Evidence-Based Medicine Might Actually Work as Long as Third-Party Payers Aren’t Involved
Intermountain has reduced the number of preterm deliveries, as well as the number of babies who must spend time in the neonatal-intensive-care unit. So-called adverse drug events, which include overdoses and allergic reactions, were cut in half in the mid-1990s. A protocol for dealing with one broad category of pneumonia cut its mortality rate by 40 percent over several years. The death rate for coronary-bypass surgery was cut to 1.5 percent, from the national average of about 3 percent. Medicare data on heart-failure and pneumonia patients show that Intermountain has significantly lower-than-average readmission rates. In all, Dr. Brent James (chief quality officer at Intermountain Healthcare) estimates that the changes have saved thousands of lives a year across Intermountain’s network. Outside experts consider that estimate to be fair.
Full story in The New York Times Magazine (Sunday).
The main point here is that these are supply side successes. They are the result of experimentation and trial and error on the part of the providers. These successes have nothing whatsoever do to with pay-for-performance or any other demand side initiative.
I agree with Joe. It’s important to draw the right lesson here. Peter Orszag and his colleagues will probably say we should try to force all doctors and all hospitals to practice medicine the way Intermountain practices. that would be a huge mistake.
Did you guys miss the part of the article where the critics say that evidence based medicine doesn’t work?
One of the primary problems with U.S. health care is inconsistent quality. Quality isn’t bad; but it varies from one facility to the next. A review of cardiac surgical mortality in California found one hospital that had no patients die, while another had more than 12 percent of cardiac surgery patients die.
Did you guys miss the part of the article where the critics say that evidence based medicine doesn’t work?
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