Tracking US Health Care Spending
In this issue of JAMA and a concurrently published issue of JAMA Health Forum, Joseph Dieleman and other researchers from the Institute for Health Metrics and Evaluation introduce an extraordinary new dataset. This dataset draws together information on spending across public and private health insurance programs, classifies that information into consistent disease categories, and reports on utilization and expenditures at the county level for each of 3110 US counties. This effort builds on a long history, dating back to Glover’s 1938 study of tonsillectomy in schoolchildren, of measuring variation in the performance of the health care system at the local level. Notably, the Dartmouth Atlas of Health Care has produced highly influential studies of variations in utilization and spending in the Medicare program since 1996. A sense of the potential impact of the new dataset from Dieleman et al can be obtained by looking at the reactions to these earlier, narrower studies. That experience suggests that these new data on variations are likely to affect health care by changing practice and, perhaps, by influencing the design of policy.
In this issue of JAMA and a concurrently published issue of JAMA Health Forum, Joseph Dieleman and other researchers from the Institute for Health Metrics and Evaluation introduce an extraordinary new dataset. This dataset draws together information on spending across public and private health insurance programs, classifies that information into consistent disease categories, and reports on utilization and expenditures at the county level for each of 3110 US counties. This effort builds on a long history, dating back to Glover’s 1938 study of tonsillectomy in schoolchildren, of measuring variation in the performance of the health care system at the local level. Notably, the Dartmouth Atlas of Health Care has produced highly influential studies of variations in utilization and spending in the Medicare program since 1996. A sense of the potential impact of the new dataset from Dieleman et al can be obtained by looking at the reactions to these earlier, narrower studies. That experience suggests that these new data on variations are likely to affect health care by changing practice and, perhaps, by influencing the design of policy.
