Cost conscious care

Question 1

Some causes of excess cost?

Answer 1

unnecessary services
inefficiency
excess admin
fraud

Question 2

Principles of high value cost-conscious care?

Answer 2

1. understand the benefits, harms, relative costs of each test/intervention
2. decrease interventions that are of no benefit or may be harmful
3. choose interventions that maximizes benefits, minimizes harm, reduces cost
4. customize care plan w/ pt to incorporate their values & address their concerns
5. identify system level opportunities to improve outcomes, minimize harms, reduce waste

Question 3

Mr. G 65 yo M hx of HTN, DM2, CAD 
c/o chest pain & dyspnea
Pain worse w/ inspiration
SaO2 88% on RA
EKG sinus tachy

Answer 3

1. PE
2. Pneumonia/Infection
3. COPD exacerbation
4. MI/ACS

Should order D-dimer, BNP, LE doppler, ABG, Echo, CTA chest, cardiac enzymes, CBC repeat etc.