New Yorker piece on cutting health care costs

Qualitymark

An incisive (ahem) piece by surgeon Atul Gawande about how targeting health care (and policing) to worst cases can dramatically slash costs:

http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPage=all

(extract) “I’d just sit there and play with the data for hours,” [Dr Jeffrey Brenner] says, and the more he played the more he found. For instance, he ran the data on the locations where ambulances picked up patients with fall injuries, and discovered that a single building in central Camden sent more people to the hospital with serious falls—fifty-seven elderly in two years—than any other in the city, resulting in almost three million dollars in health-care bills. “It was just this amazing window into the health-care delivery system,” he says.

Read more http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande#ixzz1gDBLPEhj

Qualitymark

Another extract:

In December, he introduced an expanded computer database that lets Camden doctors view laboratory results, radiology reports, emergency-room visits, and discharge summaries for their patients from all the hospitals in town—and could show cost patterns, too. The absence of this sort of information is a daily impediment to the care of patients in Boston, where I practice. Right now, we’re nowhere close to having such data. But this, I’m sure, will change. For in places like Camden, New Jersey, one of the poorest cities in America, there are people showing the way.

Read more http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande#ixzz1gDHdPLLF

2Scoops

The computer system was not needed for this Dr. Brenner to prove his point about cost-cutting. In fact, he did it without the database. I'm not convinced we need it since, we certainly can't afford it, and I am quite uncomfortable with the privacy issues. The very fact that Brenner had access to sensitive information to search on a whim is concerning.