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Published in: Applied Health Economics and Health Policy 1/2014

01-02-2014 | Practical Application

Propensity-Score Matching in Economic Analyses: Comparison with Regression Models, Instrumental Variables, Residual Inclusion, Differences-in-Differences, and Decomposition Methods

Author: William H. Crown

Published in: Applied Health Economics and Health Policy | Issue 1/2014

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Abstract

This paper examines the use of propensity score matching in economic analyses of observational data. Several excellent papers have previously reviewed practical aspects of propensity score estimation and other aspects of the propensity score literature. The purpose of this paper is to compare the conceptual foundation of propensity score models with alternative estimators of treatment effects. References are provided to empirical comparisons among methods that have appeared in the literature. These comparisons are available for a subset of the methods considered in this paper. However, in some cases, no pairwise comparisons of particular methods are yet available, and there are no examples of comparisons across all of the methods surveyed here. Irrespective of the availability of empirical comparisons, the goal of this paper is to provide some intuition about the relative merits of alternative estimators in health economic evaluations where nonlinearity, sample size, availability of pre/post data, heterogeneity, and missing variables can have important implications for choice of methodology. Also considered is the potential combination of propensity score matching with alternative methods such as differences-in-differences and decomposition methods that have not yet appeared in the empirical literature.
Literature
1.
go back to reference Terza J, Basu A, Rathouz P. Two-stage residual inclusion estimation: addressing endogeneity in health econometric modeling. J Health Econ. 2008;27:531–43.PubMedCentralPubMedCrossRef Terza J, Basu A, Rathouz P. Two-stage residual inclusion estimation: addressing endogeneity in health econometric modeling. J Health Econ. 2008;27:531–43.PubMedCentralPubMedCrossRef
2.
go back to reference D’Agostino RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998;17(19):2265–81.PubMedCrossRef D’Agostino RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998;17(19):2265–81.PubMedCrossRef
3.
go back to reference Baser O. Too much ado about propensity score models? Comparing methods of propensity score matching. Value Health. 2006;9:377–85.PubMedCrossRef Baser O. Too much ado about propensity score models? Comparing methods of propensity score matching. Value Health. 2006;9:377–85.PubMedCrossRef
4.
go back to reference Austin P. A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. Stat Med. 2008;27:2037–49.PubMedCrossRef Austin P. A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. Stat Med. 2008;27:2037–49.PubMedCrossRef
5.
go back to reference Jones AM, Rice N. Econometric evaluation of health policies. In: Glied S, Smith P, editors. The Oxford handbook of health economics. Oxford: Oxford University Press; 2009. Jones AM, Rice N. Econometric evaluation of health policies. In: Glied S, Smith P, editors. The Oxford handbook of health economics. Oxford: Oxford University Press; 2009.
6.
go back to reference Basu A, Polsky D, Manning W. Estimating treatment effects on healthcare costs under exogeneity: is there a “Magic Bullet”? Health Serv Outcomes Res Methodol. 2011;11(1–2):1–26.PubMedCentralPubMedCrossRef Basu A, Polsky D, Manning W. Estimating treatment effects on healthcare costs under exogeneity: is there a “Magic Bullet”? Health Serv Outcomes Res Methodol. 2011;11(1–2):1–26.PubMedCentralPubMedCrossRef
7.
go back to reference Basu A, Heckman J, Navarro-Lozano S, Urzua S. Use of instrumental variables in the presence of heterogeneity and self-selection: an application to treatments of breast cancer patients. Health Econ. 2007;16:1133–57.PubMedCrossRef Basu A, Heckman J, Navarro-Lozano S, Urzua S. Use of instrumental variables in the presence of heterogeneity and self-selection: an application to treatments of breast cancer patients. Health Econ. 2007;16:1133–57.PubMedCrossRef
8.
