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The Relationship Between Cost and Quality, March 14, 2012, Joynt and Jha 307 (10): 1082 — JAMA
Editorial: The Relationship Between Cost and Quality
No Free Lunch
Since this article does not have an abstract, we have provided the first 150 words of the full text. (Blogger's Note: subscription required to view $$$)
"For the past 30 years, research from
investigators at Dartmouth has demonstrated large and persistent
variations in costs
and quality across the US health care system. Beyond
simply showing that cost and quality vary by geography, the Dartmouth
Atlas has demonstrated that in many communities, care
is so fragmented and ineffective that greater spending on Medicare
beneficiaries
often leads to worse outcomes1,2 because some patients receive services that are redundant and low value and that may even have substantial risks.
However, some US policy makers have
misinterpreted the Dartmouth research and in the troves of data have
found what they believe
to be a free lunch: given the inverse relationship
between costs and quality, it follows that it should be possible to
simultaneously
reduce spending and improve care. Although this notion
is attractive, much of the subtlety of the Dartmouth work has been
lost in translation. What ....."
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