added life years. Given that so few preventive services save money and that these services are already in wide use, it is unlikely that prevention can reduce health care spending. The authors question whether the emphasis on savings is appropriate and suggest it is better to focus on high value preventive care, taking into account increased longevity and quality of life.
Thus we must pay attention to the differences between cost-effectiveness and cost-saving of cares.
2011年9月25日
My favorite four HEALTH ECONOMISTS
Guy David, genius, I love his research.
David Meltzer, technically he is not so much young, but is still. Both Dav have particular interests in specialization.
Almond, I have been attracted by issues with health shock and big famine.
Chandra, so brilliant, "malpractice" expert, and be good at almost every field of health economics.
2011年9月4日
Intro to CCS for ICD-10
The Clinical Classifications Software (CCS) for ICD-10 is a diagnosis categorization scheme that can be employed in many types of projects analyzing data on diagnoses. This tool is based on the International Classification of Diseases, 10th Revision (ICD-10), a uniform and standardized coding system, which has been used in the U.S. for mortality reporting since 1999. The ICD-10's multitude of codes – more than 32,000 diagnosis codes in all – are collapsed into a smaller number of clinically meaningful categories (only 260 types) that are sometimes more useful for presenting descriptive statistics than are individual ICD-10-CM codes.
CCS ICD-10 categories can be employed in many types of projects analyzing data on diagnoses. For example, they can be used to:
CCS ICD-10 categories can be employed in many types of projects analyzing data on diagnoses. For example, they can be used to:
- Identify populations for disease-specific studies
- Gain a better understanding of the distribution of certain conditions across disease groupings
- Examine trends in mortality by broad diagnosis groupings.
Useful links:
2011年8月29日
Links: 8/29/2011
China vs. America: Which Is the Developing Country? -- From new roads to wise leadership, sound financials and 5-year plans, China has a winning approach. BY ROBERT J. HERBOLD, From: Wall Street Journal 这位罗伯特是微软的前首席COO，是不是商人做久了就跟当官久了一样？尽信表面不如不信。文章sounds true, but funny and ironical.
"当医生不知道一个检查、一片药丸要多少钱的时候，医改就成功了。至于民众是否看得起病，那就是保障体系建设的问题了。"某L厅长说。--------这个命题，很显然，是非常错误的，医生能有效掌控卫生系统80%的卫生费用（有US的实证依据），你怎么能指望他们不管成本？还有最重要的证据是英国正在进行的医改--成立全科医师联盟，并撤销原有的NHS信托机构（卫生费用的守门人，原来是由他们和医生打交道并付费），将其掌握病人费用的权力交给全科医生，这也重重的抽了这位自以为是不学无术的厅长大人一记耳光。
we need to always remember that data and statistical tests never prove a theory. Typically, many different theories can explain almost any observed phenomenon. Data allows us only to reject a theory. The theories that survive are those that haven't been rejected yet, and that's a good reason for humility. ---The Role of Economics in an Imperfect World, by Edward Glaeser
2011年8月24日
Links: 8/25/2011
US physicians urge end to unnecessary stent operations, 冠心病支架手术的滥用已经将许多本来病情稳定的患者置于并发症风险之下，2008年有个美国Maryland州的医生Mark Midei因为一天做了30例支架手术被吊销医师执照，医生跟制售垃圾食品的supplier真是没啥区别。
罗切斯特的经济学教授Steven E. Landsburg写道：如果你不能改变一个人的消费，你就不可能对这个人收税，即便你把他银行里的钱都拿走也不行。郭凯：steven不过是说税收负担最终未必落在那个交税的人头上。我想起这大概就是所谓的"富人税（奢侈品税啊，房屋买卖课税啊~~~list~）"为什么总是伤害穷人的理论。
In this stupid country, we have enough physician, sufficient pharmacuticals and devices, but we don't have ownership, so the health system is a mess. It is growing, but it can not be evolving, re-organizing, or even moving. The system is learning, yet without development. All of these resulted from the idea that no one knows who owns it. 租值消散（dissipation of rent）或租值耗散理论(The Theory of Rent Dissipation)在国内译作"租值耗散"，又称"租耗"。 -- 公地的悲剧，产权的经济学。
2011年8月23日
Guideline of Mixed-method research
Question: How to produce a better research with mixed-method combining quantitative and qualitative approach?