go back to reference Heckman J, Navarro-Lozano S. Using matching, instrumental variables, and control functions to estimate choice models. Rev Econ and Stat. 2004;86(1):30–57.CrossRef Heckman J, Navarro-Lozano S. Using matching, instrumental variables, and control functions to estimate choice models. Rev Econ and Stat. 2004;86(1):30–57.CrossRef
9.
go back to reference Crown W. There’s a reason they call them dummy variables: a note on the use of structural equation techniques in comparative effectiveness research. Pharmacoeconomics. 2010;28(10):1–9.CrossRef Crown W. There’s a reason they call them dummy variables: a note on the use of structural equation techniques in comparative effectiveness research. Pharmacoeconomics. 2010;28(10):1–9.CrossRef
10.
go back to reference Hausman J. Specification and estimation of simultaneous equations models, In: Griliches Z, Intriligator MD, editors. Handbook of econometrics, vol. 1. Amsterdam: North Holland; 1983. p. 391–448. Hausman J. Specification and estimation of simultaneous equations models, In: Griliches Z, Intriligator MD, editors. Handbook of econometrics, vol. 1. Amsterdam: North Holland; 1983. p. 391–448.
11.
go back to reference Wooldridge J. Econometric analysis of cross-section and panel data. Cambridge: MIT Press; 2002. Wooldridge J. Econometric analysis of cross-section and panel data. Cambridge: MIT Press; 2002.
12.
go back to reference Crump R, Holtz V, Imbens G, Mitnik O. Dealing with limited overlap in estimation of average treatment effects. Biometrika. 2009;96(1):187–99.CrossRef Crump R, Holtz V, Imbens G, Mitnik O. Dealing with limited overlap in estimation of average treatment effects. Biometrika. 2009;96(1):187–99.CrossRef
13.
go back to reference Rosenbaum PR, Rubin DB. The central role of propensity score in observational studies for causal effects. Biometrika. 1983;70:41–55.CrossRef Rosenbaum PR, Rubin DB. The central role of propensity score in observational studies for causal effects. Biometrika. 1983;70:41–55.CrossRef
14.
go back to reference Borah B, Moriaty J, Crown W, Doshi J. Applications of propensity score methods in observational comparative effectiveness and safety research: where have we come and where should we go? J Comparative Effectiveness Res (in press). Borah B, Moriaty J, Crown W, Doshi J. Applications of propensity score methods in observational comparative effectiveness and safety research: where have we come and where should we go? J Comparative Effectiveness Res (in press).
15.
go back to reference Diamond S, Sekhon JS. Genetic matching for estimating causal effects: a general multivariate matching method for achieving balance in observational studies. Rev Econ Stat. 2005;95(3):932–45.CrossRef Diamond S, Sekhon JS. Genetic matching for estimating causal effects: a general multivariate matching method for achieving balance in observational studies. Rev Econ Stat. 2005;95(3):932–45.CrossRef
16.
go back to reference Brookhart MA, Schneeweiss S, Rothman KJ, Glynn RJ, Avorn J, Stürmer T. Variable selection for propensity score models. Am J Epidemiol. 2006;15;163(12):1149–56. Brookhart MA, Schneeweiss S, Rothman KJ, Glynn RJ, Avorn J, Stürmer T. Variable selection for propensity score models. Am J Epidemiol. 2006;15;163(12):1149–56.
17.
go back to reference Johnson ML, Bush RL, Collins TC, Lin PH, Liles DA, Henderson WG, Khuri SF, Petersen LA. Propensity score analysis in observational studies: outcomes following abdominal aortic aneurysm repair. Am J Surg. 2006;192(3):336–43.PubMedCrossRef Johnson ML, Bush RL, Collins TC, Lin PH, Liles DA, Henderson WG, Khuri SF, Petersen LA. Propensity score analysis in observational studies: outcomes following abdominal aortic aneurysm repair. Am J Surg. 2006;192(3):336–43.PubMedCrossRef
18.
go back to reference Austin P. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivar Behav Res. 2011;46(3):399–424.CrossRef Austin P. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivar Behav Res. 2011;46(3):399–424.CrossRef
19.
