This OECD Data Strongly Indicates That Health Cost Inflation As a % of GDP Is Somewhat

This OECD data strongly indicates that health cost inflation as a % of GDP is somewhat independent of the current models for funding health care delivery i.e. public/private/public-private.

A review of the J Wennberg data on variation in care ‘suggests’ that the USA fits closer to the other OECD countries when only Medicare and Medicaid populations are studied. This would again fit with the concepts that the current funding models are wrong and do not address the core issues of “information management and clinical decision making”. (1)

The above 2 slides-Orzag and Wennberg demonstrate that more funding using current models does not improve care. Other work from Wennberg also indicates that more doctors, nurses and beds in institutions does not improve care delivery.

This slide demonstrated that despite the advances in technologies it is more than likely that inpatient mortality has decreased (1953-) due to preventive measures, healthier diets (until recent obesity epidemic) and factors like immunization. The technology advancement (1970s-)has come with the flat phase of the graph.

The two slides from the Canadian Health System demonstrate the major cost burdens of clinical decision making on overuse and inappropriate use of resources. Note the cost per item. The use of these resources is a direct consequence of ‘unsupported clinical decision making and information management”. (2)

More than 2 decades of advanced health information technology developments and we still have the current scenarios shown above.

Two major studies from the 1990s show how the use of ‘effective clinical decision support’ nacn improve care delivery and reduce health costs. The Pestotnik study is of interest because it is one of the studies that challenges the DRG/Case-Mix and ABF models of health reimbursements.

This quote from Enrioc Coirea summarises succinctly the problems we have to solve. While governments and business continue to fund care using “business models” we will maintain the staus quo. As Prof Warner Slack states, “Medicine is not a business. Our business is clinical medicine”.(3)

1.Hannan TJ, Celia C. Are doctors the structural weakness in the e-health building? Intern Med J. 2013;43(10):1155-64. Epub 2013/10/19.

2.Leao BF. Terms of Reference for Designing the Requirements of the Health Information System of the Maputo Central Hospital and Preparation of the Tender Specifications. Geneva: World Health Organization. 2007.

3.Slack WV. Cybermedicine, How Computing Empowers Doctors and Patients for Better Health Care. 2nd ed. San Francisco: Jossey-Bass; 2001 2001.