Biomaterial Database

[Cost-effectiveness of quality improvement measures in health care]. 2002

Afschin Gandjour, and Karl Wilhelm Lauterbach

Institut für Gesundheitsökonomie und Klinische Epidemiologie, Universität zu Köln. gandjour@igke.de

OBJECTIVE To discuss the costs and cost-effectiveness of quality improvement programs in health care. A quality improvement program saves costs if its investment costs are lower than savings from avoiding medical services. Cost savings are most likely realized if a) an overuse or misuse problem is targeted, b) many patients are affected, and c) striving for optimal quality is avoided. The overall prospect of cost savings is small, however. COST-EFFECTIVENESS OF QUALITY IMPROVEMENT PROGRAMS: From a societal perspective a quality improvement is economically attractive if an improvement in health status justifies its expenses including induced costs--even if total costs increase. In the USA a cost-effectiveness ratio of $50,000 per quality-adjusted life year is often applied as a maximum acceptable threshold value. From an institutional perspective the impact of a quality program on revenues is also important. An improvement of the image may increase the number of cases and thus revenues. For services reimbursed on a per-diem basis revenues behave according to changes in the length of stay. From an institutional perspective it is therefore reasonable to consider economic criteria when targeting problem areas.

UI	MeSH Term	Description	Entries
D009313	National Health Programs	Components of a national health care system which administer specific services, e.g., national health insurance.	National Health Insurance, Non-U.S.,Health Services, National,National Health Insurance,National Health Insurance, Non U.S.,National Health Services,Services, National Health,Health Insurance, National,Health Program, National,Health Programs, National,Health Service, National,Insurance, National Health,National Health Program,National Health Service,Program, National Health,Programs, National Health,Service, National Health
D003362	Cost-Benefit Analysis	A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes.	Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D005858	Germany	A country in central Europe, bordering the Baltic Sea and the North Sea, between the Netherlands and Poland, south of Denmark. The capital is Berlin.
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D017749	Total Quality Management	The application of industrial management practice to systematically maintain and improve organization-wide performance. Effectiveness and success are determined and assessed by quantitative quality measures.	Continuous Quality Management,Lean Six Sigma,Sigma Metrics,Six Sigma,Lean Six Sigmas,Management, Continuous Quality,Management, Total Quality,Metric, Sigma,Metrics, Sigma,Sigma Metric,Sigma, Six,Sigmas, Six,Six Sigma, Lean,Six Sigmas,Six Sigmas, Lean