***EDITORS: Note proposed sidebar list immediately following story.***
Americans are not getting their money's worth from the billions of dollars spent on health research each year because the health care system fails to properly put discoveries into practice, according to a report issued by the Institute of Medicine today.
"We spend more than $1 trillion on health care annually, we have extraordinary knowledge and capacity to deliver the best care in the world, but we repeatedly fail to translate that knowledge and capacity into clinical practice," the study concludes.
The IOM study identified 20 priority areas, including early management of diseases like asthma and diabetes, treatments to help adults quit smoking and improvements in health literacy as key targets for better health care.
The report also singled out obesity as an "emerging" condition, one that poses a significant and growing threat to public health but with few studies that show how best to treat it.
Rather than endorse specific cures for specific diseases, the list of priorities emphasizes prevention and ways to manage chronic health conditions from childhood until the end of life.
Two of the priorities -- coordination of caregivers treating individuals with multiple health problems and health literacy -- do not address specific conditions but focus on areas where changes would improve health care across a broad spectrum.
The 20 priority areas were chosen for the size of their effect (in terms of number of patients and severity of disease and economic costs) and their relevance to a broad range of groups including minorities and the poor.
The list also includes conditions where there is a good likelihood, based on current studies, that the condition could be improved by implementing better health care practices, such as quickly administering medications after a heart attack or reminding caregivers to discuss smoking habits with their patients.
"We have islands of quality care, but we want to expand those into continents," said C. Tracy Orleans, senior scientist at the Robert Wood Johnson Foundation and study co-author. "By highlighting these 20 critical areas, we hope that improvements in these areas will have a filter effect to other aspects of health care systems."
The report does not discuss incentives for changing health care practices within the priority areas, but the IOM has received funding for a summit next fall that will discuss how to implement the current report's recommendations.
"The hardest thing, it seems, will be getting people to be 'creatively intolerant' with the way things are in the current health system," says study co-author Joanne Lynn, president of Americans for Better Care of the Dying.
The report recommends that the Agency for Healthcare Research and Quality, a branch of the Department of Health and Human Services, perform regular "checkups" to see if care improves in these priority areas over the next decade. But they caution that such oversight will require a new influx of federal funding, despite projected drops in government health care spending.
The 20 Priority Areas Identified in the IOM report, "Priority Areas for National Action: Transforming Health Care Quality"
* coordination of care* health literacy* evidence-based cancer screening, especially for colorectal and cervical cancer* treatment for mild and moderate asthma* children with special health care needs* early management of diabetes* advanced organ failure at the end of life* old-age frailty* high blood pressure* immunization* coronary heart disease* major depression* medication errors and antibiotic overuse* hospital infections* pain control in advanced cancer* proper care during pregnancy and childbirth * severe mental illness* stroke* tobacco addiction in adults* obesity
RSS