Effects of Expanding Health Screening on Treatment - What Should We Expect? What Can We Learn?

31 Pages Posted: 28 Feb 2018

See all articles by Rebecca Myerson

Rebecca Myerson

University of Wisconsin - Madison - Department of Population Health Sciences

Darius Lakdawalla

University of Southern California

Lisandro Colantonio

University of Alabama at Birmingham - School of Public Health

Monika Safford

Weill Cornell Medicine

David Meltzer

University of Chicago - Departments of Medicine and Economics, and Harris School

Date Written: February 2018

Abstract

Screening interventions can produce very different treatment outcomes, depending on the reasons why patients had been unscreened in the first place. Economists have paid scant attention to these complexities and their implications for evaluating screening programs. In this paper, we propose a simple economic framework to guide policy-makers and analysts in designing and evaluating the impact of screening on treatment uptake. We apply these insights to several salient empirical examples that illustrate the different kinds of effects screening programs might produce. Our empirical examples focus on contexts relevant to the top cause of death in the United States, heart disease. We find that currently undiagnosed patients differ from currently diagnosed patients in important ways, leading to lower predicted uptake of recommended treatment if these patients were diagnosed. Additionally, changes in the composition of diagnosed patients can produce misleading conclusions during policy analysis, such as spurious reductions in measured health system performance as screening expands.

Suggested Citation

Myerson, Rebecca and Lakdawalla, Darius and Colantonio, Lisandro and Safford, Monika and Meltzer, David Owen, Effects of Expanding Health Screening on Treatment - What Should We Expect? What Can We Learn? (February 2018). NBER Working Paper No. w24347. Available at SSRN: https://ssrn.com/abstract=3131057

Rebecca Myerson (Contact Author)

University of Wisconsin - Madison - Department of Population Health Sciences ( email )

610 Walnut St
Madison, WI 53726
United States

HOME PAGE: http://https://pophealth.wisc.edu/staff/myerson-rebecca/

Darius Lakdawalla

University of Southern California

Lisandro Colantonio

University of Alabama at Birmingham - School of Public Health ( email )

1665 University Blvd.
Birmingham, AL 35294
United States

Monika Safford

Weill Cornell Medicine

1300 York Avenue
New York, NY 10065
United States

David Owen Meltzer

University of Chicago - Departments of Medicine and Economics, and Harris School ( email )

5841 S. Maryland Ave.
B-220
Chicago, IL 60637
United States

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