Systems Approaches to Improve Quality, Performance, and Efficiency in the Care of Older Adults

By David B Reuben, MD

Spring 2007 - Volume 11 Number 2


In the early years of the 21st century, the US health care system is in a state of both feast and famine. New scientific breakthroughs and advances in technology have cured diseases and extended lives beyond what was imaginable even a decade ago. Yet despite these riches, the health care system is fundamentally broken. It fails on three measures of care, especially in the treatment of older persons.

The first measure is cost. In 2004, the cost of health care in the United States grew at a rate of 7.7%, compared to the overall consumer price index of 4.4%.1 In fact, many US economists have accepted--but do not like--that health care spending will rise at a rate of 2% to 3% higher than the general economy.


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