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

Author

Listed:
  • Rebecca Mary Myerson
  • Darius Lakdawalla
  • Lisandro D. Colantonio
  • Monika Safford
  • David Meltzer
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

  • Rebecca Mary Myerson & Darius Lakdawalla & Lisandro D. Colantonio & Monika Safford & David Meltzer, 2018. "Effects of Expanding Health Screening on Treatment - What Should We Expect? What Can We Learn?," NBER Working Papers 24347, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:24347
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    References listed on IDEAS

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    Cited by:

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    2. Amanda E Kowalski, 2023. "Behaviour within a Clinical Trial and Implications for Mammography Guidelines," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 90(1), pages 432-462.
    3. Rebecca M. Myerson & Reginald D. Tucker‐Seeley & Dana P. Goldman & Darius N. Lakdawalla, 2020. "Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(3), pages 577-604, June.
    4. Siddhartha Sanghi, 2019. "Health Inequality: Role of Insurance and Technological Progress," 2019 Meeting Papers 703, Society for Economic Dynamics.

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    JEL classification:

    • D0 - Microeconomics - - General
    • D8 - Microeconomics - - Information, Knowledge, and Uncertainty
    • I1 - Health, Education, and Welfare - - Health

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