Fármaco-economía UC3M

lunes, 13 de marzo de 2023

Artificial intelligence affects insurance coverage among seniors in the U.S.

An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to pain medicine. In 16.6 days, it estimated, she would be ready to leave her nursing home.

On the 17th day, her Medicare Advantage insurer, Security Health Plan, followed the algorithm and cut off payment for her care, concluding she was ready to return to the apartment where she lived alone. Meanwhile, medical notes in June 2019 showed Walter’s pain was maxing out the scales and that she could not dress herself, go to the bathroom, or even push a walker without help.

It would take more than a year for a federal judge to conclude the insurer’s decision was “at best, speculative” and that Walter was owed thousands of dollars for more than three weeks of treatment. While she fought the denial, she had to spend down her life savings and enroll in Medicaid just to progress to the point of putting on her shoes, her arm still in a sling.

Continue reading this article:
https://www.statnews.com/2023/03/13/medicare-advantage-plans-denial-artificial-intelligence/

viernes, 17 de febrero de 2023

The effect of becoming a physician on prescription drug use

Physicians tend to enjoy good physical health. The typical physician exercises more, is less likely to smoke and is less likely to be obese than his or her non-physician counterpart (Nelson et al. 1994; Frank et al. 1998; Abramson et al. 2000; John and Hanke 2003; Smith and Leggat 2007; Leuven et al. 2013). In the United States, physicians live an average of two years longer than other professionals and almost three years longer than members of the general population (Frank et al. 2000).

Continue reading this article:

http://uc3nomics.uc3m.es/2023/02/09/the-effect-of-becoming-a-physician-on-prescription-drug-use/