Research Topics
| David U HimmelsteinSummaryAffiliation: Cambridge Health Alliance Country: USA Publications
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Detail Information
Publications
Consumer directed healthcare: except for the healthy and wealthy it's unwiseSteffie Woolhandler
The Department of Medicine, Cambridge Hospital, Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139, USA
J Gen Intern Med 22:879-81. 2007..They offer little hope of slowing the growth of health care costs and add further bureaucratic costs and complexity to our health care financing system...
Hospital computing and the costs and quality of care: a national studyDavid U Himmelstein
Department of Medicine, Cambridge Hospital Harvard Medical School, Cambridge, MA 02139, USA
Am J Med 123:40-6. 2010..However, no previous studies have examined computerization's cost and quality impacts at a diverse national sample of hospitals...
Illness and injury as contributors to bankruptcyDavid U Himmelstein
Harvard Medical School, Boston, Massachusetts, USA
Health Aff (Millwood) . 2005..7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fall prey to financial catastrophe when sick...- Discounting the debtors will not make medical bankruptcy disappearDavid U Himmelstein
Harvard Medical School, USA
Health Aff (Millwood) 25:w84-8; discussion w93. 2006..However, the data from the bankruptcy courts are undeniable. Bankruptcies affect mainly middle-class, privately insured families, and about half are triggered, at least in part, by illnesses... - Administrative waste in the U.S. health care system in 2003: the cost to the nation, the states, and the District of Columbia, with state-specific estimates of potential savingsDavid U Himmelstein
The Cambridge Hospital Harvard Medical School, MA 02139, USA
Int J Health Serv 34:79-86. 2004..Because incremental reforms necessarily preserve the current fragmented and duplicative payment structure, they cannot achieve significant bureaucratic savings... - Taking care of business: HMOs that spend more on administration deliver lower-quality careDavid U Himmelstein
Department of Medicine, The Cambridge Hospital, MA 02139, USA
Int J Health Serv 32:657-67. 2002..Excess HMO bureaucracy is not only wasteful but harmful... - Medical bankruptcy in the United States, 2007: results of a national studyDavid U Himmelstein
Department of Medicine, Cambridge Hospital Harvard Medical School, Cambridge, Mass 02139, USA
Am J Med 122:741-6. 2009..Our 2001 study in 5 states found that medical problems contributed to at least 46.2% of all bankruptcies. Since then, health costs and the numbers of un- and underinsured have increased, and bankruptcy laws have tightened... - The health and health care of US prisoners: results of a nationwide surveyAndrew P Wilper
Departmentof Medicine, Cambridge Health Alliance, Cambridge, USA
Am J Public Health 99:666-72. 2009..We analyzed the prevalence of chronic illnesses, including mental illness, and access to health care among US inmates... - Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based surveyKaren E Lasser
Department of Medicine, The Cambridge Health Alliance and Harvard Medical School, Cambridge, Mass, USA
Am J Public Health 96:1300-7. 2006..We compared health status, access to care, and utilization of medical services in the United States and Canada and compared disparities according to race, income, and immigrant status... - Free drug samples in the United States: characteristics of pediatric recipients and safety concernsSarah L Cutrona
Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA 02139, USA
Pediatrics 122:736-42. 2008..Free drug samples frequently are given to children. We sought to describe characteristics of free sample recipients, to determine whether samples are given primarily to poor and uninsured children, and to examine potential safety issues... - U.S. physicians' views on financing options to expand health insurance coverage: a national surveyDanny McCormick
Department of Medicine, Cambridge Hospital and Harvard Medical School, Cambridge, MA 02139, USA
J Gen Intern Med 24:526-31. 2009..Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States... - Lack of health coverage among US veterans from 1987 to 2004David U Himmelstein
Department of Medicine, Cambridge Health Alliance Harvard Medical School, Cambridge, Mass 02139, USA
