Health Management Technology for Catastrophic Medical Conditions
Background.The excessive growth of health care expenditures in the United States is widely acknowledged. Costs are anticipated to double by the year 2006. The intractable issue which remains before health care leaders is how to appropriately restrain thes
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Health Management Technology for Catastrophic Medical Conditions D. N. Cope, E. D. Bryant, and P. Sundance ParadigmHealth Corporation, California, United States of America
Summary Background. The excessive growth of health care expenditures in the United States is widely acknowledged. Costs are anticipated to double by the year 2006. The intractable issue which remains before health care leaders is how to appropriately restrain these costs while not sacrificing a desired level of care quality. A variety of management approaches have been developed in pursuit of more rational and cost-effective use of health resources. Current management approaches have proven inadequate in stemming health care cost inflation and have raised increasing concerns about their negative impact on the quality of health care. Method. One group has created and operated a data and structured, expert consensus-driven health management technology for the management of catastrophic medical conditions, including severe brain and spinal cord injury and severe multiple trauma and burns, since 1992 and has recently applied this same technology to high risk neonates and organ transplants. This integrated, severity risk adjusted, delivery system incorporates adequate clinical data capture and analysis, coupled with empirically derived management principles and consensus expert clinical judgment. Interpretation. Preliminary data analysis indicates that patients treated under the Paradigm Health model experienced an improvement in the health care process, improved quality in health care delivery and outcomes, and overall cost reduction. Keywords: Health management technology; costs of care paradigm health corporation; evidence based care traumatic brain injuries.
Introduction
The excessive growth of health care expenditures in the United States and elsewhere is widely acknowledged, and annual expenditures are anticipated to double by the year 2007 reaching 16.6% of the United States Gross Domestic Product, or 2.1 trillion dollars [1, 2]. The intractable issue, which remains before health care leaders, is how to appropriately restrain these costs while not sacrificing a desired level of care quality. A variety of management approaches have been developed in pursuit of more rational, standardized and cost-effective use of health resources.
Current management approaches have proven inadequate in stemming health care cost inflation and have raised increasing concerns about their negative impact on the quality of health care [3, 4, 5]. Further, there is a low probability that most present techniques can have a significant beneficial impact in the future [6], especially on very complex, costly medical conditions. This paper describes a management approach that has proven successful with a subset of these complex conditions: namely; severe brain and spinal cord injury, severe multiple trauma and burns, and high-risk neonates, and most recently organ transplants. It is proposed that this same model can serve as a template for other complex conditions a . We
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