National Healthcare Disparities Report - LDI Health Economist

Chapter 7. Efficiency
Health care cost increases continue to outpace the rise in wages, inflation, and economic growth. One
approach to containing the growth of health care costs is to improve the efficiency of the health care delivery
system. This approach would allow finite health care resources to be used in ways that best support highquality
care.
Recent work examining variations in Medicare spending and quality shows that higher cost providers do not
necessarily provide higher quality care, illustrating the potential for improvement (Fisher, et al., 2003).
Improving efficiency in the Nation’s health care system is an important component of Department of Health
and Human Services (HHS) efforts to support a better health care system.
Measures
Part of the discussion about how to improve efficiency involves the question about how best to measure it.
Varying perspectives and definitions of health care efficiency exist; although consensus has not yet emerged
on what constitutes appropriate measurement of efficiency, AHRQ has supported development in this area.
This chapter has been largely shaped by a number of documents that have developed the field of health care
efficiency measurement. One major contributor is an AHRQ-commissioned report by RAND Corporation,
which systematically reviewed efficiency measures, assessed their tracking potential, and provided a typology
that emphasizes the multiple perspectives on health care efficiency (McGlynn, 2008).
This chapter of the National Healthcare Disparities Report (NHDR) is organized around the concepts of
overuse and misuse. As noted in the National Strategy for Quality in Health Care, i “Achieving optimal
results every time requires an unyielding focus on eliminating patient harms from health care, reducing
waste, and applying creativity and innovation to how care is delivered.”
The measures this year are presented in the following layout:
n Inappropriate medication use:
o Adults age 65 and over who received potentially inappropriate prescription medications.
n Preventable hospitalizations:
o Potentially avoidable hospitalization rates for adults.
o Excess avoidable hospitalizations.
o Potentially avoidable hospitalizations among Medicare home health patients.
o Perforated appendixes.
n Potentially harmful preventive services with no benefit:
o Males age 75 and over who had a prostate-specific antigen (PSA) test or a digital rectal exam
(DRE) within the last 12 months.
i
Available at www.healthcare.gov/center/reports/quality03212011a.html.
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