Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 118

Although technological advances have helped with earlier diagnoses and better treatment of disease, factors such as the greater availability of new technology drive per capita expenditures higher (Boddenheimer, 2005b). Treatment for the five most expensive health conditions include septicemia, osteoarthritis, complications of device, implant or graft, newborn care, and acute myocardial infarction (AHA, 2019). These require the use of expensive medications and technologies. While use of some technologies such as electronic record keeping may reduce costs, the presumed success of sophisticated drugs and technologies shapes consumer expectations of what the health care system can deliver (Woo, Ranji, Lundy, & Chen, 2007). Health care consumers, including both patients and providers, also contribute to the cost of health care. These consumers' demands for intense services, despite the lack of definite clinical need, strains health care spending. Mikulic (2019) reports that the number of magnetic resonance imaging (MRI) machines per million population is 37.56 in the U.S., 34.49 in Germany, 29.08 in Korea, and 28.4 in Italy. Yet the United States lags behind these same countries with respect to patient care outcomes (Commonwealth Fund, 2006).

The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who has had a hip or knee replacement is standing on French innovation. Deep‐brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss, or Japanese labs. Overseas, strict cost controls actually drive innovation. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one‐fifteenth of the American price and still make a profit (Reid, 2009).