2011年8月22日
[zt] Aid.vs.Trade
美欧的aid不能转变非洲社会，但是中非的贸易trade却能塑造shape一个新的非洲。en ~~ maybe a new idea
But aid from the outside cannot transform whole societies, whole countries. That can only come about through producing things and trading them or doing something someone else wants to pay for. Ironically, it is the capitalist West that still sees Africa as a continent that needs aid, while Communist and former Socialist governments like China and India see it as a business opportunity.
- Richard Dowden, Africa: Altered States, Ordinary Miracles.
2011年8月19日
一个HRH和health outcome的RCT--perfect！
从Prof Grepin推荐的best 10中发现一个Pakistan做的聚簇RC Trial试验，看好研究真是过瘾。在给这篇文章的correspondence里，Davis引用UNICEF的数据"In the developing world, 440 of 100,000 births result in maternal death, as compared with 12 of 100,000 in the developed world."，可见这里面还有很多工作可以做。但是话说回来，本文的RCT结果显示的是纳入传统的接生员只对Prenatal mortality有作用，对maternal mortality没有显著效果。
Source:
Jokhio A H, Winter H R and Cheng K K. 2005. An Intervention Involving Traditional Birth Attendants and Perinatal and Maternal Mortality in Pakistan. New England Journal Of Medicine 352: 2091-9
2011年8月4日
hospitalist II
--------DMH Hospitalist program 说明--------
Hospitalists are fully trained Internal Medicine physicians who devote all their clinical time to the care of hospitalized patients. They serve as attending physicians for patients who are directed to inpatient care by their primary care physician.
A model for hospital care in Europe for half a century, Hospitalists are also represented some of the United States leading hospitals
Hospitalist focus on patient care, comfort
A full-time hospital-based physician has distinct benefits. For example, a Hospitalist has the ability to rapidly coordinate inpatient care and react in real-time throughout the day to clinical data and changes in a patient's medical status.
At each step, whether ordering treatments, test, or consult with specialists when appropriate, communication between the Hospitalist and your primary care physician is seamless.
Hospitalists are also available consistently throughout a patient's stay to answer questions, discuss test results and provide reassurance. The Hospitalists also are familiar with hospital staff and the latest technologies available at hospital.
2011年7月16日
EQIS1.0 for QALY
EQIS 1.0, a software allows calculating Health Related Quality of Life weights. As health economist, we often concern values for QALYs (Quality Adjusted Life Years).
The website: http://www.econ.unavarra.es/~eqis/Examples.php
USER GUIDE: www.econ.unavarra.es/~eqis/EQIS%201.0%20USER%20GUIDE.pdf
2011年7月14日
Intro to Health Outcome
I reviewed some websites and literature on health outcome and related measurements today:
Intro:
http://www.ahrq.gov/clinic/outfact.htm U.S. Department of Health & Human Services 下辖的 Agency for Healthcare Research and Quality (AHRQ)
List of measurement instruments (工具非常多，有个网页上说有800多种):
人体最舒适-温度-湿度-风速-设定
我国国家规定了空气调节标准，对空调温度设定做了规范性的参数：
| 夏季空调温度设置 | 温度以24-28°C为宜，相对湿度40%-65%，风速在0.3米/秒以下 |
| 冬季空调温度设置 | 温度以18-22°C为宜，相对湿度40%-60%，风速在0—2米/秒以下 |
当然，这种规定是指导性的，不同场合、不同功用的房间对空调温度的设定要求也不一样，应具体分析：
| 青年人卧室： | 温度 | 相对湿度 |
| 夏季空调设置 | 25—29°C | 50%—65% |
| 冬季空调设置 | 20—25°C | 50%—60% |
| 病人、老人、小孩卧室： | 温度 | 相对湿度 |
| 夏季空调设置 | 26—27°C | 45%—65% |
| 冬季空调设置 | 22—23°C | 40%—60% |
| 客厅以及起居 | 温度 | 相对湿度 |
| 夏季空调设置 | 26—28°C | 50%—65% |
| 冬季空调设置 | 22—25°C | 40%—55% |
source： http://www.foxiangwang.com/994.html
payment reform and a JAMA paper
麻省实施了一个a global payment system called the Alternative Quality Contract (AQC)后一年里，对费用和服务质量的影响，分析用的是individual data，采用了前后测量和DD方法。--真是漂亮啊！这是这期JAMA上宋zirui一篇文章，虽然他还没拿到PhD，但是文章级别水平那真是~~~没的说！
Last month I joined a provincial workshop which discussed how to implement payment reform by conducting a combination of "Shanzhai DRG" for inpatient care and a global payment for outpatient care, since then I was just wondering how to evaluate effects of those payment reform.
