In the healthcare industry, cost and quality go hand in hand. Though in the ideal world, this should not be the case, in the American health system it is. The wealthy can afford better care by going to private hospitals and health institutions and the middle class has to go through the public health system which has complicated rules and policies with insurance and payment plans. And talk about insurance, the government provides insurance policies have been known to have high premiums, and not cover all types of care especially for women. So knowing all this, let’s discuss how Cost and Quality in Healthcare can be measured and tracked for the purpose of improvement.
Measuring Quality of Care
When it comes to measuring the quality of care, there are metrics that can be used to provide quantitative figures which give better accuracy.
- Life expectancy: This is a validated, readily available, and easily understandable measure for a critical health concept.
- Well-being: Self-reported well-being captures the subjective dimensions of health related to the quality of life and often predicts use of and satisfaction with healthcare.
- Overweight and obesity: These metrics point to causes and consequences that extend beyond the health system.
- Addictive behavior: This represents a complex challenge for the health system, communities, and families.
- Unintended pregnancy: Unintended pregnancy and teenage pregnancy is a measure that aggregates a variety of social, behavioral, cultural, and health factors.
- Healthy communities include critical elements of health that fall outside the care system, such as housing, employment, and environmental factors.
- Preventive services present a valuable opportunity for both improving health and reducing costs.
- Access to care is a critical precondition for a high-quality health system.
- Patient safety: This requires a culture that prioritizes and assesses safety through a reliable index of organizational results.
- Care match with patient goals ensures that the healthcare system is focusing on the aspects of care that matter most to patients.
- Individual and community engagement ensures individuals are aware of their options and responsibilities in caring for their own health and that of their families and communities. It also provides different levels of resources to support efforts to maintain and improve individual and family health.
Measuring Cost of Care
The American healthcare system relies on market forces to ration the cost of care. However, these market forces are not those normally considered constructive or functional. Rather than price competition, the united states ration healthcare costs by not covering a portion of the population for timely health care while requiring the provision of emergency care for all without explicit funding. This leads to a unique set of dysfunctional market behaviors—substantial cost shifting between public and private sectors, increasing preference for healthy patients rather than sick ones, and pricing arrangements that reward errors, inefficiency, and poor outcomes. There are several reasons for this odd construct, but especially notable is the lack of transparency related to price and cost.
Transparency of cost and quality in health care is very important. Patients and consumers get especially disadvantaged when it comes to the lack of transparency around the price and cost of healthcare products and services. Shielded in the past by comprehensive public or private insurance coverage (which as mentioned above is quite a mess), consumers are faced with substantial increases in cost-sharing. Significant increases in bankruptcy related to healthcare costs for insured middle-class Americans indicate how perilous this transition has become. As costs increase, market proponents should insist that consumers have access to comparative information, the price and cost of the products or services compared, and an analysis of the possible scenarios relevant to their purchasing decision.
Also, Personal spending burden can limit access to care, lead people to avoid care, or prevent them from spending money in other areas of value to them. Population spending burden can be measured at national, state, local, and institutional levels. Multiple third parties are involved in the American healthcare system that influences the purchasing process. In the case of those publicly insured, various federal and state laws govern the purchasing of health products and services. The political process is the major driver. Many Americans are skeptical of the government’s ability to purchase efficiently and are worried about their market power when they do. For those privately insured, employers are influential in purchasing and setting the levels of cost sharing. As the cost of health care increases and the economic climate worsens, employers are less able to absorb these costs.