Changes in the Use of Medical Technologies, 1972-82: A Study of Ten Inpatient Diagnoses. Executive Summary

摘要

How have changes in clinical practice contributed to the rising costs of hospital care. To answer this question, 2,011 patients were studied who were hospitalized at the University of California, San Francisco, in 1972, 1977, or 1982 with one of ten common diagnoses. After converting all services to 1982 prices and adjusting for case severity, it was found that for most diagnoses total hospital resource use did not change substantially over the decade. Length of stay and the use of special care and the clinical laboratory generally remained the same or declined. There was an increase in the use of imaging technologies for only certain diagnoses. The provision of surgery to patients who formerly would have been treated medically and the use of increasingly intensive treatments for critically ill patients were the main contributors to rising costs. These types of changes may be difficult for the hospital reimbursement system to control.