Tag Archives: Healthcare costs
Dr. Joseph S. Alpert

Sloppy, Greedy, or Overworked?

In early 2010, my administrative assistant, Barbara Raney, came into my office with a worried expression on her face. She told me that a lawyer from the Department of Justice (DOJ) in Washington, DC was on the phone and wanted to speak with me. My immediate thought was “What have I done that would raise […]

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Hospitalists, Medical Education, and U.S. Health Care Costs

  Hospitalists are general internists whose full-time practice is to treat hospitalized patients. They are the fastest-growing medical specialty in the United States. They increased in number from 4000 in the year 2000 to 50,000 in 20161 and now are the largest subspecialty in internal medicine. By 2016, nearly all teaching hospitals and 75% of all […]

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Death or Debt? National Estimates of Financial Toxicity in Persons with Newly-Diagnosed Cancer

The purpose of this study was to evaluate the impact of cancer upon a patient’s net worth and debt in the US. Methods This longitudinal study used the Health and Retirement Study from 1998–2014. Persons ≥50 years with newly-diagnosed malignancies were included, excluding minor skin cancers. Multivariable generalized linear models assessed changes in net worth […]

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Learning to De-Adopt Ineffective Healthcare Practices

With rapidly rising healthcare costs constraining US wages and forcing difficult policy decisions, there is increasing pressure to identify means to decrease spending. One attractive target is the de-adoption of medical practices found to be ineffective or harmful. Just as emerging scientific evidence can support novel practices that improve health, it can also reverse beliefs […]

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Proportion of patients with at least one unnecessary test based on chart review, frequency with which testing led to a change in patient management and the overall outcome of testing on patients.

The Frequency of Unnecessary Testing in Hospitalized Patients

Testing is an important part of medicine across all specialties and settings. As a result, the volume of testing is enormous, with an estimated 4-5 billion tests performed in the United States each year.1 Unnecessary laboratory testing and diagnostic imaging is believed to be common. Studies looking at testing of patients have found 40%-60% of tests […]

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Cardiology Consultation in the Emergency Department

Re-hospitalization after discharge for acute decompensated heart failure is a common problem. Low-socioeconomic urban patients suffer high rates of re-hospitalization and often over-utilize the emergency department (ED) for their care. We hypothesized that early consultation with a cardiologist in the ED can reduce re-hospitalization and health care costs for low-socioeconomic urban patients with acute decompensated […]

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