Prompt I
In healthcare, case-control studies consist of comparing a sample of patients that have a specific condition with those that do not. A researcher is able to identify specific factors causing or associated with the illness, using a variety of evidence such as medical records and observation. The advantage of case-control studies is that they are less expensive and time-consuming, beneficial in cases where data may be difficult to obtain.
It also has the advantage of studying dynamic populations or tracking rare diseases, in both cases follow-ups may not be available and there may be a significant period between exposure and the manifestation of the disease. However, case-control studies are considered less reliable than randomized or cohort studies. This is because they attempt to demonstrate a statistical relationship between, for example, a specific factor and disease exposure in order to prove causation. It may not always be the case, leading to a certain degree of selection or observation bias. Furthermore, case-control studies are limited in the calculation of incidence (Sedgwick, 2014).
Randomized controlled trials (RCTs) have become the staple of evidence-based research, particularly in the health industry, as it provides an effective form for transferring research data into clinical practice. The biggest advantage of RCTs is their comparative design which allows comparing treatments or any two research factors to determine the best one, thus providing strong empirical evidence of efficacy.
RCTs also help to minimize bias through the randomized design which inherently limits the researcher’s ability for allocation or selection bias. Furthermore, binding, double-binding, and allocation concealment used in such trials can lessen performance and assessment bias.
The design also offers statistical reliability with strong sample sizes and a variety of statistical tests utilized while minimizing confounding factors on the data. RCTs have the biggest disadvantage of posing logistical challenges as they are more expensive and time-consuming to implement due to the sample size, trial run time, and data collection practices. Furthermore, the applicability of results may be challenging as trials do not always represent real-life scenarios or treatment factors (Spieth et al., 2016).
Prompt II
The growing costs of health care are largely unsustainable for the U.S. economy and, in the long term, far outweigh the benefits of improvement and innovation that they may bring. The costs make up approximately 18 percent of the U.S. GDP, increasing at a rate of 2 percent faster than the national GDP growth (Committee for a Responsible Federal Budget, 2018). This is far greater than other developed countries and remains unsustainable for all involved stakeholders include the government, private practices, insurance companies, and consumers. The costs have and will continue to negatively influence a variety of economic factors such as marginally higher taxes necessary to finance the system.
The overall health of the economy demonstrated by the GDP will decline along with decreased employment, both in health care and other sectors since costs increase labor expenses as well. Finally, as national budgets, as well as regular consumer funds, are diverted to pay for healthcare, it is taken from other areas leading to a lower standard of living in all income brackets (Alliance for Health Reform, 2017).
The extreme health care costs are impacting direct consumers and patients more than anything, influencing their attitude and process of receiving the necessary health care. The direct annual costs of more than $10,000 per year are limiting options for many middle class and lower-income families. For example, more than 40 percent of Americans have indicated that they chose to not go to the doctor during an illness or skip a recommended test or procedures (Gillies, 2018).
The majority of those surveyed indicated health insurance coverage but chose to avoid the overwhelming billing that would arrive anyway for even a simple visit to the doctor. However, this creates a paradox since missing medical care ultimately results in worsening population health which leads to more significant health issues that are inherently difficult and expensive to treat. It is a consequence of impacting the quality of care and patient outcomes.
References
Alliance for Health Reform. (2017). High and rising costs of health care in the U.S. The challenge: Changing the trajectory. Web.
Committee for a Responsible Federal Budget. (2018). American health care: Health spending and federal budget. Web.
Gillies, T. (2018). Why health care costs are making consumers more afraid of medical bills than an actual illness. CNBC. Web.
Sedgwick, P. (2014). Case-control studies: Advantages and disadvantages. BMJ 348, f7707-f7708. Web.
Spieth, P. M., Kubasch, A. S., Penzlin, A. I., Illigens, B. M., Barlinn, K., & Siepmann, T. (2016). Randomized controlled trials – A matter of design. Neuropsychiatric Disease and Treatment, 12, 1341-1349. Web.