Do your homework: times reporters respond in Dartmouth Atlas spar

Over the weekend, the two are New York Times reporter, that the core results of the Dartmouth Atlas of health challenged their guns in a detailed response to the Rejoinder their criticism. The Dartmouth Atlas, which documents to spend regional variation in Medicare offers the intellectual, the support for assertions by health care reformer (including those in the White House), 30 percent of all health issues is wasted and not improved quality or the result of supply.

The "times original criticism (see this GoozNews post) the three most important ideas include:"

Dartmouth researchers do not fit their cards for regional differences; the Dartmouth don't fit their cards for disease researchers stress; and assertion that leads to worse results more expenditure is confirmed by the data. In some cases more spending leads to better results.

Some of these can back and forth like a quibble about language klingen.Ist it is wasted "30 percent" of health care or "up to 30 percent," as of Dartmouth researchers now see in public? Reed Abelson and Gardiner of Harris offer a link to the original 21 page response to your requests. "We think that 30 per cent estimate could be too low," wrote the Dartmouth researchers in a marked section.

On the other hand the Times reporter seem a step back the price issue.Harvard Economist originally quoted which went back to David Cutler, health care. "Cutler told you that adjust the original 2003 article by John Wennburg and Elliott Fisher of Dartmouth, who appeared in the medical literature, in fact, for the price.""But he said he agreed with the times assert that most of the atlas's, be adapted cards and rankings unlike the Group academic work in, not fully for prices," wrote Abelson and Harris.

"Cutler is its bets on the argument"30 percent is waste"in particular, now hedging.""Some believe that number is higher, and others think that it is lower," he wrote in the latest health affairs."But there is little disagreement that health care is marked by enormous waste."

I believe that the dispute over the quality, which really needs is to other researchers and werden.Beseitigung waste explores policy makers to improve quality should be.It has been always true in the making, that reduce steps and reducing waste not only costs, but it reduces the quality of the finished product improved.

There is no reason to believe it will be true in the delivery of complex services such as health care, some have compared to build and to increase that errors will occur in the process that translates in health care in more complications, additional costs and, in some cases, the likelihood the lives lost jet aircraft fliegen.Tun more than necessary the job is done.

Times reporters still by its dissection of Dartmouth data to make that actually go further expenditure for other services entstehen.Sie quality back to the original research - the two studies published in 2003 - your comment:

Researchers are wrong in saying that the results of these studies were 2003 "all in the same direction."In fact, two of the various measures of quality and mortality quoted in articles actually showing seemed that more issues could correlate to better care.

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Commentology: Times reporter to respond

New York Times health policy reporter Gardiner of Harris responded on THCB founder and editor Matthew holt's comments on the recent series of reports, which he business writer Reed Abelson questioning the science behind the Dartmouth Atlas has written.  Gardiner had this to say in defense of his newspaper's investigation:

The main point of reeds and my pieces on the Dartmouth work is that the data is simply not good enough to cause output decisions in Government 484 million dollar Medicare programme.If this point had confirmed the Dartmouth researchers, our history would be less interesting gewesen.Aber you can not even bring and in fact have repeatedly exaggerated and mischaracterized propose your own work in public settings it may be prescriptive.

An additional point was on Capitol Hill, which tend to warn administration and journalists to these popular cards from the Atlas. You have scoffed that it is a small thing, that the Dartmouth researchers do not fit your online data for price and disease. But misconceptions about these are widespread.The landmark piece of Dr. Gawande cited used who Atlas's unadjusted Daten.Dutzende stories in newspapers and magazines across the country uses the unadjusted data, criticize the health institutions. Even David Cutler, among the top health economists of the country was not aware that the Atlas offered largely unadjusted data.

Accuracy may seem a small point. It is to us.

Our Friday piece also pointed out that Dr. Elliott Fisher and Mr Jon Skinner claimed that your 2003 a negative correlation between expenditure and results found Annals pieces.In fact, the pieces found no correlation between expenditure and results.This is a negative correlation no small Unterschied.Wenn, will actually improve health cuts in spending.If no match is found, then cuts to far harder and may be more painful.We can not go to believe the work easily enormous impact on Capitol Hill had his wird.Aber Dartmouth researchers have proposed, which has this siren song reform our health care system.

In aside, when was the last time researchers saw you so deeply mischaracterize your own work? how it is possible that you claim your Annals pieces something could be if you do not? I can't remember ever happen to see.

-Gardiner of Harris

June 22, 2010

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