go back to reference Cochran W. The effectiveness of adjustment by subclassification in removing bias in observational studies. Biometrics. 1968;24:295–313.PubMedCrossRef Cochran W. The effectiveness of adjustment by subclassification in removing bias in observational studies. Biometrics. 1968;24:295–313.PubMedCrossRef
20.
go back to reference Hullsiek KH, Louis TA. Propensity score modeling strategies for the causal analysis of observational data. Biostatistics. 2002;3:179–93.PubMedCrossRef Hullsiek KH, Louis TA. Propensity score modeling strategies for the causal analysis of observational data. Biostatistics. 2002;3:179–93.PubMedCrossRef
21.
go back to reference Imbens G. Nonparametric estimation of average treatment effects under exogeneity: a review. Review Econ Stat. 2004;86:4–29.CrossRef Imbens G. Nonparametric estimation of average treatment effects under exogeneity: a review. Review Econ Stat. 2004;86:4–29.CrossRef
22.
go back to reference Little R, Rubin D. Causal effects in clinical and epidemiological studies via potential outcomes, concepts, and analytic approaches. Ann Rev Pub Health. 2000;21:121–45.CrossRef Little R, Rubin D. Causal effects in clinical and epidemiological studies via potential outcomes, concepts, and analytic approaches. Ann Rev Pub Health. 2000;21:121–45.CrossRef
23.
go back to reference Hirano K, Imbens G, Ridder G. Efficient estimation of average treatment effects using the estimated propensity score. Econometrica. 2003;71:1161–89.CrossRef Hirano K, Imbens G, Ridder G. Efficient estimation of average treatment effects using the estimated propensity score. Econometrica. 2003;71:1161–89.CrossRef
24.
go back to reference Joffe M, Ten Have T, Feldman H, Kemmel S. Model selection, confounder control, and marginal structural models: review and new applications. Am Stat. 2004;58:272–9.CrossRef Joffe M, Ten Have T, Feldman H, Kemmel S. Model selection, confounder control, and marginal structural models: review and new applications. Am Stat. 2004;58:272–9.CrossRef
25.
go back to reference Bang H, Robins JM. Doubly robust estimation in missing data and causal inference models. Biometrics. 2005;61:962–72.PubMedCrossRef Bang H, Robins JM. Doubly robust estimation in missing data and causal inference models. Biometrics. 2005;61:962–72.PubMedCrossRef
26.
go back to reference Scharfstein DO, Rotnitzky A., Robins JM. Adjusting for nonignorable drop-out using semiparametric nonresponse models. J Am Stat Assoc. 1999;94:1096–1120 (Rejoinder, 1135–1146). Scharfstein DO, Rotnitzky A., Robins JM. Adjusting for nonignorable drop-out using semiparametric nonresponse models. J Am Stat Assoc. 1999;94:1096–1120 (Rejoinder, 1135–1146).
27.
go back to reference Robins JM, Rotnitzky A, Zhao LP. Analysis of semiparametric regression models for repeated outcomes in the presence of missing data. J Amer Stat Assoc. 1995;90:106–21.CrossRef Robins JM, Rotnitzky A, Zhao LP. Analysis of semiparametric regression models for repeated outcomes in the presence of missing data. J Amer Stat Assoc. 1995;90:106–21.CrossRef
28.
go back to reference Johnson M, Crown W, Martin B, Dormuth C, Siebert U. Good research practices for comparative effectiveness research: analytic methods to improve causal inference from non-randomized studies of treatment effects using secondary data sources. Report of the ISPOR retrospective database analysis task force—Part III. Value Health. 2009;12(8):1062–73.PubMedCrossRef Johnson M, Crown W, Martin B, Dormuth C, Siebert U. Good research practices for comparative effectiveness research: analytic methods to improve causal inference from non-randomized studies of treatment effects using secondary data sources. Report of the ISPOR retrospective database analysis task force—Part III. Value Health. 2009;12(8):1062–73.PubMedCrossRef
29.
go back to reference Manca A, Austin P. Using propensity score methods to analyze individual patient-level cost-effectiveness data from observational studies. The University of York: Health Economics and Data Group Working Paper 08/20; 2008. Manca A, Austin P. Using propensity score methods to analyze individual patient-level cost-effectiveness data from observational studies. The University of York: Health Economics and Data Group Working Paper 08/20; 2008.
