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Med.", "DOI": "10.1056/NEJMp1205634", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/22784112", "accessDate": "2012-08-01T22:35:40Z", "PMID": "22784112", "PMCID": "", "ISSN": "1533-4406", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Cost-Benefit Analysis", "type": 1 }, { "tag": "Diagnosis, Differential", "type": 1 }, { "tag": "Health Care Costs", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Physician's Practice Patterns", "type": 1 }, { "tag": "Physicians", "type": 1 }, { "tag": "Resource Allocation", "type": 1 }, { "tag": "United States", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-01-15T20:06:31Z", "dateModified": "2014-01-15T20:06:31Z" } }, { "key": "AKEX9Q39", "version": 17, "library": { "type": "group", "id": 237398, "name": "VMC HealthCare Value", "links": { "alternate": { "href": "https://www.zotero.org/groups/vmc_healthcare_value", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/237398/items/AKEX9Q39", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/vmc_healthcare_value/items/AKEX9Q39", "type": "text/html" } }, "meta": { "createdByUser": { "id": 622653, "username": "vududude", "name": "Michael Hwa, MD", "links": { "alternate": { "href": "https://www.zotero.org/vududude", "type": "text/html" } } }, "creatorSummary": "Owens et al.", "parsedDate": "2011-02-01", "numChildren": 1 }, "data": { "key": "AKEX9Q39", "version": 17, "itemType": "journalArticle", "title": "High-value, cost-conscious health care: concepts for clinicians to evaluate the benefits, harms, and costs of medical interventions", "creators": [ { "creatorType": "author", "firstName": "Douglas K", "lastName": "Owens" }, { "creatorType": "author", "firstName": "Amir", "lastName": "Qaseem" }, { "creatorType": "author", "firstName": "Roger", "lastName": "Chou" }, { "creatorType": "author", "firstName": "Paul", "lastName": "Shekelle" }, { "creatorType": "author", "name": "Clinical Guidelines Committee of the American College of Physicians" } ], "abstractNote": "Health care costs in the United States are increasing unsustainably, and further efforts to control costs are inevitable and essential. Efforts to control expenditures should focus on the value, in addition to the costs, of health care interventions. Whether an intervention provides high value depends on assessing whether its health benefits justify its costs. High-cost interventions may provide good value because they are highly beneficial; conversely, low-cost interventions may have little or no value if they provide little benefit. Thus, the challenge becomes determining how to slow the rate of increase in costs while preserving high-value, high-quality care. A first step is to decrease or eliminate care that provides no benefit and may even be harmful. A second step is to provide medical interventions that provide good value: medical benefits that are commensurate with their costs. This article discusses 3 key concepts for understanding how to assess the value of health care interventions. First, assessing the benefits, harms, and costs of an intervention is essential to understand whether it provides good value. Second, assessing the cost of an intervention should include not only the cost of the intervention itself but also any downstream costs that occur because the intervention was performed. Third, the incremental cost-effectiveness ratio estimates the additional cost required to obtain additional health benefits and provides a key measure of the value of a health care intervention.", "publicationTitle": "Annals of internal medicine", "publisher": "", "place": "", "date": "Feb 1, 2011", "volume": "154", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "174-180", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Ann. Intern. Med.", "DOI": "10.7326/0003-4819-154-3-201102010-00007", "citationKey": "", "url": "", "accessDate": "", "PMID": "21282697", "PMCID": "", "ISSN": "1539-3704", "archive": "", "archiveLocation": "", "shortTitle": "High-value, cost-conscious health care", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Benchmarking", "type": 1 }, { "tag": "Comparative Effectiveness Research", "type": 1 }, { "tag": "Cost Control", "type": 1 }, { "tag": "Cost-Benefit Analysis", "type": 1 }, { "tag": "Defibrillators, Implantable", "type": 1 }, { "tag": "Drug Costs", "type": 1 }, { "tag": "Health Care Costs", "type": 1 }, { "tag": "Health Care Reform", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Quality of Health Care", "type": 1 }, { "tag": "Quality-Adjusted Life Years", "type": 1 }, { "tag": "United States", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-01-15T20:06:31Z", "dateModified": "2014-01-15T20:06:31Z" } }, { "key": "WU6HT3EV", "version": 17, "library": { "type": "group", "id": 237398, "name": "VMC HealthCare Value", "links": { "alternate": { "href": "https://www.zotero.org/groups/vmc_healthcare_value", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/237398/items/WU6HT3EV", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/vmc_healthcare_value/items/WU6HT3EV", "type": "text/html" } }, "meta": { "createdByUser": { "id": 622653, "username": "vududude", "name": "Michael Hwa, MD", "links": { "alternate": { "href": "https://www.zotero.org/vududude", "type": "text/html" } } }, "creatorSummary": "Weinberger", "parsedDate": "2011-09-20", "numChildren": 1 }, "data": { "key": "WU6HT3EV", "version": 17, "itemType": "journalArticle", "title": "Providing high-value, cost-conscious care: a critical seventh general competency for physicians", "creators": [ { "creatorType": "author", "firstName": "Steven E", "lastName": "Weinberger" } ], "abstractNote": "There is general agreement that the U.S. economy cannot sustain the staggering economic burden imposed by the current and projected costs of health care. Whereas governmental approaches are focused primarily on decreasing spending for medical care, it is the responsibility of the medical profession to become cost-conscious and decrease unnecessary care that does not benefit patients but represents a substantial percentage of health care costs. At present, the 6 general competencies of the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) that drive residency training place relatively little emphasis on residents' understanding of the need for stewardship of resources or for practicing in a cost-conscious fashion. Given the importance in today's health care system, the author proposes that cost-consciousness and stewardship of resources be elevated by the ACGME and the ABMS to the level of a new, seventh general competency. This will hopefully provide the necessary impetus to change the culture of the training environment and the practice patterns of both residents and their supervising faculty.", "publicationTitle": "Annals of internal medicine", "publisher": "", "place": "", "date": "Sep 20, 2011", "volume": "155", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "386-388", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Ann. Intern. 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However, medical education has traditionally avoided addressing costs, and most residency programs currently lack curricula to fulfill this requirement. With the recent widespread emphasis on unsustainable costs, inefficiencies, and waste in healthcare, the need to appropriately train physicians in this domain is increasingly apparent. 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