Thursday, May 2, 2013

Oregon Health Study - first results

Here's a little more information about the Oregon Health Study's first published results, reported today in the New York Times. Unfortunately, the full article, in the New England Journal of Medicine, here, is behind a paywall. But here's the best take away, from the study's web site:
For uninsured low-income adults, Medicaid significantly increased the probability of being diagnosed with diabetes, though it had no statistically significant effect on measured blood pressure or cholesterol. Medicaid reduced observed rates of depression by 30 percent and increased self-reported mental health. Medicaid virtually eliminated out-of-pocket catastrophic medical expenditures, and increased use of physician services, prescription drugs, and hospitalizations.

This is not nothing, and those commenters who think it is are overstating. But as always, it's important to interpret statistical studies carefully. To its credit, the Times Economix Blog has a post
"What the Oregon Health Study Can't Tell" by reporter Annie Lowrey that does so:
Where it says something, it says a lot: it provides strong evidence that Medicaid recipients will spend more, use more tests, experience less depression, have fewer bills sent to collection agencies, and so on. It shows health insurance working just the way insurance is supposed to work: protecting the financial stability of the people purchasing it.
The biometric results are compelling, too. The authors chose a handful of conditions that were common, important, easy to test for and treatable to include in the study. Medicaid does not seem to do much to improve health outcomes related to those conditions in two years.
But there are many more questions that the Oregon Health Study simply cannot answer, despite the overheated rhetoric out there today. Does Medicaid improve health over a decade? What might Medicaid do for lifetime health costs? We do not know, even if the study provides some clues. Nor could this study answer the question of whether the Medicaid expansion will be “worth it,” and why. What study could?

You can find a roundup of responses here.

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