Download The Quality Cure: How Focusing on Health Care Quality Can by David Cutler PDF
By David Cutler
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Extra resources for The Quality Cure: How Focusing on Health Care Quality Can Save Your Life and Lower Spending Too
Example text
Tertiary prevention involves keeping acute disease under control. A patient who has congestive heart failure may have missed opportunities for primary and secondary prevention; however, he or she can still benefit from tertiary prevention. Tertiary prevention has the clearest cost savings. 33 Often the patient did not see a doctor or nurse in the intervening period, and many did not take medications appro- The Value Proposition / 29 priately. Preventing readmission is not difficult. Ensuring understanding of medication recommendations and adherence to them, as well as seeing a physician or nurse after discharge, can prevent many readmissions.
Thus insurance reform directly links to the issue of premium subsidies; we can’t attempt one without the other. And that brings us back to the costs of those subsidies. • • • In health care, all roads lead to costs. And those costs are big numbers. 26 As Figure 2 shows, this is over twice the average of other rich countries. Since the United States is richer than other countries, it ought to spend more on medical care. But income alone does not explain these differences. Even as a share of income, medical spending in the United States is 50 percent higher than in other countries.
Simple back pain is limited in scope, while more serious pain typically manifests itself also in other parts of the body, including leg pain, fever, and dysfunctional excretion. Optimal 22 / The Value Proposition table 3 Excessive Medicare spending Area Examples Poor care delivery Unnecessary Back surgeries, elective services inductions, stenting Failures of care Medical errors delivery Failures of care Inadequate risk factor coordination control, poor use of chronic medications, hospital readmissions Excessive admin.