PharmacoEconomics & Outcomes News 315 - 2 Jun 2001 Is the US getting value for its healthcare dollar? A recent analysis by investigators from the US National Center for Health Statistics indicates that the US population has been getting more healthcare services for its healthcare dollar over the 15 years to 1998. The analysis, which used data from the National Health Care Survey and other surveys, showed that the US population has been receiving more ambulatory surgery, more cardiac procedures, more pharmaceuticals, more therapies in nursing homes and more home healthcare over time. Major trend: more care for the elderly Overall, there has been a 30% reduction in hospital length of stay since 1970, report the investigators. In particular, their analysis showed that the number of hospital discharges decreased from 148 per 1000 population in 1985 to 116 per 1000 population in 1997/1998. Concomitantly, an increase in the number of ambulatory procedures was observed. And although the number of procedures performed in hospitals declined steadily over the 15-year period, the number of cardiovascular procedures performed more than doubled (increasing 108%); there was an even larger increase in the elderly, note the investigators. Notably, the rates of angioplasty among the elderly increased by 218% between 1990 and 1998. Also, the rate of nursing- home discharges per 1000 persons increased significantly (from 38 in 1985 to 63 in 1997/1998). Furthermore, the number of elderly receiving home healthcare increased from 29 per 1000 in 1990/1992 to 38 per 1000 in 1997/1998. The analysis also showed that the number of medications prescribed increased from 109 per 100 visits in 1985 to 137 per 100 visits in 1997/1998. Effect of payment policy? The investigators comment that it is important to examine the duration and content of medical encounters over time. For example, although rates of hospital discharge declined over the 15-year period, remaining hospital stays were more resource intensive and costly than in the past. The investigators also comment that data must be analysed within the context of changes in payment policy, although ‘one would hope that utilization would be more strongly correlated with need than with payment policy’, they comment. Bernstein AB, et al. Trend data on medical encounters: tracking a moving target. Health Affairs 20: 58-72, Mar-Apr 2001 800817556 1 PharmacoEconomics & Outcomes News 2 Jun 2001 No. 315 1173-5503/10/0315-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Is the US getting value for its healthcare dollar?

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PharmacoEconomics & Outcomes News 315 - 2 Jun 2001

Is the US getting value for itshealthcare dollar?

A recent analysis by investigators from the USNational Center for Health Statistics indicates that theUS population has been getting more healthcareservices for its healthcare dollar over the 15 years to1998.

The analysis, which used data from the NationalHealth Care Survey and other surveys, showed that theUS population has been receiving more ambulatorysurgery, more cardiac procedures, morepharmaceuticals, more therapies in nursing homes andmore home healthcare over time.

Major trend: more care for the elderlyOverall, there has been a 30% reduction in hospital

length of stay since 1970, report the investigators. Inparticular, their analysis showed that the number ofhospital discharges decreased from 148 per 1000population in 1985 to 116 per 1000 population in1997/1998. Concomitantly, an increase in the numberof ambulatory procedures was observed. And althoughthe number of procedures performed in hospitalsdeclined steadily over the 15-year period, the number ofcardiovascular procedures performed more thandoubled (increasing 108%); there was an even largerincrease in the elderly, note the investigators. Notably,the rates of angioplasty among the elderly increased by218% between 1990 and 1998. Also, the rate of nursing-home discharges per 1000 persons increasedsignificantly (from 38 in 1985 to 63 in 1997/1998).Furthermore, the number of elderly receiving homehealthcare increased from 29 per 1000 in 1990/1992 to38 per 1000 in 1997/1998. The analysis also showedthat the number of medications prescribed increasedfrom 109 per 100 visits in 1985 to 137 per 100 visits in1997/1998.

Effect of payment policy?The investigators comment that it is important to

examine the duration and content of medical encountersover time. For example, although rates of hospitaldischarge declined over the 15-year period, remaininghospital stays were more resource intensive and costlythan in the past. The investigators also comment thatdata must be analysed within the context of changes inpayment policy, although ‘one would hope thatutilization would be more strongly correlated with needthan with payment policy’, they comment.Bernstein AB, et al. Trend data on medical encounters: tracking a moving target.Health Affairs 20: 58-72, Mar-Apr 2001 800817556