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El fracaso inevitable de las actuales estrategias de contención de costos. Por qué solo pueden proporcionar un alivio
JAMA
|January 9, 1987
Resumen
La eliminación de la atención hospitalaria innecesaria ahorra dinero a corto plazo, pero no aborda los principales factores de costo como el crecimiento de la población, el aumento de los precios y las nuevas tecnologías. El verdadero control de costos requiere abordar estas cuestiones fundamentales.
Área de la Ciencia:
- Economía de la salud Economía de la salud
- Gestión de la Administración Hospitalaria.
- Política de la atención de la salud Política de salud.
Sus antecedentes:
- Las estrategias actuales de contención de costos de atención médica se centran en eliminar la atención no valiosa.
- Estas estrategias pasan por alto los principales impulsores del aumento de los costos reales en los hospitales.
- A menudo se descuidan factores como el crecimiento de la población, la inflación de los precios de los insumos y los avances tecnológicos.
Objetivo del estudio:
- Analizar el impacto de la eliminación de la atención hospitalaria no valiosa en las tendencias generales de costos.
- Identificar los principales factores que contribuyen al aumento sostenido de los costos reales hospitalarios.
- Evaluar la efectividad a largo plazo de las actuales medidas de control de costos.
Principales métodos:
- Análisis de datos y tendencias de costos hospitalarios.
- Examen de los factores que influyen en los gastos de atención médica, incluida la demografía de la población, los precios de la canasta del mercado y la difusión de la tecnología.
- Evaluación de los ahorros potenciales por la eliminación de días innecesarios de hospitalización.
Principales resultados:
- La eliminación de hasta el 30% de la atención hospitalaria no valiosa puede producir ahorros significativos a corto plazo.
- Estos ahorros son insuficientes para contrarrestar el impacto a largo plazo del crecimiento de la población, el aumento de los precios de los insumos y la innovación tecnológica.
- Las reducciones de costos observadas en 1984 enmascararon un aumento de costos reales subyacente de aproximadamente el 7%.
Conclusiones:
- Las estrategias centradas únicamente en la eliminación de la atención no valiosa proporcionan sólo un alivio temporal del aumento de los costos hospitalarios.
- Los impulsores de costos fundamentales requieren un enfoque más amplio de la financiación de la atención médica.
- La contención de costos futuros puede requerir limitaciones en la innovación tecnológica o racionamiento de servicios beneficiosos.
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