30.
go back to reference Mitra N, Indurkhya A. A propensity score approach to estimating the cost-effectiveness of medical therapies from observational data. Health Econ. 2005;14(8):805–15.PubMedCrossRef Mitra N, Indurkhya A. A propensity score approach to estimating the cost-effectiveness of medical therapies from observational data. Health Econ. 2005;14(8):805–15.PubMedCrossRef
31.
go back to reference Sekhon JS, Grieve RD. A matching method for improving covariate balance in cost-effectiveness analyses. Health Eco. 2011;21(6):695–714.CrossRef Sekhon JS, Grieve RD. A matching method for improving covariate balance in cost-effectiveness analyses. Health Eco. 2011;21(6):695–714.CrossRef
32.
go back to reference Dheiia R, Wahba S. Nonexperimental studies: reevaluating the evolution of training programs. J Amer Stat Assoc. 1999;94(448):1053–62.CrossRef Dheiia R, Wahba S. Nonexperimental studies: reevaluating the evolution of training programs. J Amer Stat Assoc. 1999;94(448):1053–62.CrossRef
33.
go back to reference Seeger J, Walker A, Williams P, Saperia G, Sacks F. A propensity score-matched cohort study of the effect of statins, mainly fluvastatin, on the occurrence of acute myocardial infarction. Am J Cardiol. 2003;92:1447–51.PubMedCrossRef Seeger J, Walker A, Williams P, Saperia G, Sacks F. A propensity score-matched cohort study of the effect of statins, mainly fluvastatin, on the occurrence of acute myocardial infarction. Am J Cardiol. 2003;92:1447–51.PubMedCrossRef
34.
go back to reference Kang JD, Schafer JL. Demystifying double robustness: a comparison of alternative strategies for estimating a population mean from incomplete data. Stat Sci. 2007;22(4):523–39.CrossRef Kang JD, Schafer JL. Demystifying double robustness: a comparison of alternative strategies for estimating a population mean from incomplete data. Stat Sci. 2007;22(4):523–39.CrossRef
35.
go back to reference Carpenter JR, Kenwood MG. A comparison of multiple imputation and doubly robust estimation for analyses with missing data. J R Statist Soc. 2006;169(3):1–14.CrossRef Carpenter JR, Kenwood MG. A comparison of multiple imputation and doubly robust estimation for analyses with missing data. J R Statist Soc. 2006;169(3):1–14.CrossRef
36.
go back to reference Hausman J. Specification tests in econometrics. Econometrica. 1978;46:1251–71.CrossRef Hausman J. Specification tests in econometrics. Econometrica. 1978;46:1251–71.CrossRef
37.
go back to reference Cameron C, Trivedi P. Regression analysis of count data. Cambridge: Cambridge University Press; 2013. Cameron C, Trivedi P. Regression analysis of count data. Cambridge: Cambridge University Press; 2013.
38.
go back to reference Maddala GS. Limited dependent variables and qualitative variables in econometrics. Cambridge: Cambridge University Press; 1986. Maddala GS. Limited dependent variables and qualitative variables in econometrics. Cambridge: Cambridge University Press; 1986.
39.
go back to reference Vytlacil E. Independence, monotonicity, and Latent Index Models: an equivalence result. Econometrica. 2002;70(1):331–41. Vytlacil E. Independence, monotonicity, and Latent Index Models: an equivalence result. Econometrica. 2002;70(1):331–41.
40.
go back to reference Evans H, Basu A. Exploring comparative effect heterogeneity with instrumental variables: prehospital intubation and mortality. Health, Econometrics, and Data Group: The University of York; 2011. Evans H, Basu A. Exploring comparative effect heterogeneity with instrumental variables: prehospital intubation and mortality. Health, Econometrics, and Data Group: The University of York; 2011.