Song Z, Safran D G, Landon B E, He Y, Ellis R P, Mechanic R E, Day M P and Chernew M E 2011 Health Care Spending and Quality in Year 1 of the Alternative Quality Contract New Engl J Med null-null
2011年7月9日
好医院是由医生领导？
在欧美的趋势是医院公司化，领导职业经理人化（没有医学相关学位的人领导）。国内离这一步还差远吧，医生联盟统治的医院几乎是滴水不漏的。现在有文章检验欧美的趋势，但是结论离因果效应还差得远吧。
Top-performing hospitals are typically ones headed by a medical doctor rather than a manager. That is the finding from a new study of what makes a good hospital.
Its conclusions run counter to a modern trend across the western world to put generally trained managers — not those with a medical degree — at the helm of hospitals. This trend has been questioned, particularly by the Darzi Report, which was commissioned by the U.K. National Health Service, but until now there has been no clear evidence.
Amanda Goodall PhD, at the Institute for the Study of Labor (IZA) in Bonn, Germany, constructed a detailed database on 300 of the most prominent hospitals in the United States. She then traced the professional background and personal history of each leader. The research focused particularly on hospital performance in the fields of cancer, digestive disorders and heart surgery.
The study shows that hospital quality scores are approximately 25% higher in physician-run hospitals than in the average hospital.
Goodall stressed that more research would be needed before cause-and-effect could be truly understood. The study, a cross-sectional one, uses data from 2009. "This is an intriguing pattern but these snap-shot results for a single point in time do not prove that doctors make the best heads of hospitals, although they are consistent with that claim. More research following a range of hospitals through time is urgently needed," she said.
"Physician-Leaders and Hospital Performance: Is There an Association?", by Amanda H. Goodall, is in press at Social Science and Medicine. It can be downloaded free of charge as from the IZA website (www.iza.org) as IZA Discussion Paper No. 5830:http://ftp.iza.org/dp5830.pdf
2011年6月24日
Barack Obama
2011年6月19日
Small-Area Analysis(小地域分析)
Small-Area Analysis:
A method of analyzing the variation in utilization of health care in small geographic or demographic areas. It often studies, for example, the usage rates for a given service or procedure in several small areas, documenting the variation among the areas. By comparing high- and low-use areas, the analysis attempts to determine whether there is a pattern to such use and to identify variables that are associated with and contribute to the variation.
Synonym: small-area variation analysis, small-area variations, small-area variation, small-area study.
2011年6月17日
范畴经济 VS. 规模经济
economies of scope --范畴经济 or 范围经济，又可叫做"外部规模经济"（External Economy of Scale）
定义：因同时生产(经营)几种相关的产品或服务而引起的经济效益提高。 透过营运范畴的扩大，两个以上的事业单位共同分担研发、营销、生产等成本，而享有的经济效益，使总成本下降。
单一厂商同时生产两项以上物品和服务的成本比分别由专业厂商生产的成本更低廉导致厂商生产出现范畴经济的原因，可能是来自多元化的经营策略、营运范畴的扩大、资源的分享、投入要素的共同、统一管理的效率、财务会计的优势，导致生产成本降低的效果规模经济是相对于专业化而言，范畴经济则是相对于多元化而言，两者并没有直接的关联
范畴经济也就是多样化经济，即企业在生产不同的产品时，若出现成本递减的现象，则就可称之为范畴经济。
(1) 当q1，q2代表不同产量，C(q1+ q2) < C(q1) + C(q2)表示联合生产的总成本小于分别生产的成本总和，亦即存在「规模经济」。
(2) 当q1，q2代表不同产品，C(q1+ q2) < C(q1) + C(q2)表示不同产品"一起"生产的总成本低于分别生产的成本总和，亦即存在「范畴经济」。
2011年6月16日
2011年6月14日
Hospitalist
Robert M. Wachter 1996年他第一个在NEJM上的一篇文章coined这个名词 hospitalist -- 这近20年在美国迅速发展的医疗科系（Hospital Medicine）从业人士名称。Hospital Medicine 和 Hospitalist几乎是密不可分的，同时这两者也是我最关注的health workforce development的组成部分。
-----Wikipeida的释义：
Hospital medicine in the United States is the discipline concerned with the medical care of acutely ill hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists; this type of medical practice has extended beyond the US into Canada. The practical effect of the hospitalist is to act as transition coordinator and case manager, due to the tremendous growth in medical knowledge and resultant number of medical specialists.
