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Improving Quality While Reducing Costs:
AHCPR Research Findings
Research supported by the Agency for Health Care Policy and Research (AHCPR) continues to demonstrate that better quality can cost less. These examples are relevant to Medicare, Medicaid, and other programs.
Treating Pneumonia with Lower Cost Antibiotics. Use of the antibiotic erythromycin for treating community-acquired pneumonia (CAP) in most outpatients age 60 and under significantly reduces treatment costs compared with the use of other antibiotics by two-thirds and has no adverse effects on medical outcomes. About four-fifths of the 4 million Americans who develop pneumonia each year are treated as outpatients. Direct outpatient treatment costs exceed $1 billion per year, of which roughly $100 million is spent on antibiotic therapy.
Low-Cost, Effective Emergency Asthma Treatments. An AHCPR-supported study
found that Emergency Diagnostic and Treatment Units (EMTUs) offer an alternative to
inpatient hospitalization for adults suffering from reversible diseases such as acute
asthma. This research shows that more than half of the asthma patients that we now
admit to the hospital could be treated just as effectively—at about half the cost.
High-Cost Admissions of Patients with Chest Pain. An AHCPR-supported randomized
controlled trial showed that patients suffering from chest pain can avoid a costly hospital
admission and be treated just as effectively when accelerated diagnostic protocols are
used in an observational unit of an Emergency Department.
Preventable Errors in Care. Prior research conducted by Dr. Lucian Leape and others,
and supported by AHCPR, has demonstrated that "errors in care are prevalent and often
preventable." Dr. Leape has estimated that 180,000 people die each year partly as a result
of treatment-caused injuries; most of these deaths are preventable through a combination
of system redesign and education of health personnel and patients. By addressing these
"system" errors, the potential for preventing unnecessary death and injury and the
associated treatment and malpractice costs is enormous.
Treating Ear Infections with Lower Cost Antibiotics. Treatment of common ear
infections in children with antibiotics, such as amoxicillin instead of more costly choices,
could save millions of dollars a year without changing recovery rates. Middle ear
infection is the most frequent reason for giving antibiotics to children in the United
States. No single antibiotic has been found to be superior in treating this condition.
However, costs vary widely, from $2.94 to $62.80. If, in 1992, only half the
prescriptions were written using a lower cost antibiotic alone, Colorado's Medicaid
program would have saved $399,412.
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Current as of April 30, 1998