Am J Public Health 97:2199-203. 2007..We sought to determine how many veterans were uninsured, trends in veterans' coverage, and whether uninsured veterans lacked access to medical care... - Privatization in a publicly funded health care system: the U.S. experienceDavid U Himmelstein
Department of Medicine, Cambridge Hospital Harvard Medical School, MA 02139, USA
Int J Health Serv 38:407-19. 2008..The poor performance of U.S. health care is directly attributable to reliance on market mechanisms and for-profit firms, and should warn other nations from this path... - Hypertension, diabetes, and elevated cholesterol among insured and uninsured U.S. adultsAndrew P Wilper
Department of Medicine, University of Washington, USA
Health Aff (Millwood) 28:w1151-9. 2009..Undiagnosed and uncontrolled chronic illness, which is common among insured people, is even more frequent among the uninsured... - National health insurance: liberal benefits, conservative spendingSteffie Woolhandler
Cambridge, MA 02139, USA
Arch Intern Med 162:973-5. 2002 - Characteristics of recipients of free prescription drug samples: a nationally representative analysisSarah L Cutrona
Department of Medicine, Cambridge Hospital, 1493 Cambridge St, Cambridge, MA 02139, USA
Am J Public Health 98:284-9. 2008..Free prescription drug samples are used widely in the United States. We sought to examine characteristics of free drug sample recipients nationwide... - Waits to see an emergency department physician: U.S. trends and predictors, 1997-2004Andrew P Wilper
Harvard Medical School affiliated with the Cambridge Health Alliance, in Cambridge, Massachusetts, USA
Health Aff (Millwood) 27:w84-95. 2008..2 percent per year. Blacks, Hispanics, women, and patients seen in urban EDs waited longer than other patients did... - America's neglected veterans: 1.7 million who served have no health coverageSteffie Woolhandler
Harvard Medical School, USA
Int J Health Serv 35:313-23. 2005..Thus millions of U.S. veterans and their family members are uninsured and face grave difficulties in gaining access to even the most basic medical care... - Health insurance and mortality in US adultsAndrew P Wilper
Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
Am J Public Health 99:2289-95. 2009..A 1993 study found a 25% higher risk of death among uninsured compared with privately insured adults. We analyzed the relationship between uninsurance and death with more recent data... - A national study of chronic disease prevalence and access to care in uninsured U.S. adultsAndrew P Wilper
Cambridge Health Alliance Harvard Medical School, Cambridge, Massachusetts 02139, USA
Ann Intern Med 149:170-6. 2008..No recent national studies have assessed chronic illness prevalence or access to care among persons without insurance in the United States... - Single-payer national health insurance. Physicians' viewsDanny McCormick
Department of Medicine, Cambridge Hospital and Harvard Medical School, Cambridge, MA 02139, USA
Arch Intern Med 164:300-4. 2004..One proposed solution is a single-payer health care financing system with universal coverage. Yet, physicians' views of such a system have not been well studied... - Health care administration in the United States and Canada: micromanagement, macro costsSteffie Woolhandler
Harvard Medical School, Cambridge, MA 02139, USA
Int J Health Serv 34:65-78. 2004..2 to 27.3 percent; in Canada it grew from 16.0 percent in 1971 to 19.1 percent in 1996. Reducing U.S. administrative costs to Canadian levels would save at least dollar 209 billion annually, enough to fund universal coverage... - Relationship between low quality-of-care scores and HMOs' subsequent public disclosure of quality-of-care scoresDanny McCormick
Department of Medicine, Cambridge Hospital and Harvard Medical School, 1493 Cambridge St, Cambridge, MA 02139, USA
JAMA 288:1484-90. 2002..But, because disclosure is voluntary, some HMOs could subvert these objectives by refusing to release unfavorable data... - National health insurance or incremental reform: aim high, or at our feet?David U Himmelstein
Department of Medicine, Cambridge Hospital Harvard Medical School, Mass, USA