The term hospitalist was first coined by Robert Wachter and Lee Goldman in a 1996 New England Journal of Medicine article. Hospitalist activities may include patient care, teaching, research, and leadership related to hospital care. Hospital medicine, like emergency medicine, is a specialty organized around a site of care (the hospital), rather than an organ (like cardiology), a disease (like oncology), or a patient's age (like pediatrics).
--------Wikipeida的历史说明：
Hospital medicine is a relatively new phenomenon in American medicine. Almost unheard of a generation ago, this type of practice arose from three powerful shifts in medical practice:
- Nearly all states, as well as the national residency accreditation organizations, the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA), have established limitations on house staff duty hours, the number of hours that interns and residents can work. This effectively reduces by 10-25% the amount of inpatient coverage provided per[citation needed]. Many hospitalists are coming to perform the same tasks formerly performed by residents; although this is usually referred to as a House Officer rather than a Hospitalist[citation needed]. The fundamental difference between a Hospitalist and a House Officer is that the Hospitalist is the Attending Physician of a patient while that patient is hospitalized. The House Officer admits the patient for another Attending Physician and cares for that patient until the Attending Physician can see the patient.
- Most primary care physicians are experiencing a shrinking role in hospital care. Many primary care physicians find they can generate more revenue in the office during the hour or more they would have spent on inpatient rounds, including traveling to and from the hospital[citation needed].
Hospitalists represent one of the most rapidly growing forms of medical practice in the US. Currently a large proportion of hospitalists are recently-graduated residents, who continue familiar duties for a few years. As residency programs are encouraged to limit inpatient duty hours and provide more outpatient education, this pattern may shift. If this specialty evolves as emergency and intensive care medicine did, it will become a formal specialty with its own residencies and board certification within a decade or two. A few distinct residency and fellowship training programs are currently operating at major universities[citation needed].
In addition to patient care duties, hospitalists are often involved in developing and managing aspects of hospital operations such as inpatient flow and quality assurance. The formation of hospitalist training tracks in residency programs has been driven in part by the need to educate future hospitalists about business and operational aspects of medicine, as these topics are not covered in traditional residencies[citation needed].
2011年6月12日
医疗纠纷[zt]
周老师关于医疗纠纷的思考--"医纠诉讼"如果做一个专有名词，一个专门课题，起码有两方面的意见（赞成和反对），两方面意见对"医纠诉讼"的positive和negative效果的看法截然不同，且效果之间存在cost-effectiveness的tradeoff，所以到底要赞同还是控制"医纠诉讼"，必须有实证依据加以支持，所以我们经济学家需要上场啦。
-------摘录：
尽管每位医师都有可能碰到医疗纠纷或诉讼，不过研究指出医疗案件发生在某些特定医师的机率比其它医师高很多，但这不表示这些医师的医疗质量比其它的医师差，其它研究发现，有专科证照的医师比没有专科证照的医师(美国的专科医师不一定要有专科证照)容易发生医疗纠纷，比较常被病人抱怨的医师发生医疗纠纷的机率也会比较高。(这是很耐人寻味的现象，意谓医疗纠纷的发生可能与医师的技术较没有关系，而与其医病关系特质有密切关系，我直觉上会同意这个论点，也许可以拿医院的医纠与抱怨的案件出来做回归分析)。不过研究发现，医疗纠纷的发生率与医师所就读的医学院排名无关，也与医师是美国人还是外国人、单独开业或与其它医师一起执业都无关。
至于医疗纠纷的诉讼对不当的医疗行为是否真有遏止的效果，目前的研究发现并没有明显的作用，主要原因是真正因为过失而致伤害的病人提出告诉的比例很低，最后获得赔偿的比例更低，因此医师所承担的风险事实上不大；另一个原因是医师大多有购买医疗纠纷保险，这些保险大多以科别风险订定各科医师的保费，而不是用个别医师过去的医疗纠纷理赔记录计算每位医师应缴的保费，这就更降低了医师要额外谨慎诊疗的诱因。
