Brian K. Chen
Department of Health Services Policy and Managemen
Arnold School of Public Health
University of South Carolina
915 Greene Street #354
Columbia, SC 29205
Institutional Affiliation: University of South Carolina
NBER Working Papers and Publications
|June 2019||Are Quality-Adjusted Medical Prices Declining for Chronic Disease? Evidence from Diabetes Care in Four Health Systems|
with Karen Eggleston, Chih-Hung Chen, Ying Isabel Chen, Talitha Feenstra, Toshiaki Iizuka, Janet Tinkei Lam, Gabriel M. Leung, Jui-fen Rachel Lu, Beatriz Rodriguez-Sanchez, Jeroen N. Struijs, Jianchao Quan, Joseph P. Newhouse: w25971
Improvements in medical treatment have contributed to rising health spending. Yet there is relatively little evidence on whether the spending increase is “worth it” in the sense of producing better health outcomes of commensurate value—a critical question for understanding productivity in the health sector and, as that sector grows, for deriving an accurate quality-adjusted price index for an entire economy. We analyze individual-level panel data on medical spending and health outcomes for 123,548 patients with type 2 diabetes in four health systems. Using a “cost-of-living” method that measures value based on improved survival, we find a positive net value of diabetes care: the value of improved survival outweighs the added costs of care in each of the four health systems. This finding is...
|May 2017||Is Preventive Care Worth the Cost? Evidence from Mandatory Checkups in Japan|
with Toshiaki Iizuka, Katsuhiko Nishiyama, Karen Eggleston: w23413
Using unique individual-level panel data, we investigate whether preventive medical care triggered by health checkups is worth the cost. We exploit the fact that biomarkers just below and above a threshold may be viewed as random. We find that people respond to health signals and increase physician visits. However, we find no evidence that additional care is cost effective. For the “borderline type” (“pre-diabetes”) threshold for diabetes, medical care utilization increases but neither physical measures nor predicted risks of mortality or serious complications improve. For efficient use of medical resources, cost effectiveness of preventive care must be carefully examined.
|January 2016||Forecasting Trends in Disability in a Super-Aging Society: Adapting the Future Elderly Model to Japan|
with Hawre Jalal, Hideki Hashimoto, Sze-Chuan Suen, Karen Eggleston, Michael Hurley, Lena Schoemaker, Jay Bhattacharya: w21870
Japan has experienced pronounced population aging, and now has the highest proportion of elderly adults in the world. Yet few projections of Japan’s future demography go beyond estimating population by age and sex to forecast the complex evolution of the health and functioning of the future elderly. This study adapts to the Japanese population the Future Elderly Model (FEM), a demographic and economic state-transition microsimulation model that projects the health conditions and functional status of Japan’s elderly population in order to estimate disability, health, and need for long term care. Our FEM simulation suggests that by 2040, over 27 percent of Japan’s elderly will exhibit 3 or more limitations in IADLs and social functioning; almost one in 4 will experience difficulties with 3 o...
Published: Brian K. Chen & Hawre Jalal & Hideki Hashimoto & Sze-chuan Suen & Karen Eggleston & Michael Hurley & Lena Schoemaker & Jay Bhattacharya, 2016. "Forecasting Trends in Disability in a Super-Aging Society: Adapting the Future Elderly Model to Japan," The Journal of the Economics of Ageing, . citation courtesy of
|November 2013||Moral Hazard and Economies of Scope in Physician Ownership of Complementary Medical Services|
with Paul J. Gertler, Chuh-Yuh Yang: w19622
When physicians own complementary medical service facilities such as clinical laboratories and imaging centers, they gain financially by referring patients to these service entities. This situation creates an incentive for the physician to exploit the consumers' trust by recommending more services than they would demand under full information. This moral hazard cost, however, may be offset by gains in economies of scope if the complementary services are integrated into the physician's practice. We assess the extent of moral hazard and economies of scope using data from Taiwan, which introduced a "separating" policy, similar to the Stark Law in the US, that restricts physician ownership of pharmacies unless they are fully integrated into the physician's practice. We find that physicians who...