Am J Public Health 93:102-5. 2003..While national health insurance is often dismissed as ultra left by the policy community, it is dead center in public opinion. Polls have consistently shown that at least 40%, and perhaps 60%, of Americans favor such reform... - State health reform flatlinesSteffie Woolhandler
Cambridge Hospital, MA 02139, USA
Int J Health Serv 38:585-92. 2008..Unfortunately, none of those efforts can be judged a success. The authors briefly review this earlier experience and caution against premature declaration of victory... - Costs of health care administration in the United States and CanadaSteffie Woolhandler
Department of Medicine, Cambridge Hospital and Harvard Medical School, Cambridge, Mass, USA
N Engl J Med 349:768-75. 2003..S. and Canadian spending on health care administration has grown to 752 dollars per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system... - Life and health insurance industry investments in fast foodArun V Mohan
Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA 02139, USA
Am J Public Health 100:1029-30. 2010..Insurers own $1.88 billion of stock in the 5 leading fast food companies. We argue that insurers ought to be held to a higher standard of corporate responsibility, and we offer potential solutions... - Sources of U.S. physician income: the contribution of government payments to the specialist-generalist income gapKaren E Lasser
Department of Medicine, The Cambridge Health Alliance and Harvard Medical School, Cambridge, MA 02139, USA
J Gen Intern Med 23:1477-81. 2008..Physician income varies threefold among specialties. Lower incomes have produced shortages in primary care fields... - Proposal of the Physicians' Working Group for Single-Payer National Health InsuranceSteffie Woolhandler
Department of Medicine, Cambridge Hospital Harvard Medical School, Cambridge, Mass 02139, USA
JAMA 290:798-805. 2003..An NHI program is the only affordable option for universal, comprehensive coverage... - Diabetes and cardiovascular disease among Asian Indians in the United StatesSarita A Mohanty
Department of Medicine, Division of Geriatric and General Internal Medicine, University of Southern California, Los Angeles, CA 90033, USA
J Gen Intern Med 20:474-8. 2005..Studies, mostly from outside the United States, have found high prevalence of diabetes, coronary heart disease (CHD), and hypertension among Asian Indians, despite low rates of associated risk factors... - Massachusetts' approach to universal coverage: high hopes and faulty economic logicDavid U Himmelstein
Department of Medicine, Cambridge Hospital Harvard Medical School, Cambridge, MA 02139, USA
Int J Health Serv 37:251-7. 2007..Hence, it is unlikely to achieve universal coverage or to stabilize the state's health care financing system... - Health care expenditures of immigrants in the United States: a nationally representative analysisSarita A Mohanty
Department of Medicine, Division of Geriatric and General Internal Medicine, University of Southern California, 2020 Zonal Ave, IRD 627, Los Angeles, CA 90033, USA
Am J Public Health 95:1431-8. 2005..We compared the health care expenditures of immigrants residing in the United States with health care expenditures of US-born persons... - Our health care system at the crossroads: single payer or market reform?David U Himmelstein
The Department of Medicine, Cambridge Health Alliance Harvard Medical School, Cambridge, Massachusetts, USA
Ann Thorac Surg 84:1435-46. 2007 - Competition in a publicly funded healthcare systemSteffie Woolhandler
Department of Medicine, Cambridge Hospital, Harvard Medical School, Cambridge, MA, USA
BMJ 335:1126-9. 2007 - Paying for national health insurance--and not getting itSteffie Woolhandler
Harvard Medical School, USA
Health Aff (Millwood) 21:88-98. 2002..National health insurance would require smaller tax increases than most people imagine and would make government's role in financing care more visible and explicit... - Do minorities in the United States receive fewer mental health services than whites?Karen E Lasser
Department of Medicine, Cambridge Hospital, MA 02139, USA
Int J Health Serv 32:567-78. 2002..6 vs. 85.1; P < .0001 for both comparisons) and drug therapy (38.3 and 29.1 vs. 71.8; P < .0001 for both comparisons). These results indicate that minorities receive about half as much outpatient mental health care as whites... - Treating opioid addiction with buprenorphine-naloxone in community-based primary care settingsIra L Mintzer
