Wiseman Benjamin

One of the key questions in health economics is what is the direction of causality: does poverty cause poor health outcomes; does low education cause poor health outcomes; does poor health result in lack of productivity; does poor health cause poor educational and income outcomes; and how is this all related to mental health if at all. We are used to breaking down data into fragments as researchers: an investigator who is predominantly focused on health outcomes will approach the problem with disease as the dependent variable and income as the conditioning variable. However, if we are interested in income inequality we will reverse the direction and income will be the dependent variable with health status as the conditioning variable.

The representation above allows us to visualize data as a function of multiple fragments. For example, if we want to understand how depression is related to income, one can look at the figure to observe that with lower income there is a higher likelihood of being depressed. With this simple illustration, we can see that establishing causal links can be very tricky, if not incredibly challenging.

Objective

Our primary goal is to move towards establishing a causal link between binge drinking, mental health, employment, and income. 

There is a resurgence in the need to evaluate the economic burden of prescription drug hospitalizations in the United States. We used the Wisconsin 2014 Hospital Discharge data to examine opioid related hospitalization incidence and costs. Fentanyl, a powerful synthetic opioid, is frequently being used for as an intraoperative agent in anesthesia, and post-operative recovery in hospitals. According to a 2013 study, synthetic Fentanyl is 40 times more potent than heroin and other prescription opioids; the strength of Fentanyl leads to substantial hospitalizations risks. Since, 1990 it has been available with a prescription in various forms such as transdermal patches or lollipops for treatment of serious chronic pain, most often prescribed for late stage cancer patients. There have been reported fatal overdoses associated with misuse of prescription fentanyl. In Wisconsin number of total opioid related deaths increased by 51% from 2010 to 2014 with the number of deaths involving prescription opioids specifically increased by 23% and number of deaths involving heroin increased by 192%. We hypothesized that opioids prescription drugs, as a proxy of Fentanyl use, result in excessive health care costs.

Objective

In this paper we used hospital charges to assess costs incurred due to prescription drug/opioid hospitalizations