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The Richard and Hinda Rosenthal Lectures 2005 Next Steps Toward Higher Quality Health Care (2006) / Chapter Skim
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Elliott S. Fisher, M.D., M.P.H. - Dartmouth Medical School, Hanover, NH
Pages 5-9

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 5...
... The differences in spending are largely due to differences in the quantity of care provided to similar patients. Compared to similar patients at Strong Memorial Hospital, patients cared for at NYU Medical Center spend twice as much time in the hospital, spend two-and-a-half times as many days in the intensive care unit, and have three times as many physician visits.
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From page 6...
... This latter finding fits perfectly with the much greater apparent complexity of care in high-costs systems. Seriously ill patients cared for by the highest cost academic medical centers are more than three times as likely to have 10 or more different doctors involved in their care.
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From page 7...
... A wonderful question for clinical scientists to pursue would be how all health care systems could achieve the high quality and low per capita costs achieved by Strong Memorial or the Mayo Clinic. Academic medical centers and the NIH need to take the lead in exploring the health implications of the natural experiments inherent in their remarkably different practice patterns and investment.
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From page 8...
... One unintended consequence may have been to reinforce a public perception that good outcomes can be guaranteed and that the problems we face in medicine represent a few technical glitches that can easily be fixed. The public belief that more medical care means better medical care is deeply entrenched, so I'm afraid that we've got real work ahead of us.
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From page 9...
... George has been a leader in the field of improving quality and performance of health care from a systems point of view and was quite instrumental along the way for a number of projects here at the Institute of Medicine. He is still active, serving, for example, as a member of our board on population health and public health practice, and he was also the chair of the committee that produced the report on priority areas for national action transforming health care quality.
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Key Terms

  • medical centers
  • technical quality
  • clinical practice
  • care means
  • practice patterns

  • strong memorial
  • patients cared
  • heart attack
  • physician visits
  • medical decisions

  • medical students
  • health practice
  • population health
  • nyu medical
  • transforming health

  • health implications
  • care quality
  • care physician
  • care unit
  • intensive care

  • capita costs
  • natural experiments
  • public nor
  • routine public
  • technically oriented

  • spending fifth
  • mayo clinic
  • patients tend
  • finding fits
  • cost academic


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