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Analysis of health care in US indicates that improvement in outcomes has slowed
Date:11/12/2013

ince the mid-1970s and sharply over the last decade.

  • Despite the increases in resources devoted to health care, multiple health metrics, including life expectancy at birth and survival with many diseases, shows the United States trailing peer nations.

    Contributors to Costs

    In addition, the researchers note that findings from their analysis contradict several common assumptions:

    • Price of professional services, drugs and devices, and administrative costs, not demand for services or aging of the population, produced 91 percent of cost increases since 2000.

    • Personal out-of-pocket spending on insurance premiums and co-payments have declined from 23 percent to 11 percent since 1980.

    • In 2011, chronic illnesses account for 84 percent of costs overall among the entire population, not only of the elderly. Chronic illness among individuals younger than 65 years accounts for 67 percent of spending.

    Contributors to Change

    The authors add that three factors have produced the most change:

    • Consolidation, with fewer insurers and general hospitals (but more single-specialty hospitals and large physician groups) has produced financial concentration in health systems, insurers, pharmacies, and benefit managers;

    • Information technology, in which investment has occurred but value is elusive;

    • The patient as consumer, whereby influence is sought outside traditional channels, using social media, informal networks, new public sources of information, and self-management software.

    These forces create a triangle of tension among patient aims for choice, personal attention, and unbiased guidance; physician aims for professionalism and autonomy; and public and private payer aims for aggregate economic value across large populations. "Measurements of cost and outcome (applied to groups) are supplanting individuals' preferences. Clinicians
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  • Contact: Stephanie Desmon
    sdesmon1@jhmi.edu
    410-955-8665
    The JAMA Network Journals
    Source:Eurekalert

    Page: 1 2 3

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