0
Summaries for Patients |

High-Value, Cost-Conscious Health Care FREE

[+] Article and Author Information

The full report is titled “High-Value, Cost-Conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions.” It is in the 1 February 2011 issue of Annals of Internal Medicine (volume 154, pages 174-180). The authors are D.K. Owens, A. Qaseem, R. Chou, and P. Shekelle, for the Clinical Guidelines Committee of the American College of Physicians.


Ann Intern Med. 2011;154(3):I-30. doi:10.7326/0003-4819-154-3-201102010-00001
Text Size: A A A

Who developed these recommendations?

The American College of Physicians (ACP) developed this advice. Members of ACP are internists, specialists in the care of adults.

What is the problem and what is known about it so far?

Health care costs in the United States are high and getting higher. If nothing is done, less money will be available for other important things, such as housing, transportation, food, and schools. Americans must decide what things they will and will not spend money on in health care. The ACP thinks that focusing on the value of tests and treatments will help to control health care costs while ensuring that all Americans receive excellent care.

What does “high value” mean in the context of tests and treatments?

“High value” means that a test or treatment has benefits that make its harms and costs worthwhile. “Value” is not the same as “inexpensive.” Some expensive tests and treatments have high value because they provide high benefit and low harm. Some inexpensive tests or treatments have low value because they do not provide enough benefit to justify even their low costs and may even be harmful.

How can we estimate the value of tests and treatments?

First, the benefits, harms, and costs of a test or treatment are considered. Benefits include improvements in health or quality of life. Harms include adverse effects, unnecessary care, or care that ultimately hurts the patient. Second, costs include the cost of the test or treatment itself plus costs from any unwanted events caused by the test or treatment. Third, cost-effectiveness analysis evaluates the value of different tests or treatments by comparing the benefits, harms, and costs of one type of health care with others. Comparative effectiveness research is research that can help patients, providers, and policymakers compare the benefits and harms of different types of care.

Why are so many low-value tests and treatments used in the United States?

Many patients assume that better care means more tests and treatments and may be dissatisfied when a doctor does not use a test or treatment that the patient has heard about. Often, ordering tests or treatments is easier for doctors than explaining why they are not using them. More tests and treatments usually means more money for such entities as the company that makes the test or treatment or for a doctor or hospital that uses the test or treatment. Therefore, advertising and other marketing tools are designed to make people want more tests and treatments. Doctors also worry about lawsuits if they do not do what patients expect.

What does ACP recommend that patients and doctors do?

Doctors and patients should consider the value of tests and treatments and choose high-value options. Avoiding tests and treatments that provide little or no value will improve care and avoid harms to patients and needless costs. Doctors should use a patient's history and physical examination to determine whether the value of a test or treatment is likely to be high. When considering the value of a test or treatment, patients and doctors should consider not only the benefits and price but also the adverse effects and other unwanted events that may happen.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)