对于防卫性医疗与医疗诉讼有多少关连，以及其程度的大小，经济学家曾做过一些探讨。有的学者针对美国不同州的情形加以研究，发现防卫性医疗程度与该州病人的诉讼倾向没有相关性。有一份研究发现若某一州的法律对医师产生的医疗纠纷压力较大，该州的防卫性医疗程度也较高，但是医疗的结果都差不多。
2011年5月28日
经济学blogs和journals排名--全是经济学家自己打分的
Favorite Economics Blogs排名：其中 J. Bradford DeLong and Paul Krugman是~~你知道的！
------
Mankiw, Greg
Marginal Revolution
Krugman, Paul
DeLong, J. Bradford
Freakonomics
Becker, Posner
EconLog
Coordination Problem
The Economist's View
Voxeu
Café Hayek
Environmental Economics
Baseline Scenario
Hamilton, James
Rodrik, Dani
Favorite Economics Journals排名：这个政治倾向不重
--------
American Ec. Rev.
J. of Ec. Perspectives
J. of Political Economy
J. of Ec. Literature
Econometrica
Quarterly J. of Ec.
J. of Labor Ec.
J. of Ec. Issues
J. of Human Resources
The Economist
J. of Urban Ec.
National Tax J.
J. of Ec. History
Rev. of Ec. and Statistics
American J. of Agricultural Ec.
J. of Environmental and Ec.Management
Cambridge J. of Ec.
Ec. Inquiry
History of Political Economy
Public Choice
Rand J. of Ec.
J. of Ec. Behavior and Organization
J. of Sports Ec.
J. of Money, Credit, and Banking
J. of Public Ec.
Feminist Ec.
J. of International Ec.
J. of Management Education
Independent Rev.
J. of History of Ec. Thought
J. of Development Ec.
Southern Ec. J.
J. of Post Keynesian Ec.
source: econjwatch.org/file_download/487/DavisMay2011.pdf
2011年5月26日
英语简写[zt from: douban]
1ce once
2 to
26y4u too sexy for you
2day today
2mor tomorrow
2moro tomorrow
2morrow tomorrow
2nite tonight
3sum threesome
4 for
911 emergency - call me
add address
afaik as far as i know
agreemt agreement
aka also known as
asap as soon as possible
atb all the best
ayor at your own risk
b be
b/c because
b4 before
b4n or bfn bye for now
bbl be back late(r)
bcnu be seeing you
b''day birthday
bhl8 be home late
bil boss is listening
brb be right back
btdt been there done that
btw by the way
buzz off buzz off
c see
cid consider it done
cmi call me
coz because
ctr center
cu see you
cu @ see you around
cub l8r call you back later
cul see you later
cul8tr see you later
cuz because
cya see you
cyr bos call your boss
cyr bro call your brother
cyr h call your husband
cyr ma call your mother
cyr ofis call your office
cyr pa call your father
cyr sis call your sister
cyr wf call your wife
da the
don doing
dylm do you like me
ez easy
f2f face to face
f2t free to talk
fotflol falling on the floor, laughing out loud
fyi for your information
gal get a life
gr8 great
grt great
gtg got to go
gudluk good luck
h8 hate
hak hugs and kisses
hand have a nice day
hot4u hot for you
how r u how are you
hp handphone
ic i see
iluvu i love you
im2gud4u i''m too good for you
imho in my humble opinion
imnsho in my not so humble opinion
imtng in meeting
iyq i like you
j/k just kidding
jhb johannesburg
jic just in case
jk just kdding
k okay
kit keep in touch
kwim know what i mean
l8 late
l8er later
l8r later
l&n landing
ldn london
lol laughing out loud or loads of love
luv love
lv love
lyn lying
m8 mate
mgmt management
mmfu my mate fancies you
mob mobile
msg message
msia malaysia
mtfbwu may the force be with you
mtg meeting
mth month
myob mind your own business
n and
n case in case
n/a not applicable
ne any
ne1 anyone
nethng anything
niting anything
no1 no one
nufn nothing
np no problem
nvm never mind
oic oh, i see
omg oh, my god
paw parents are watching
pcm please call me
pcme please call me
pl& planned
pls please
plz please
plz4gv me please forgive me
po$bl possible
ppl people
prl parents are listening
puks pick up kids
r are
rgds regards
ringl8 running late
rtfm read the flippin'' manual
ru are you
rucmng are you coming
ruok are you ok?