Harvard Medical School Cambridge Health Alliance, Cambridge, MA 02139, USA
Ann Fam Med 5:146-50. 2007..Efficacy of this treatment in non-research clinical settings has not been studied. We examined the efficacy and practicality of buprenorphine-naloxone treatment in primary care settings... - The high costs of for-profit careSteffie Woolhandler
Department of Medicine, Cambridge Hospital/Harvard Medical School, Cambridge, MA 02139, USA
CMAJ 170:1814-5. 2004 - No care for the caregivers: declining health insurance coverage for health care personnel and their children, 1988-1998Brady G S Case
Harvard Medical School, 955 Massachusetts Ave, PMB 321, Cambridge, MA 02139, USA
Am J Public Health 92:404-8. 2002..This study examined trends in health insurance coverage for health care workers and their children between 1988 and 1998... - Infective endocarditis in the U.S., 1998-2009: a nationwide studyDavid H Bor
Department of Medicine and Division of Infectious Diseases, Cambridge Health Alliance Harvard Medical School, Cambridge, Massachusetts, United States of America
PLoS ONE 8:e60033. 2013..S. at about 4 per 100,000 population. Small-scale studies elsewhere have reported similar incidence rates. However, no nationally-representative population-based studies have verified these estimates... - Giving office-based physicians electronic access to patients' prior imaging and lab results did not deter ordering of testsDanny McCormick
Harvard Medical School, Boston, MA, USA
Health Aff (Millwood) 31:488-96. 2012..We conclude that use of these health information technologies, whatever their other benefits, remains unproven as an effective cost-control strategy with respect to reducing the ordering of unnecessary tests... - Hope and hype: predicting the impact of electronic medical recordsDavid U Himmelstein
Harvard Medical School, Massachusetts, USA
Health Aff (Millwood) 24:1121-3. 2005..The RAND analysis continues the tradition of hope and hype. Unfortunately, behind their impressive predictions of savings lie a disturbing array of unproven assumptions, wishful thinking, and special effects... - US health care: single-payer or market reformDavid U Himmelstein
Harvard Medical School, Department of Medicine, Cambridge Hospital, Cambridge MA 02139, USA
Urol Clin North Am 36:57-62, vi. 2009..NHI could restore the physician-patient relationship, offer patients a free choice of physicians and hospitals, and free physicians from the hassles of insurance paperwork... - Timing of new black box warnings and withdrawals for prescription medicationsKaren E Lasser
Department of Medicine, Cambridge Hospital, Cambridge, MA 02139, USA
JAMA 287:2215-20. 2002..Recently approved drugs may be more likely to have unrecognized adverse drug reactions (ADRs) than established drugs, but no recent studies have examined how frequently postmarketing surveillance identifies important ADRs... - Does investor-ownership of nursing homes compromise the quality of care?Charlene Harrington
Department of Social and Behavioral Sciences, University of California, San Francisco, USA
Int J Health Serv 32:315-25. 2002..In the multivariate analysis, investor-ownership predicted 0.679 additional deficiencies per home; chain-ownership predicted an additional 0.633 deficiencies per home. Nurse staffing ratios were markedly lower at investor-owned homes... - Double catastrophe: injury-related bankruptciesSteffie Woolhandler
Med Care 45:699-701. 2007 - The new Massachusetts health reform: half a step forward and three steps backSteffie Woolhandler
Physicians for a National Health Program, USA
Hastings Cent Rep 36:19-21. 2006 - National health insurance: falling expectations and the safety netSteffie Woolhandler
Med Care 42:403-5. 2004 - Getting more for their dollar: Kaiser v the NHS. Price adjustments falsify comparisonDavid U Himmelstein
BMJ 324:1332; author reply 1332. 2002 - Brief report: Influenza vaccination and health care workers in the United StatesWilliam D King
CARE Center, Department of Infectious Disease, University of California, Los Angeles, CA, USA
J Gen Intern Med 21:181-4. 2006..To determine influenza vaccination rates among U.S. health care workers (HCWs) by demographic and occupational categories... - National health insuranceSteffie Woolhandler
Health Aff (Millwood) 21:299. 2002