The meaning of quality is “the right care for the right person at the right time”. Quality can be well-defined as the value, efficiency, consistency, and outcome of the care being provided. The Center for Medicare and Medicaid Service’s (CMS) stated “an rise in health care spending from $2.34 trillion in 2008 to $ 2.47 trillion in 2009, the largest one year increase since 1960” (Pickert, 2010). “The action to improve the American health care delivery system as a whole, in all of its quality dimensions such as efficiency, effectiveness, equitability, timeliness, patient-centeredness, and safety for all Americans” (IOM, 2011). This paper aims to find out the relationship between cost and quality relating to health care. Relationship of Cost and Quality in Healthcare “Americans are not healthier than some of the other developed nations, regardless of these extensive costs” (WHO, 2007). “Almost 40 million Americans are uninsured and about 18% of Americans under the age of 65 receive half of the recommended healthcare services” (Goldman, and McGlynn, 2005). “Though, quality of care was …show more content…
For example, in Colorado State, 77% of spending accounted for high-cost antibiotics, while 20% spending was noted in the use of low-cost antibiotics for pediatric population for the most common infection like Otitis Media. AHRQ revealed that “the same rates of the second course of antibiotics by expending less expensive antibiotics, thus saving Medicaid nearly $400,000 for Colorado” (AHRQ, 2002). American-Academy of Pediatrics recommends usage of less expensive antibiotics for treatment of Otitis Media as a result of the growth of this research. AHRQ is helping the research to assess the quality and lessen costs in health care
The facts bear out the conclusion that the way healthcare in this country is distributed is flawed. It causes us to lose money, productivity, and unjustly leaves too many people struggling for what Thomas Jefferson realized was fundamental. Among industrialized countries, America holds the unique position of not having any form of universal health care. This should lead Americans to ask why the health of its citizens is “less equal” than the health of a European.
On a global scale, the United States is a relatively wealthy country of advanced industrialization. Unfortunately, the healthcare system is among the costliest, spending close to 18% of gross domestic product (GDP) towards funding healthcare (2011). No universal healthcare coverage is currently available. United States healthcare is currently funded through private, federal, state, and local sources. Coverage is provided privately and through the government and military. Nearly 85% of the U.S. population is covered to some extent, leaving a population of close to 48 million without any type of health insurance. Cost is the primary reason for lack of insurance and individuals foregoing medical care and use of prescription medications.
The United States spends vast amounts on its healthcare, while falling short of achieving superiority over other developed nations. One cannot overlook that the deepening recession has left many without jobs and therefore lacking health insurance. According to Fairhall and Steadman, (2009), even though the recession is hard on all, it is worse on the uninsured due to health care and insurance cost rising faster than incomes. Nevertheless, even those with jobs are lacking in health insurance due to employers, who provide insurance, are increasingly dropping their sponsored insurance. Many find that purchasing a health policy or paying for medical care out-of-pocket is cost prohibitive. “Since the recession began in December 2007, the number of unemployed Americans has increased by 3.6 million,” (Fairhall & Steadman, 2009). In 2009 it was stated that approximately 46 million Americans were uninsured, however not all of that number is due to the inability to afford coverage. According to a 2009 story written by Christopher Weaver of Kaiser Health News, 43% of that number should be classified as “voluntarily” uninsured. This subset of uninsured Americans consist of nearly half being young and healthy; therefo...
There are several basic approaches that can be utilized when conducting economic evaluations for any new health care intervention; which can include medications that are designed for the treatment and prevention of disease and how to relate the effectiveness with the overall monetary value of the new treatment. The economic tools that can be employed to perform such an analysis can be broken down into four basic parts that consist of cost-minimization analysis (CMA), cost-effectiveness analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA). These four categories will contain the major financial analytical techniques employed when evaluating medical treatments and interventions along with other types termed cost-consequence
In order to make ones’ health care coverage more affordable, the nation needs to address the continually increasing medical care costs. Approximately more than one-sixth of the United States economy is devoted to health care spending, such as: soaring prices for medical services, costly prescription drugs, newly advanced medical technology, and even unhealthy lifestyles. Our system is spending approximately $2.7 trillion annually on health care. According to experts, it is estimated that approximately 20%-30% of that spending (approx. $800 billion a year) appears to go towards wasteful, redundant, or even inefficient care.
Despite the established health care facilities in the United States, most citizens do not have access to proper medical care. We must appreciate from the very onset that a healthy and strong nation must have a proper health care system. Such a health system should be available and affordable to all. The cost of health services is high. In fact, the ...
Introduction to healthcare quality management (2nd ed.). Chicago, IL: Health Administration Press. Young, G. J., Charns, M. P., & Barbour, G. L. (1997). Quality improvement for the US Veterans Health Administration. International Journal of Quality Health Care, 9(3), 183-188.
The balance between quality patient care and medical necessity is a top priority and the main concern of many of the healthcare organizations today. Due to the rising cost of healthcare, there has been a change in the focus of reimbursement strategies that are affecting the delivery of patient care. This shift from a fee-for-service towards a value-based system creates a challenge that has shifted many providers’ focus more directly on their revenue. As a result, organizations are forced to take a hard look at the cost of services they are providing patients and then determining if the services and level of care are appropriate for the prescribed patient care.
... is an abstract model that proposes an exploratory plan for health services and evaluating quality of health care. In accordance with the model, information about quality of care can be obtained from three categories: structure, process, and outcomes. In addition, not long ago The Joint Commission include outcomes in its accreditation valuations (Sultz, & Young, 2011, p. 378).
Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.
The U.S. expends far more on healthcare than any other country in the world, yet we get fewer benefits, less than ideal health outcomes, and a lot of dissatisfaction manifested by unequal access, the significant numbers of uninsured and underinsured Americans, uneven quality, and unconstrained wastes. The financing of healthcare is also complicated, as there is no single payer system and payment schemes vary across payors and providers.
Reforming the health care delivery system to progress the quality and value of care is indispensable to addressing the ever-increasing costs, poor quality, and increasing numbers of Americans without health insurance coverage. What is more, reforms should improve access to the right care at the right time in the right setting. They should keep people healthy and prevent common, preventable impediments of illnesses to the greatest extent possible. Thoughtfully assembled reforms would support greater access to health-improving care, in contrast to the current system, which encourages more tests, procedures, and treatments that are either
The US health system has both considerable strengths and notable weaknesses. With a large and well-trained health workforce, access to a wide range of high-quality medical specialists as well as secondary and tertiary institutions, patient outcomes are among the best in the world. But the US also suffers from incomplete coverage of its population, and health expenditure levels per person far exceed all other countries. Poor measures on many objective and subjective indicators of quality and outcomes plague the US health care system. In addition, an unequal distribution of resources across the country and among different population groups results in poor access to care for many citizens. Efforts to provide comprehensive, national health insurance in the United States go back to the Great Depression, and nearly every president since Harry S. Truman has proposed some form of national health insurance.
towards the quality and cost of health care in the United States in the general public. In
Nguyen, N. (2009, August). Improving quality and value in the u.s. health care system. Retrieved from http://www.brookings.edu/research/reports/2009/08/21-bpc-qualityreport