41.
go back to reference Basu A. Economics of individualization in comparative effectiveness research and a basis for a patient-centered health care. J Health Econ. 2011;30:549–59.PubMedCentralPubMedCrossRef Basu A. Economics of individualization in comparative effectiveness research and a basis for a patient-centered health care. J Health Econ. 2011;30:549–59.PubMedCentralPubMedCrossRef
42.
go back to reference Crown W, Obenchain R, Englehart L, Lair T, Buesching D, Croghan T. Application of sample selection models to outcomes research: the case of evaluating effects of antidepressant therapy on resource utilization. Stat Med. 1998;17:1943–58.PubMedCrossRef Crown W, Obenchain R, Englehart L, Lair T, Buesching D, Croghan T. Application of sample selection models to outcomes research: the case of evaluating effects of antidepressant therapy on resource utilization. Stat Med. 1998;17:1943–58.PubMedCrossRef
43.
go back to reference Hadley J, Polsky D, Mandelblatt J, Mitchell J, Weeks J, Wang Q, Hwang Y and the OPTIONS Research Team. An exploratory instrumental variable analysis of the outcomes of localized breast cancer treatments in a medicare population. Health Econ. 2003;12:171–86. Hadley J, Polsky D, Mandelblatt J, Mitchell J, Weeks J, Wang Q, Hwang Y and the OPTIONS Research Team. An exploratory instrumental variable analysis of the outcomes of localized breast cancer treatments in a medicare population. Health Econ. 2003;12:171–86.
44.
go back to reference Bound J, Jaeger DA, Baker RM. Problems with instrumental variables estimation when the correlation between the instruments and the endogenous explanatory variable is weak. J Am Stat Assoc. 1995;90(430):443–50. Bound J, Jaeger DA, Baker RM. Problems with instrumental variables estimation when the correlation between the instruments and the endogenous explanatory variable is weak. J Am Stat Assoc. 1995;90(430):443–50.
45.
go back to reference Staiger D, Stock JH. Instrumental variables regression with weak instruments. Econometrica. 1997;65:557–86.CrossRef Staiger D, Stock JH. Instrumental variables regression with weak instruments. Econometrica. 1997;65:557–86.CrossRef
46.
go back to reference Hahn J, Hausman J. A new specification test for the validity of instrumental variables. Econometrica. 2002;70:163–89.CrossRef Hahn J, Hausman J. A new specification test for the validity of instrumental variables. Econometrica. 2002;70:163–89.CrossRef
47.
go back to reference Kleibergen F, Zivot E. Bayesian and classical approaches to instrumental variables regression. J Econometrics. 2003;114:29–72.CrossRef Kleibergen F, Zivot E. Bayesian and classical approaches to instrumental variables regression. J Econometrics. 2003;114:29–72.CrossRef
48.
go back to reference Crown W, Henk H, VanNess D. Endogenous treatment selection: how bias in instrumental variables estimators is affected by instrument strength, instrument Contamination, and sample size. Val Health. 2011;14:1078–84.CrossRef Crown W, Henk H, VanNess D. Endogenous treatment selection: how bias in instrumental variables estimators is affected by instrument strength, instrument Contamination, and sample size. Val Health. 2011;14:1078–84.CrossRef
49.
go back to reference Brookhart M, Rassen J, Schneeweiss S. Instrumental variable methods in comparative safety and effectiveness research. Pharmacoepidemiol Drug Saf. 2010;19(6):537–54.PubMedCentralPubMedCrossRef Brookhart M, Rassen J, Schneeweiss S. Instrumental variable methods in comparative safety and effectiveness research. Pharmacoepidemiol Drug Saf. 2010;19(6):537–54.PubMedCentralPubMedCrossRef
50.
