Eliminating Waste in US Health Care
Eliminating Waste in US Health Care
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DOI：
10.1001/jama.2012.362
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发表时间：
2012-04-11
影响因子：
120.7
通讯作者：
Hackbarth, Andrew D.
中科院分区：
文献类型：
--
作者：
Berwick, Donald M.;Hackbarth, Andrew D.
迫切需要将美国的医疗保健费用纳入公共和私人支付者可持续的范围内。通常，控制成本的计划会采用削减措施，例如降低支付水平、福利结构和资格。危害较小的策略会减少浪费，而不是增值护理。机会是巨大的。仅在 6 类浪费中——过度处理、护理协调失败、护理流程执行失败、管理复杂性、定价失误以及欺诈和滥用——最低可用估计的总和就超过了医疗保健总支出的 20%。实际总数可能要大得多。通过系统、全面和合作地减少废物，即使是部分减少，也可能实现的节省远远高于直接和粗暴地削减护理和覆盖范围。然而，潜在的经济混乱很严重，需要通过谨慎的转型战略来缓解。贾马。 2012;307(14):1513-1516 2012 年 3 月 14 日在线发布。doi:10.1001/jama.2012.362
The need is urgent to bring US health care costs into a sustainable range for both public and private payers. Commonly, programs to contain costs use cuts, such as reductions in payment levels, benefit structures, and eligibility. A less harmful strategy would reduce waste, not value-added care. The opportunity is immense. In just 6 categories of waste-overtreatment, failures of care coordination, failures in execution of care processes, administrative complexity, pricing failures, and fraud and abuse-the sum of the lowest available estimates exceeds 20% of total health care expenditures. The actual total may be far greater. The savings potentially achievable from systematic, comprehensive, and cooperative pursuit of even a fractional reduction in waste are far higher than from more direct and blunter cuts in care and coverage. The potential economic dislocations, however, are severe and require mitigation through careful transition strategies. JAMA. 2012;307(14):1513-1516 Published online March 14, 2012. doi:10.1001/jama.2012.362