shopn shopping
sit stay in touch
soz sorry
spk speak
stfu shut the flip up
sum1 someone
tel telephone
thanq thank you
thkq thank you
thx thanks
tmb text me back
tq thank you
ttyl talk to you later
tx thanks
txt bac text back
tyvm thank you very much
u you
ur your
ura* you are a star
uraqt you are a cutie
w/ with
w/o without
w8 wait
w84m wait for me
waiting w8n
wan2 want to
wan2tlk want to talk?
wbs with
wearing a walkman
wel well
wiv write back soon
wknd weekend
wot what
wru where are you?
wu what''s up?
wud? what you doing
wygowm will you go out with me
x kiss
xlnt excellent
xoxox hugs and kisses
y why
yr your
yyssw yeah yeah sure sure whatever
2 to
26y4u too sexy for you
2day today
2mor tomorrow
2moro tomorrow
2morrow tomorrow
2nite tonight
3sum threesome
4 for
911 emergency - call me
add address
afaik as far as i know
agreemt agreement
aka also known as
asap as soon as possible
atb all the best
ayor at your own risk
b be
b/c because
b4 before
b4n or bfn bye for now
bbl be back late(r)
bcnu be seeing you
b''day birthday
bhl8 be home late
bil boss is listening
brb be right back
btdt been there done that
btw by the way
buzz off buzz off
c see
cid consider it done
cmi call me
coz because
ctr center
cu see you
cu @ see you around
cub l8r call you back later
cul see you later
cul8tr see you later
cuz because
cya see you
cyr bos call your boss
cyr bro call your brother
cyr h call your husband
cyr ma call your mother
cyr ofis call your office
cyr pa call your father
cyr sis call your sister
cyr wf call your wife
da the
don doing
dylm do you like me
ez easy
f2f face to face
f2t free to talk
fotflol falling on the floor, laughing out loud
fyi for your information
gal get a life
gr8 great
grt great
gtg got to go
gudluk good luck
h8 hate
hak hugs and kisses
hand have a nice day
hot4u hot for you
how r u how are you
hp handphone
ic i see
iluvu i love you
im2gud4u i''m too good for you
imho in my humble opinion
imnsho in my not so humble opinion
imtng in meeting
iyq i like you
j/k just kidding
jhb johannesburg
jic just in case
jk just kdding
k okay
kit keep in touch
kwim know what i mean
l8 late
l8er later
l8r later
l&n landing
ldn london
lol laughing out loud or loads of love
luv love
lv love
lyn lying
m8 mate
mgmt management
mmfu my mate fancies you
mob mobile
msg message
msia malaysia
mtfbwu may the force be with you
mtg meeting
mth month
myob mind your own business
n and
n case in case
n/a not applicable
ne any
ne1 anyone
nethng anything
niting anything
no1 no one
nufn nothing
np no problem
nvm never mind
oic oh, i see
omg oh, my god
paw parents are watching
pcm please call me
pcme please call me
pl& planned
pls please
plz please
plz4gv me please forgive me
po$bl possible
ppl people
prl parents are listening
puks pick up kids
r are
rgds regards
ringl8 running late
rtfm read the flippin'' manual
ru are you
rucmng are you coming
ruok are you ok?
shopn shopping
sit stay in touch
soz sorry
spk speak
stfu shut the flip up
sum1 someone
tel telephone
thanq thank you
thkq thank you
thx thanks
tmb text me back
tq thank you
ttyl talk to you later
tx thanks
txt bac text back
tyvm thank you very much
u you
ur your
ura* you are a star
uraqt you are a cutie
w/ with
w/o without
w8 wait
w84m wait for me
waiting w8n
wan2 want to
wan2tlk want to talk?