go back to reference Murray M. Avoiding invalid instruments and coping with weak instruments. J Econ Perspect. 2007;20(4):111–32.CrossRef Murray M. Avoiding invalid instruments and coping with weak instruments. J Econ Perspect. 2007;20(4):111–32.CrossRef
51.
go back to reference Bertrand M, Duflo E, Mullianathan S. How much should we trust differences-in-differences estimates? Quart J Econ. 2004;119(1):249–75.CrossRef Bertrand M, Duflo E, Mullianathan S. How much should we trust differences-in-differences estimates? Quart J Econ. 2004;119(1):249–75.CrossRef
52.
go back to reference Heckman J, Ichimura H, Todd P. Matching as an econometric evaluation estimator: evidence from evaluating a job training program. Rev Econ Stud. 1997;64(4):605–54. Heckman J, Ichimura H, Todd P. Matching as an econometric evaluation estimator: evidence from evaluating a job training program. Rev Econ Stud. 1997;64(4):605–54.
53.
go back to reference Heckman J, Ichimura H, Todd P. Matching as an econometric evaluation estimator: evidence from evaluating a job training program. Rev Econ Stud. 1998;65(2):261–94. Heckman J, Ichimura H, Todd P. Matching as an econometric evaluation estimator: evidence from evaluating a job training program. Rev Econ Stud. 1998;65(2):261–94.
54.
go back to reference Blinder A. Wage discrimination: reduced form and structural estimates. J Hum Resour. 1973;8:436–55.CrossRef Blinder A. Wage discrimination: reduced form and structural estimates. J Hum Resour. 1973;8:436–55.CrossRef
55.
go back to reference Oaxaca R. Male-female wage differentials in urban labor markets. Int Econ Rev. 1973;9:693–709.CrossRef Oaxaca R. Male-female wage differentials in urban labor markets. Int Econ Rev. 1973;9:693–709.CrossRef
56.
go back to reference Oaxaca R, Ransom M. On discrimination and the decomposition of wage differentials. J Econom. 1994;61:5–21.CrossRef Oaxaca R, Ransom M. On discrimination and the decomposition of wage differentials. J Econom. 1994;61:5–21.CrossRef
57.
go back to reference Pylypchuk Y, Selden T. A discrete choice decomposition analysis of racial and ethnic differences in children’s health insurance coverage. J Health Econ. 2008;27:1109–28.PubMedCrossRef Pylypchuk Y, Selden T. A discrete choice decomposition analysis of racial and ethnic differences in children’s health insurance coverage. J Health Econ. 2008;27:1109–28.PubMedCrossRef
58.
go back to reference Cook B, McGuire T, Meara E, Zaslavsky A. Adjusting for health status in non-linear models of health care disparities. Health Serv Outcomes Res Method. 2009;9:1–21.CrossRef Cook B, McGuire T, Meara E, Zaslavsky A. Adjusting for health status in non-linear models of health care disparities. Health Serv Outcomes Res Method. 2009;9:1–21.CrossRef
59.
go back to reference Chow G. Tests of equality between sets of coefficients in two linear regressions. Econometrica. 1960;28:591–605.CrossRef Chow G. Tests of equality between sets of coefficients in two linear regressions. Econometrica. 1960;28:591–605.CrossRef
60.
go back to reference Kennedy P. A guide to econometrics. 6th ed. Hoboken: Wiley-Blackwell; 2008. Kennedy P. A guide to econometrics. 6th ed. Hoboken: Wiley-Blackwell; 2008.
61.
go back to reference Efron B. Bootstrap methods: another look at the jackknife. Ann Stat. 1979;7:1–26.CrossRef Efron B. Bootstrap methods: another look at the jackknife. Ann Stat. 1979;7:1–26.CrossRef
Metadata
Title
Propensity-Score Matching in Economic Analyses: Comparison with Regression Models, Instrumental Variables, Residual Inclusion, Differences-in-Differences, and Decomposition Methods
Author
William H. Crown
Publication date
01-02-2014
Publisher
Springer International Publishing
Published in
Applied Health Economics and Health Policy / Issue 1/2014
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-013-0075-4

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