美国医疗保健系统的浪费:估计成本和节约潜力
William H Shrank1, Teresa L Rogstad1, Natasha Parekh2
1Humana Inc, Louisville, Kentucky.
JAMA
|October 8, 2019
概括
美国医疗废弃物每年耗资7.6亿至9.35亿美元,占全国医疗支出的很大一部分. 实施有针对性的干预措施可以节省1910亿至2860亿美元,
科学领域:
- 健康经济学
- 医疗服务研究
- 公共卫生政策
背景情况:
- 美国的医疗费用不断上升,接近国内生产总值 (GDP) 的18%.
- 之前的研究表明,高达30%的医疗保健支出可能是浪费.
- 尽管有持续的努力, 美国医疗保健系统仍然存在大量浪费.
研究的目的:
- 通过六个已确定的领域量化美国当前的医疗保健浪费.
- 估计通过减少废物干预可以实现的潜在经济节约.
主要方法:
- 2012年1月至2019年5月的同行评审和灰色文献的系统文献审查.
- 分析主要集中在六个领域:护理提供失败,护理协调失败,过度治疗/低价值护理,定价失败,欺诈和滥用以及行政复杂性.
- 废物成本估计和干预节省经过编制,标准化为2019美元,并汇总.
主要成果:
- 据估计,美国每年的医疗保健浪费在760亿美元至935亿美元之间 (约占总支出的25%).
- 在定价失败 (230.7亿美元-240.5亿美元) 和行政复杂性 (265.6亿美元) 中发现了大量浪费.
- 减少废物干预的潜在年度节约在1910亿美元至2860亿美元之间 (不包括行政复杂性).
结论:
- 美国的医疗保健系统每年浪费大量资金, 估计为760-935亿美元.
- 有针对性的干预措施可以节省1910亿至2860亿美元,从而减轻医疗保健支出的上升.
- 解决浪费问题对于控制美国医疗支出不断增加至关重要.
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