US spending largely driven by technology and high prices, according to a new Commonwealth Fund report

According to a new report by the Commonwealth Fund, health care spending in the U.S. far exceed that of other high-income countries, although spending growth has slowed in the U.S. and in most other countries in recent years.

The U.S. spends more public dollars on health care than all but two of the other countries.  Americans have relatively few hospital admissions and physician visits, but are greater users of expensive technologies like magnetic resonance imaging (MRI) machines.  Despite its heavy investment in health care, the U.S. sees poorer results on several key health outcome measures such as life expectancy and the prevalence of chronic conditions. Mortality rates from cancer are low and have fallen more quickly in the U.S. than in other countries, but the reverse is true for mortality from ischemic heart disease. 

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IOM report establishes framework for standardized measures set

A recent Institute of Medicine (IOM) report, Vital Signs: Core Metrics for Health and Health Care Progress, identifies fundamental problems with the current state of health care quality measures as too many, unfocused, and unorganized and identifies a framework to streamline the measures.
The IOM report uses four domains—healthy people, care quality, lower cost, and engaged people—to propose the following 15 standardized measure sets that represent a more wholistic, organized and focused approach for required measures at the national, state, and local levels and recommends steps to implement the measures:
1. Life expectancy
2. Well-being
3. Overweight and obesity
4. Addictive behavior
5. Unintended pregnancy
6. Healthy communities
7. Preventive services
8. Care access
9. Patient safety
10. Evidence-based care
11. Care match with patient
12. Personal spending
13. Population spending
14. Individual engagement
15. Community engagement
The  report was published online April 28, 2015 in The Journal of the American Medical Association by the Commonwealth Fund's David Blumenthal, M.D. and the Institute of Medicine's J. Michael McGinnis, M.D.