Assessing students' and health professionals' competency learning from interprofessional education collaborative workshops.

Interprofessional education (IPE) is a key element in preparing current and future health professionals to function in a collaborative practice-ready workforce. California State University, Fresno's College of Health and Human Services and Valley Children's Healthcare have partnered together to create an IPE collaborative that organizes and provides interagency-sponsored workshops that align learning objectives of relevant healthcare topics with 2016 IPEC core competencies for university students and health professionals. Using a pre/post design with the IPEC Competency Self-Assessment Tool, two cross-sectional studies were conducted to measure whether interprofessional learning of core competencies improved after participation in IPE workshops, and if such improvements were different between students and health professionals. In Study 1, 67 participants attended a Pediatric Head Injury IPE workshop. Of these, 19 students and 22 health professionals consented to participate and complete the IPEC survey. In Study 2, 99 participants attended an Error Disclosure IPE workshop. Of these, 26 students and 29 health professionals consented to participate and complete the IPEC survey. This investigation showed that the IPEC Competency Self-Assessment Tool discriminated competency ratings between students and health professionals in both studies and demonstrated a positive impact of IPE workshops on students' and health professionals' self-assessment of interprofessional competencies.

Using common random numbers in health care cost-effectiveness simulation modeling.

OBJECTIVES: To identify the problem of separating statistical noise from treatment effects in health outcomes modeling and analysis. To demonstrate the implementation of one technique, common random numbers (CRNs), and to illustrate the value of CRNs to assess costs and outcomes under uncertainty. METHODS: A microsimulation model was designed to evaluate osteoporosis treatment, estimating cost and utility measures for patient cohorts at high risk of osteoporosis-related fractures. Incremental cost-effectiveness ratios (ICERs) were estimated using a full implementation of CRNs, a partial implementation of CRNs, and no CRNs. A modification to traditional probabilistic sensitivity analysis (PSA) was used to determine how variance reduction can impact a decision maker's view of treatment efficacy and costs. RESULTS: The full use of CRNs provided a 93.6 percent reduction in variance compared to simulations not using the technique. The use of partial CRNs provided a 5.6 percent reduction. The PSA results using full CRNs demonstrated a substantially tighter range of cost-benefit outcomes for teriparatide usage than the cost-benefits generated without the technique. CONCLUSIONS: CRNs provide substantial variance reduction for cost-effectiveness studies. By reducing variability not associated with the treatment being evaluated, CRNs provide a better understanding of treatment effects and risks.

Payment contracts in a preventive health care system: a perspective from operations management.

We consider a health care system consisting of two noncooperative parties: a health purchaser (payer) and a health provider, where the interaction between the two parties is governed by a payment contract. We determine the contracts that coordinate the health purchaser-health provider relationship; i.e. the contracts that maximize the population's welfare while allowing each entity to optimize its own objective function. We show that under certain conditions (1) when the number of customers for a preventive medical intervention is verifiable, there exists a gate-keeping contract and a set of concave piecewise linear contracts that coordinate the system, and (2) when the number of customers is not verifiable, there exists a contract of bounded linear form and a set of incentive-feasible concave piecewise linear contracts that coordinate the system.

A game-theoretic framework for estimating a health purchaser's willingness-to-pay for health and for expansion.

A health purchaser's willingness-to-pay (WTP) for health is defined as the amount of money the health purchaser (e.g. a health maximizing public agency or a profit maximizing health insurer) is willing to spend for an additional unit of health. In this paper, we propose a game-theoretic framework for estimating a health purchaser's WTP for health in markets where the health purchaser offers a menu of medical interventions, and each individual in the population selects the intervention that maximizes her prospect. We discuss how the WTP for health can be employed to determine medical guidelines, and to price new medical technologies, such that the health purchaser is willing to implement them. The framework further introduces a measure for WTP for expansion, defined as the amount of money the health purchaser is willing to pay per person in the population served by the health provider to increase the consumption level of the intervention by one percent without changing the intervention price. This measure can be employed to find how much to invest in expanding a medical program through opening new facilities, advertising, etc. Applying the proposed framework to colorectal cancer screening tests, we estimate the WTP for health and the WTP for expansion of colorectal cancer screening tests for the 2005 US population.