Improving the Quality of Health and Long-Term Care
Table of Contents
- » Introduction
- » Redefining the Challenge
- » The Problem is Overstated
- » Meeting the Challenge
- Spending Health Dollars Wisely
- Improving Longterm Care
- Promoting Better Preventive Care
- Creating a National System for Home- and Community-Based Care
- Livable Communities
- Keeping Social Security Solvent
- Helping Americans Build More Retirement Assets
- Helping Americans to Work Longer
- Restoring the Federal Revenue Base
- » Conclusion
Despite the fact that the United States spends more of its GDP on health care than any other nation, American patients often suffer avoidable medical mistakes or do not receive appropriate care.50 Quality problems are pervasive, occurring across care settings and delivery models. Too often, some socioeconomic, racial, and ethnic groups experience health care disparities as well.51 And, of course, we cannot ignore the unique quality problems faced by America’s most vulnerable citizens, those who occupy nursing homes, where substandard care is all too common.
In the long run, a more efficient health and long-term care system—one that offers patients the right health care and support services at the right time in the right setting—may yield system-wide savings. However, these savings will not be achieved until the nation makes the significant investments necessary to create an infrastructure to support improvements. In the short term, scarce health and long-term care resources could be put to better use by avoiding wasteful expenditures for unnecessary medical services or for redundant procedures or hospital readmissions arising from medical errors. Another improvement would be to maintain the health and functional status of individuals so that more complicated and more expensive care can be minimized. The National Committee for Quality Assurance has estimated that more than $9 billion in lost productivity and almost $2 billion in hospital costs could be averted through more consistent delivery of best-practice, evidence-based care.52
Even without substantial savings, improved health care is valuable in and of itself. All Americans, old and young alike, stand to gain from improved quality. AARP has identified guideposts that will help the nation assess progress toward quality improvement. These are:
- Implementation of health information technology to enable doctors and other providers to conduct clinical and administrative activities in a paperless environment;
- Collection and reporting of standardized measures of doctor, hospital, and nursing home performance that will facilitate transparency, accountability, and quality improvement;
- Realignment of provider and practitioner reimbursement to reward high quality, particularly with respect to nursing homes; and
- Implementation of remedies such as better state government oversight, funding for more staff with better training, and reinventing the culture of nursing homes to focus primarily on the quality of life of their residents.