wbs with
wearing a walkman
wel well
wiv write back soon
wknd weekend
wot what
wru where are you?
wu what''s up?
wud? what you doing
wygowm will you go out with me
x kiss
xlnt excellent
xoxox hugs and kisses
y why
yr your
yyssw yeah yeah sure sure whatever
NBER这期的bulletin-2011-5
很久没有跟新了，最近很是纠结，人生不总是风顺，转折加上旅行，不知道下一站在哪？
NBER这期的bulletin介绍几篇好看的aging和health的wp：
Using Nudges in Exercise Commitment Contracts讲文章"Committing to Exercise: Contract Design for Virtuous Habit Formation" (NBER Working Paper 16624), 作者Jeremy Goldhaber-Fiebert, Erik Blumenkranz, and Alan Garber。他们用网站(www.stickk.com)为基础的合同方式来做随机控制实验来检定财务小nudges对人们是否忠于锻炼允诺的效果，很是有趣。因为里面运用行为经济学关于人对长期、短期决策的假定，到卫生经济学关于weight loss的研究范畴中，又用了网络来做随机试验，实在是亮点多多。
The Effect of Rising Health Care Costs on U.S. Tax Rates 美国的高比例H-GDP是个问题吗？如果大部分决策权是个人手里的话，那是国民自己的意愿，关谁卵事呢（当然States的问题没那么简单，公司买保很多，政府税收预算大把纠葛）？哎~ 先假设这是个big issue吧。Katherine Baicker and Jonathan Skinner的" Health Care Spending Growth and the Future of U.S. Tax Rates" (NBER Working Paper 16772). 自发展了一个宏观模型讨论高比例H-GDP、税收、消费和劳动力供给等因素间的互相作用，我头大！写评论的人最后写到While most observers of the U.S. health care system conclude that there must be a break in the trend of rising real health care costs at some point, it is not clear what policy or condition would effect that change. This study suggests "strains on the revenue-raising system may exert a natural brake on health care spending, and thus may be a key (albeit inefficient) mechanism for constraining overall health care spending growth."欧洲70年代一些国家高tax-GDP比例的国家后来在H-GDP比例上控制得好，虽然效率不咋地，那么堂堂US也要左转看齐用低效的"strains on the revenue-raising system（没看懂！）"来踩啥车吗？
2011年4月28日
[Excerpt] From J. Goodman's Bureaucrats vs. Entrepreneurs
[Excerpt] From J. Goodman's Bureaucrats vs. Entrepreneurs:
I used to think the biggest obstacle to getting agreement about health care reform was ideology (socialism vs. capitalism). Then I decided it was sociology (engineers vs. economists). I now am inclined to believe it ispsychology (bureaucrats vs. entrepreneurs).
- The Google Lunar X Prize offers $30 million to the first privately-funded team to land a robot on the moon.
- The Wendy Schmidt Oil Cleanup X Challenge offers $1 million to the team that is most successful at cleaning up oil spills.
- The Progressive Insurance Automotive X Prize awarded $10 million to three teams that built cars achieving 100 miles per gallon in real world driving.
To my knowledge, there is no award for any discovery in paying for or delivering health care, however, with one exception noted below. Heritage Provider Network is offering a $3 million prize "to anyone who can build the algorithm that best predicts which patients will be hospitalized and for how many days over the course of a year, based on a given data set." See the description in Slate.
