ECONOMETRICS IN OUTCOMES RESEARCH: The Use of Instrumental Variables

Author:

Newhouse Joseph P.12,McClellan Mark12

Affiliation:

1. Division of Health Policy Research and Education, Harvard University, 180 Longwood Avenue, Boston, Massachusetts 02115;

2. Department of Economics, Stanford University, Stanford, California 94305;

Abstract

▪ Abstract  We describe an econometric technique, instrumental variables, that can be useful in estimating the effectiveness of clinical treatments in situations when a controlled trial has not or cannot be done. This technique relies upon the existence of one or more variables that induce substantial variation in the treatment variable but have no direct effect on the outcome variable of interest. We illustrate the use of the technique with an application to aggressive treatment of acute myocardial infarction in the elderly.

Publisher

Annual Reviews

Subject

Public Health, Environmental and Occupational Health,General Medicine

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