米国保健医療システムにおける廃棄物:推定コストと節約の可能性
William H Shrank1, Teresa L Rogstad1, Natasha Parekh2
1Humana Inc, Louisville, Kentucky.
JAMA
|October 8, 2019
まとめ
医療費は年間760億ドルから935億ドルで 国全体の医療費の大部分を占めています ターゲットを絞った介入を 実施すれば1910億から280億ドルの 節約が可能で 医療費の総額が削減されます
科学分野:
- 健康 経済
- 医療サービス研究
- 公衆衛生政策
背景:
- 米国では医療費が増加しており,国内総生産 (GDP) の18%近くに達しています.
- 以前の研究によると 医療費の30%は 浪費になる可能性があります
- 継続的な努力にも関わらず,米国の医療制度では大量に廃棄物が残っています.
研究 の 目的:
- 既存の6つの領域で米国における現在の医療費の浪費を定量化します
- 廃棄物削減の介入によって達成可能な潜在的な財政的節約を推定する.
主な方法:
- 2012年1月から2019年5月のピアレビューおよびグレーの文献の体系的なレビュー.
- 分析は6つの分野に焦点を当てた. 介護の提供の失敗,介護の調整の失敗,過度の治療/低価値の介護,価格設定の失敗,詐欺と濫用,行政の複雑さ.
- 廃棄物コストの推定額と介入コストの削減額をまとめ,2019年のドルで標準化し,集約しました.
主要な成果:
- 米国における年間医療費の総額は 760 億ドルから 935 億ドル (総支出の約 25%) と推定されています.
- 価格設定の失敗 ($230.7B - $240.5B) と行政の複雑さ ($265.6B) で大きな浪費が確認されました.
- 廃棄物削減による年間節約の可能性は1910億ドルから2860億ドル (行政上の複雑さを除く) です.
結論:
- 米国保健医療制度は,年間760~935億ドルと推定される,相当な財政的浪費を課しています.
- 標的を絞った介入は1910億ドルから280億ドルまでの 莫大な節約の可能性をもたらし 医療費の増大を緩和する可能性があります
- 医療費の継続的な増加を抑えるには 廃棄物対策が不可欠です
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