Is spending more always wasteful? The appiropriateness of cave and outcomes among colorectal cancer patients
Is spending more always wasteful? The appiropriateness of cave and outcomes among colorectal cancer patients
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DOI：
10.1377/hlthaff.27.1.159
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发表时间：
2008-01-01
期刊：
影响因子：
9.7
通讯作者：
Keating, Nancy L.
中科院分区：
文献类型：
--
作者：
Landrum, Mary Beth;Meara, Ellen R.;Keating, Nancy L.
地区医疗支出的增加与患者治疗效果或质量的改善并不相关，因此支持了高支出地区削减支出的理由。然而，所有额外支出不一定都是浪费。通过检查结直肠癌患者的护理，我们发现高支出地区比其他地区更有可能使用推荐护理，但也更有可能使用酌情和非推荐护理，后者会给患者带来不良后果。我们的研究结果表明，旨在为最有可能受益的患者提供服务的政策不仅不会削减支出，反而会增加医疗支出的价值。
Increased area-level medical spending is not correlated with improved patient outcomes or quality, thereby supporting the case for spending reductions in high-spending regions. However, all additional spending need not be wasteful. Examining the care of patients with colorectal cancer, we show that high-spending regions are more likely than other regions to use recommended care but are also more likely to use discretionary and nonrecommended care, the latter of which has adverse outcomes for patients. Our results show that instead of cutting spending, policies designed to target services to patients most likely to benefit could increase the value of medical spending.