title: Is technological change in medicine always worth it? The case of acute myocardial infarction.
abstract: We examine Medicare costs and survival gains for acute myocardial infarction (AMI) during 1986-2002. As David Cutler and Mark McClellan did in earlier work, we find that overall gains in post-AMI survival more than justified the increases in costs during this period. Since 1996, however, survival gains have stagnated, while spending has continued to increase. We also consider changes in spending and outcomes at the regional level. Regions experiencing the largest spending gains were not those realizing the greatest improvements in survival. Factors yielding the greatest benefits to health were not the factors that drove up costs, and vice versa.
authors.affiliation: Dartmouth Medical College.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Skinner
authors.forename: Douglas O
authors.initials: DO
authors.lastname: Staiger
authors.forename: Elliott S
authors.initials: ES
authors.lastname: Fisher
mesh_terms: D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D020811:Biomedical Technology / Q000191:economics*; D006328:Cardiac Catheterization; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics*; D009203:Myocardial Infarction / Q000191:economics* / Q000401:mortality* / Q000628:therapy; D016016:Proportional Hazards Models; D016019:Survival Analysis; D013673:Technology Assessment, Biomedical / Q000191:economics*; D016896:Treatment Outcome; D014481:United States
chemical_list: D000319:Adrenergic beta-Antagonists