Tag: Rand Corporation

Hospice Care Costs on Dementia

The RAND Corporation conducted a new study that set off a few red flames about the increasing cost of dementia within the U.S. healthcare system. According to RAND, dementia is one of the nation’s most expensive health conditions, charging the U.S. between $157 billion dollars and $215 billion dollars a year in health care and other expenses.

Compared to other common costly illnesses, the immediate healthcare expenses of treating dementia, approximated at $109 billion dollars in 2010, are in line with cardiovascular disease ($102 billion) and considerably greater than cancer ($72 billion). Beyond immediate healthcare expenses, it is approximated that an additional $48 to $106 billion dollars is spent on the unofficial care for dementia, which primarily includes lost wages and care provided by close relatives at home. The estimated growth is also eye opening, both the expenses and the number of individuals with dementia will more than double within 30 years, a rate that overrules many other serious illnesses. These incredible researches clearly strengthen the need for the U.S. to find better solutions for those suffering from dementia.

Medical health insurance rules require a doctor to approve that an individual coming into a hospital is likely to die within six months or less. Physicians are much more likely to do so when the disease is cancer or heart failure. As a result, too many sufferers are declined access to hospice care, which provides modern care (i.e. comfort care) for the dying and support for their family members. Without hospice care, those being affected by dementia may be exposed to several hospitalizations, obtrusive treatments and poor pain /symptom management.

Today, dementia sufferers are blatantly under served as less than 10% of people dying of dementia receive hospice care and often times are registered too late, within a few weeks of death. Relatively, more than 40% of People in America who die each year are in hospice care. The decision to put a loved one into hospice is without doubt one of life’s most difficult choices. But, better prognoses and education about the benefits of hospice may reduce struggling and needless medical costs.

EMR and Patient Care

The EMR or electronic medical record’s guarantee of participation to health care price benefits got a second look recently, and the results were inadequate at best.  But what I found interesting was the “second look” was from the same company that did the first look: the corporately-funded, non-profit think-tank called the RAND Corporation.

From their second and more recent report:

A team of RAND Corporation researchers estimated in 2005 that fast adopting of health information technology (IT) could save the United States more than $81 billion dollars yearly. Seven years later, the scientific data on the technology’s impact on health care performance and safety are combined, and yearly health care expenses in the United States have grown by $800 billion dollars.

Who would have thought that such a famous company like the RAND Corporation could have made such a little, tiny multi-billion dollar mistake? After all, their 2005 study was financed entirely by several of the major EMR producers who have gained enormous amounts in income on EMR sales since.  Is there any wonder that now the same RAND Corporation sensed that the EMRs deficiency of price benefits is really the end-users’ fault?

In our view, the frustrating performance of health IT to date can be mostly linked to several factors: gradual adopting of health IT techniques, in addition to the choice of techniques that are neither interoperable nor easy to use; and the failing of medical service providers and organizations to re-engineer patient care procedures to obtain the benefits of health IT.

What a superficial evaluation.  There is no talk of the price of these techniques, their maintenance, deficiency of interoperability, inadequate user-interfaces, and in many cases, deficiency of design support.  Even more interesting, there was no consideration that someone might actually figure out a way to efficiently dress the government’s arcane certification requirements for compensation that would permit more patient care spending.  No, those tests would have been too obvious.  Instead, the Rand Corporation informs us that there were no price benefits with the EMRs because doctor- and hospital-customers did not re-engineer their patient care procedures or “adopt” poor first-generation techniques.