ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

US Needs to Rethink Spending for Chronic Illnesses, Dartmouth Study Says

by Margot Fromer • September 1, 2006

  • Tweet
  • Email
Print-Friendly Version

A new study from Dartmouth Medical School documents “staggering variations in how hospitals care for chronically ill elderly patients.” The study points to problems with quality and faults Medicare for unnecessary spending. It goes on to say that less use of acute care hospitals and fewer physician visits could lead to better results for patients.

You Might Also Like

  • Medicare Battle Heats Up: Geographic Disparities spark look into spending variation
  • A Look at National Health Spending
  • Dartmouth Atlas Takes Aim at Excess Utilization of Medical Resources
  • IPAB is Medicare’s New Hammer for Spending Accountability
Explore This Issue
September 2006

The study was done at Dartmouth’s Center for Evaluative Clinical Services under the direction of John E. Wennberg, MD, MPH. He said that three issues drive differences in cost and quality of care: an unmanageable supply of resources; limited evidence about what kinds of care really benefit the chronically ill; and falsely optimistic assumptions about conditions that cannot be cured.

The Numbers

The study looked at the records of 4.7 million Medicare enrollees who died of chronic disease between 2000 and 2003. The researchers came to the conclusion that Medicare could have saved $40 billion if all hospitals practiced the high-quality, low-cost standard set by the Salt Lake City region. It also found that hospitals that treat patients more intensively and spent more Medicare money did not get better results. In fact, regions with the best quality and outcomes used the fewest resources: Rochester, Minn., and Portland, Ore., in addition to Salt Lake City, Utah. Patients there are admitted less frequently to hospitals, spend less time in an ICU, and see fewer specialists.

“This excessive and misplaced use of resources is only one manifestation of a totally chaotic health-care system.” – —Alfred Munzer, MD

The variation among academic medical centers for the average number of hospital days during the last six months of life ranged from 12.9 days at St. Mary’s Hospital in Rochester, MN, to 23.9 days at New York Presbyterian Hospital. The University of California–Los Angeles had the highest number of ICU days at 11.4—3.5 times higher than University of California-San Francisco (3.3 days). Medicare enrollees at New York University Medical Center had the most physician visits (76.2), the Robert Wood Johnson Hospital in New Brunswick, NJ, had the next most (57.7). At the University of Kentucky in Lexington there were only 18.6 physician visits.

Dr. Wennberg said that resources per capita devoted to managing chronic illness are increasing steadily each year—13.6% more ICU beds in 2003 than in 2000, 13.4% more for medical specialists, and 7.7% more for primary physicians. Acceleration was greatest in regions already using the most care.

Causes of the Trends

Medicare and other payers are part of the driving force behind the increases. “They encourage overuse of acute care hospital services and proliferation of medical specialists. The care of people with chronic illness accounts for more than 75% of US health-care expenditures, indicating that overuse and overspending is more than a Medicare problem,” said the report.

Pages: 1 2 3 | Single Page

Filed Under: Departments, Health Policy, Practice Management Tagged With: chronic illness, healthcare reform, Medicare, policy, Quality, spending, treatmentIssue: September 2006

You Might Also Like:

  • Medicare Battle Heats Up: Geographic Disparities spark look into spending variation
  • A Look at National Health Spending
  • Dartmouth Atlas Takes Aim at Excess Utilization of Medical Resources
  • IPAB is Medicare’s New Hammer for Spending Accountability

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Why Virtual Grand Rounds May Be Here to Stay
    • Otolaryngologist Leverages His Love of Pinball into Second Business
    • These New Imaging Advances May Help to Protect Parathyroids
    • Is the Training and Cost of a Fellowship Worth It? Here’s What Otolaryngologists Say
    • Which Otologic Procedures Poses the Greatest Risk of Aerosol Generation?

Polls

Have you used 3D-printed materials in your otolaryngology practice?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.