The latest edition of the Harvard Business Review offers an interesting analyis of how healthcare costs can be controlled and lowered by measuring patient quality outcomes rather than organizational groups or narrow diagnostic treatment groups.
The new healthcare model is presently being tested at the Head and Neck Center at MD Anderson, the Cleft Lip and Palate Program at Brigham and Women’s Hospital in Boston.
Costs, as everyone knows, are a hot-button issue. Politically, medical malpractice reform has been the easy if not facile solution to the cost issue. However the authors of this article believe the problem is systemic that requires a new way of facing the problem.
“The proper goal for any health care delivery system is to improve the value delivered to patients. Value in health care is measured in terms of the patient outcomes achieved per dollar expended. It is not the number of different services provided or the volume of services delivered that matters but the value. More care and more expensive care is not necessarily better care. To properly manage value, both outcomes and cost must be measured at the patient level. Measured outcomes and cost must encompass the entire cycle of care for the patient’s particular medical condition, which often involves a team with multiple specialties performing multiple interventions from diagnosis to treatment to ongoing management. A medical condition is an interrelated set of patient circumstances that are best addressed in a coordinated way and should be broadly defined to include common complications and comorbidities. The cost of treating a patient with diabetes, for example, must include not only the costs associated with endocrinological care but also the costs of managing and treating associated conditions such as vascular disease, retinal disease, and renal disease. For primary and preventive care, the unit of value measurement is a particular patient population—that is, a group with similar primary care needs, such as healthy children or the frail and elderly with multiple chronic conditions.”
Any one interested or concerned about the cost of healthcare and the issue of the quality of patient care must read this article.
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