2011年4月18日
weblinks 2011-4-19
NBER
The Psychological Costs of War: Military Combat and Mental Health 战争导致的心理卫生服务成本=2Billion Dollars
Broadening Focus: Spillovers, Complementarities and Specialization in the Hospital Industry 医院组织层面的专业化及其溢出效应
School accountability laws and the consumption of psychostimulants
Farasat A.S.Bokhari, Helen Schneider, Journal of Health Economics, Volume 30, Issue 2, March 2011, Pages 355-372
过去几十年许多州(US)制定不同级别的问责(accountability)法案--这也成就了Bush在2001年的No Child Left Behind Act。法案本来是要促进学生的成绩和学校教学质量，但是呢，因为不同地区不同学校对此方法的意愿和措施级别有差异，客观上形成了一种自然试验。这个政策的一个意外的后果是其问责压力对在校学生注意缺陷多动障碍(Attention Deficit/ Hyperactivity Disorder , ADHD)医疗诊断和后续治疗的影响。利用这个自然试验一般的条件，居然发现了法案越严厉的地方更易诊断出ADHD，并开出中枢兴奋剂(psychostimulant)的处方药物。但是给定诊断而言，法案并没有进一步改变患者接受药物治疗的概率。
Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians
原来很多年前（2000）就有人做随机试验发现护士和医生的产出差不多，至少 In an ambulatory care situation in which patients were randomly assigned to either nurse practitioners or physicians, and where nurse practitioners had the same authority, responsibilities, productivity and administrative requirements, and patient population as primary care physicians, patients' outcomes were comparable.
2011年4月15日
HE之06/07最佳论文摘要
Therapeutic non-adherence: a rational behavior revealing patient preferences? Karine Lamiraud1,*, Pierre-Yves Geoffard1,2,3 Article first published online: 15 FEB 2007
这篇得了06/07年HE最佳的论文让我一头雾水，好量化啊，题目叫"治疗非依附性：这是一种揭示病人偏好的理性行为吗？"我决定翻一下其摘要：
文章基于病人是否遵从他们接受的处方来提供一种对病人福祉的间接测评手段。依附行为(Adherence behavior)被认为是可揭示病人对某种治疗的主观评价。我们写了一段简单的病人依附行为的理论模型—其反应了可知成本(perceived costs)和可知疗效(observed regimen efficacy)之间的权衡。一个离散选择框架(discrete choice framework)被用来进行估计，如两种药物摄入治疗所产生受益的比较。所以实证分析是基于对"与依附性相关的病人特征和药物特征"之间的识别。经济计量方法是通过一个联合分析"与依附性、病人对治疗反应相关的影响因素"的双变量面板双方程模拟系统进行研究的。数据来自1999-2001在法国进行的一个比较两种HIV 三疗法(tritherapy)的随机临床试验。
理论和实证结果都认为，对于可比较的临床疗效和毒理级别而言，更高的依附性和更好的病人福祉是相关的，因此研究为仅仅是生物统计分析产生的结论增加了更有价值的参考信息。所以从病人感知来说，依附性增加(adherence-enhancing)的药物必定是受偏爱的。我们基于面板数据的结果还认为，无法观测的病人特征是解释病人对药物评价的主要因素，而且治疗过程中病人对药物的评价是会改变的。另外我们提供了对依附性数据分析的一个新框架。这个微观计量框架强调非依附性是内生行为，这为改进依附性提出了新的途径。
Abstract
This paper offers an indirect measure of patient welfare based on whether patients comply with the prescription they receive. Adherence behavior is supposed to reveal patients' subjective valuations of particular therapies. We write a simple theoretical model of patient adherence behavior, that reflects the trade-off between perceived costs and observed regimen efficacy. A discrete choice framework is then used for the estimation, i.e. the comparison of the incremental benefit of drug intake between two regimens. Consequently, the empirical analysis is based on the identification of patient and drug characteristics associated with adherence. The econometric approach is implemented through a bivariate panel two-equation simultaneous system studying jointly the factors associated with adherence and response to treatment. The data come from a randomized clinical trial conducted in France between 1999 and 2001 and comparing the efficacy of two tritherapy strategies in HIV disease.
Both the theoretical and empirical results suggest that, for comparable clinical efficacy and toxicity levels, a higher adherence level is associated with higher patient welfare, thus adding valuable information to conclusions drawn by a mere biostatistical analysis. Therefore, from the perspective of the patient, the adherence-enhancing drug must be favored. Our results based on panel data also stress that unobserved patient characteristics account substantially for drug valuation and that the assessment evolves during the course of the treatment. Furthermore, we provide a new framework for the analysis of adherence data. The microeconometric framework highlights that non-adherence is an endogenous behavior, thus suggesting new ways for improving adherence.
Keywords: drug valuation method; revealed preferences; endogenous adherence behavior; panel bivariate probit estimation; HIV
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