1a. The Evolution of Hospitals in the U.S.
In the mid-Eighteenth Century, hospitals in the United States were essentially isolation wards used during epidemics. Institutionalized health care was provided for the lower classes in charitable organizations such as almshouses, which also provided support for the destitute (Mann Wall, n.d.). Right into the Nineteenth Century, the upper and middle classes were cared for at home. Towards the end of the Nineteenth Century, medical technologies were advancing and institutionalized care was becoming a better choice than home care. Medical practices became increasingly professionalized and tended more and more often to take place in hospitals (Mann Wall, n.d.).
1b. The Role of Technology in the Rising Cost of Health Care
Health care costs have steadily risen and most analysis points to the proliferation of technological advances in treatment and diagnostics as being responsible. However, the issue may be more complex than that. The different modes of technology may have different impacts on the cost of health care (Sorenson, Drummond & Khan, 2013). For example, vaccinations may be a cost effective or at least a neutral innovation, whereas high-end neonatal and cancer treatments are very costly and benefit a limited number in the population. Other factors that contribute to the rising cost of health care are an ageing demographic and an increasing demand for the newest technologies on the part of the patients. Further, medical schools tend to focus on high-end diagnostic technology and therefore doctors tend to use it (Sorenson, et al., 2013).
2a. Organizational Models Used to Curb Expenditure
The role of medical technology in the rising cost of health care might best be examined by linking the cost of medical technology research and the cost of the high-end equipment with outcome factors such as quality of life and improvement in productivity. It is important to determine if the increased benefits that result from the new technology justify the cost, and under what circumstance they provide higher quality health care (Sorenson, et al., 2013).
2b. Benefits of Integration
A number of cost cutting and value-based models have been implemented to help slow down the rising cost of medical care. Overall coordination of health care resources has been introduced. For example, electronic health records are one way of coordinating care between hospitals and between hospital departments and reducing inefficiency (Dunn & Becker, 2013). In order to reduce redundancy of facilities, individual states must demonstrate a need for new health care facilities before they are erected. Other means of coordinating clinical care are by employing physicians, who are then aligned with hospital value-based models, and managing service organizations (Dunn & Becker, 2103).
References
Dunn, L. and Becker, S. (2013). 50 Things to Know About the Hospital Industry. Becker’s Hospital Review. Retrieved from http://www.beckershospitalreview.com/hospital-management-administration/50-things-to-know-about-the-hospital-industry.html
Mann Wall, B. (n.d.) History of Hospitals. Retrieved from http://www.nursing.upenn.edu/nhhc/Welcome%20Page%20Content/History%20of%20Hospitals.pdf
Sorenson, C., Drummond, M., & Khan, B. B. (2013). Medical technology as a key driver of rising health expenditure: disentangling the relationship. ClinicoEconomics and Outcomes Research 5, 223–234. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686328/
