Health Care Quality and Costs Not Always Correlated
A Dartmouth study authored by economists Jonathan Skinner and Douglas Staiger and physician Elliott Fisher, funded by the National Institute on Aging and published in Health Affairs looked at Medicare costs and survival gains for acute myocardial infarction (AMI) between 1986 and 2002. It found that increased costs moved along with gains in post-AMI survival until 1996 but this has no longer been the case since then though the cost part of the equation kept ramping up. As discrepancies between regions show, it is not how much you spend that matters so much as how you spend. Sometimes simple low-tech items such as aspirin and beta-blockers can lead to better treatment cost-efficiency. the authors do not suggest that simply cutting spending is the solution, rather they look at productivity gains and faster speading of best practices to help reduce incremental spending with no attached benefit.
More details in this press release that also mentions to complementary perpectives: Making Sense Of Medical Technology (which calls for experiments with financial incentives to both providers and individual patients to identify sources of increased efficiency) and To Use Technology Better (which states more resources should be focused on better using what the tools already available). Hospital Buyer is decicated on materials management to the extent that it is put in proper perpective with the end goal: better health for patients. Input needs to be seen in the light of output, and we will continue to dedicate a significant part of our news coverage to quality and efficiency issues, not just mere purchasing questions.
February 7, 2006 Related topics: Quality, Safety, Errors, Cost savings, Benchmarking