At the Center for Health System Sustainability (CHeSS), we help countries learn from one another to optimize patient care and build resilient and sustainable health systems. We do so by leveraging patient-level data and global partnerships to produce comparative data insights and actionable policy recommendations.
What is the biggest issue with the RI healthcare system?
CHeSS: A new center at Brown to study health care systems across countries
A discussion comparing health policy challenges facing the U.S. to those faced by other high-income countries illustrated how the Center for Health System Sustainability aims to improve health care systems through research.
Since 1999, the National Institute for Health and Care Excellence has weighed costs against benefits to help the NHS decide what it should buy. The institute’s boss, Sam Roberts, calls it a mindful “health-care innovation shopper”. Within a fixed budget, every new drug it buys risks squeezing essentials like GPs or ambulances among existing health-care services.
We performed a longitudinal, retrospective cohort study involving adults 50 to 85 years of age who were included in the Health and Retirement Study and the Survey of Health, Ageing, and Retirement in Europe between 2010 and 2022. Wealth quartiles were defined according to age group and country, with quartile 1 comprising the poorest participants and quartile 4 the wealthiest. Mortality and Kaplan–Meier curves were estimated for each wealth quartile across the United States and 16 countries in northern and western, southern, and eastern Europe. We used Cox proportional-hazards models that included adjustment for baseline covariates (age group, sex, marital status [ever or never married], educational level [any or no college education], residence [rural or nonrural], current smoking status [smoking or nonsmoking], and absence or presence of a previously diagnosed long-term condition) to quantify the association between wealth quartile and all-cause mortality from 2010 through 2022 (the primary outcome).
In recent months, a new kind of partnership between telehealth companies and pharmaceutical manufacturers has come under scrutiny over concerns that such arrangements could lead to inappropriate prescriptions and poor care. Eli Lilly and Pfizer, along with five telehealth companies accessible through the pharma companies’ websites, have recently received letters from four senators echoing those concerns, asking questions about care, prescription volume, and the flow of data and money between the firms. The lawmakers want to determine whether pharma-telehealth deals may be violating the federal anti-kickback statute. That question has also piqued the interest of three health policy researchers at Brown University.
Harmonizing International Health Data for Better Outcomes
Professor Irene Papanicolas joins Megan Hall on the Humans in Public Health podcast to discussed her work: she aims to standardize data from across global health systems and compare them in order to inform policy choices and improve health care value and patient care.