As the explosion in health care costs has led to serious efforts at cost containment, concerns have been raised that some of the methods used to contain costs may cause more harm than good. In particular, many commentators have criticized the practice of giving physicians personal financial incentives to limit the provision of care to their patients. These critics have argued that, if physician...

If the desirable clinical effects of health insurance are ignored, constraining health care cost growth can be simply achieved by providing less generous coverage or no coverage at all. In fact, the numbers of Americans who are uninsured or underinsured is at an all time high, reflecting the trade off between the high cost of health benefits and remaining viable in today’s economy.1 Although ri...

The author defends himself against an attack by Smith and Bopp on his views on smoking and taxation. The theory that, on the grounds of equity and/or fairness, smokers should pay via taxation on tobacco for the health care costs of treating smoking-related medical conditions is discussed and shown to be defective. It is argued that the fundamental mistake that Smith and Bopp make is to confuse ...

As the number and cost of new technologies grow, it is increasingly important that we develop sound policies for payment for those technologies while their clinical impacts are being defined. Such policies need to balance social interests in promotion of innovation, early access to promising technology, patient safety, control of health care costs, and return on investment. We present a rationa...

Summarizing the results of research related to identifying potential predictors of hospital readmissions has been difficult because of conflicting results across studies. Using the techniques of meta-analysis, the results from 44 studies were examined in the present study. Overall, the mean readmission rate was 27%, with significant differences based on patient diagnosis. Although diagnosis, ag...

This course covers the major chronic diseases and their risk factors. The importance of this subject cannot be overstated since it is the major factor driving health care costs. The U.S. now spends more money per capita than any other nation yet is behind in longevity. Chronic diseases are the major factors driving these costs. The more epidemiologists understand about these diseases, the bette...

In this article, the authors provide an overview of the problem of health care cost containment. Both the growth of health care spending and its underlying causes are discussed. Further, the authors define cost containment, provide a framework for describing cost-containment strategies, and describe the major cost-containment strategies. Finally, the role of research in choosing such a strategy...

BACKGROUND In contrast to other pregnancy complications the economic impact of stillbirth is poorly understood. We aimed to carry out a preliminary exploration of the healthcare costs of stillbirth from the time of pregnancy loss and the period afterwards; also to explore and include the impact of a previous stillbirth on the healthcare costs of the next pregnancy. METHODS A structured review...

Health care cost control is often debated in terms of markets versus bureaucracies. Market restraints are limited in practice by the goal of providing access to care. Therefore, effective cost control requires budgeting. Experience from budgeting for other services should put health care cost control in perspective: The goal should not be rational and efficient allocations, merely better ones. ...