Further Opportunities for Cost Reduction of Medical Care

Malach, Monte; Baumöl, William J.

doi:10.1007/s10900-010-9253-6

Cited by 10 publications

(6 citation statements)

References 63 publications

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“…Moreover, we show that one can either improve the cost of personalized medicine or its clinical performance to allow HSPs to utilize it more. To this end, when considering small improvement steps, the improvement in clinical performance outperforms the improvement in cost reduction which is known to be relatively quicker to achieve (100)(101)(102).…”

Section: Discussionmentioning

confidence: 99%

Investigation toward the economic feasibility of personalized medicine for healthcare service providers: the case of bladder cancer

Savchenko,

Bunimovich-Mendrazitsky

2024

Front. Med.

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In today's complex healthcare landscape, the pursuit of delivering optimal patient care while navigating intricate economic dynamics poses a significant challenge for healthcare service providers (HSPs). In this already complex dynamic, the emergence of clinically promising personalized medicine-based treatment aims to revolutionize medicine. While personalized medicine holds tremendous potential for enhancing therapeutic outcomes, its integration within resource-constrained HSPs presents formidable challenges. In this study, we investigate the economic feasibility of implementing personalized medicine. The central objective is to strike a balance between catering to individual patient needs and making economically viable decisions. Unlike conventional binary approaches to personalized treatment, we propose a more nuanced perspective by treating personalization as a spectrum. This approach allows for greater flexibility in decision-making and resource allocation. To this end, we propose a mathematical framework to investigate our proposal, focusing on Bladder Cancer (BC) as a case study. Our results show that while it is feasible to introduce personalized medicine, a highly efficient but highly expensive one would be short-lived relative to its less effective but cheaper alternative as the latter can be provided to a larger cohort of patients, optimizing the HSP's objective better.

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Section: Discussionmentioning

confidence: 99%

Investigation toward the economic feasibility of personalized medicine for healthcare service providers: the case of bladder cancer

Savchenko,

Bunimovich-Mendrazitsky

2024

Front. Med.

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“…As a result, resuscitation efforts often are initiated and maintained by emergency medical services providers in many futile situations. 13–18 …”

Section: Discussionmentioning

confidence: 99%

Benefit of a Tiered-Trauma Activation System to Triage Dead-on-Arrival Patients

Danner¹,

Wilson²,

Heron³

et al. 2012

WestJEM

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IntroductionAlthough national guidelines have been published for the management of critically injured traumatic cardiopulmonary arrest (TCPA) patients, many hospital systems have not implemented in-hospital triage guidelines. The objective of this study was to determine if hospital resources could be preserved by implementation of an in-hospital tiered triage system for patients in TCPA with prolonged resuscitation who would likely be declared dead on arrival (DOA).MethodWe conducted a retrospective analysis of 4,618 severely injured patients, admitted to our Level I trauma center from December 2000 to December 2008 for evaluation. All of the identified patients had sustained life-threatening penetrating and blunt injuries with pre-hospital TCPA. Patients who received cardiopulmonary resuscitation (CPR) for 10 minutes were assessed for survival rate, neurologic outcome, and charge-for-activation (COA) for our hospital trauma system.ResultsWe evaluated 4,618 charts, which consisted of patients seen by the MSM trauma service from December 2001 through December 2008. We identified 140 patients with severe, life-threatening traumatic injuries, who sustained pre-hospital TCPA requiring prolonged CPR in the field and were brought to the emergency department (ED). Group I was comprised of 108 patients sustaining TCPA (53 blunt, 55 penetrating), who died after receiving < 45 minutes of ACLS after arrival. Group II, which consisted of 32 patients (25 blunt, 7 penetrating), had resuscitative efforts in the ED lasting > 45 minutes, but all ultimately died prior to discharge. Estimated hospital charge-for-activation for Group I was approximately $540,000, based on standard charges of $5000 per full-scale trauma system activation (TSA).ConclusionFull-scale trauma system activation for patients sustaining greater than 10 minutes of prehospital TCPA in the field is futile and economically depleting.

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“…Indeed our record, in terms of mortality and morbidity, is far down on the list, with most other wealthy countries' inhabitants living longer and suffering from fewer medical problems. In this third of three articles [2,3] 1 we have written on the subject, we demonstrate the continued abundance of opportunities for substantial reduction in the level of health care costs-opportunities that readily can be put to use.…”

mentioning

confidence: 88%

“…In our prior publications [2,3] we have noted that the evolution of diagnostic and therapeutic management of acute myocardial infarction (AMI) has dramatically changed. In addition, there is continuing controversy regarding the need for interventional coronary artery procedures following AMI versus the use of optimal medical therapy (OMT), which has proven beneficial and adequate in asymptomatic patients after AMI (Note: OMT includes aspirin, beta blockers, ACE or ARB drugs, and lipid-lowering drugs).…”

Section: Cardiovascular Diseasementioning

confidence: 99%

Opportunities for Cost Reduction of Medical Care: Part 3

Malach

Baumöl

2012

J Community Health

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The level of health care spending in the United States and other developed nations is rising at a disturbingly rapid rate. However, in the United States, these increases are not justified by superior performance. Rather, most other wealthy countries' inhabitants live longer and suffer from fewer medical problems than the average American. This paper demonstrates the continued abundance of opportunities for substantially reducing health care costs without decreasing the quality of care. In particular, it emphasizes the need to reduce the practice of defensive medicine and to enlarge the cadre of non-specialist physicians who educate future doctors. Such cost-saving opportunities are not rare phenomena but are widely available and offer the United States opportunities to move toward the markedly lower cost levels that have been achieved in other countries.

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Further Opportunities for Cost Reduction of Medical Care

Cited by 10 publications

References 63 publications

Investigation toward the economic feasibility of personalized medicine for healthcare service providers: the case of bladder cancer

Investigation toward the economic feasibility of personalized medicine for healthcare service providers: the case of bladder cancer

Benefit of a Tiered-Trauma Activation System to Triage Dead-on-Arrival Patients

Opportunities for Cost Reduction of Medical Care: Part 3

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