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


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Bush2001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.