Showing papers by "Gary C. Brown published in 2013"

Update on value-based medicine.

Abstract: Purpose of reviewTo update concepts in Value-Based Medicine, especially in view of the Patient Protection and Affordable Care Act.Recent findingsThe Patient Protection and Affordable Care Act assures that some variant of Value-Based Medicine cost–utility analysis will play a key role in the healthca

We are producers of patient value and financial value.

Abstract: The authors herein, all top people in their fields, have written superior reviews on critically relevant subjects to practicing ophthalmologists. In each instance, the patient value gains (comparative effectiveness) associated with ophthalmic interventions, whether therapeutic or diagnostic, are addressed. Although improving patient value (quality-of-life and/or length-of-life) is the most important thing we do, it is by no means all we do. Many lament that United States direct medical costs are sunk costs, those that have been incurred and cannot be recovered, especially when they are projected to approach 17.8% of the Gross Domestic Product in 2013 [1]. George Beauchamp, a prominent paediatric ophthalmologist, has long been an advocate of the concept that our medical interventions yield not only patient value but also economic (financial) value [2]. In essence, many of our interventions yield a positive financial return-on-investment to society over and above the direct medical costs expended. Thus, these interventions produce an increase in the net wealth of the USA, as is also the case for medical interventions in other countries. William Nordhaus, the noted Yale economist, estimates that 50% of the wealth created in the USA during the 20th century occurred as a result of healthcare advances [3]. The 30-year increase in average life expectancy alone, from 47 years in 1900 to 77 years in 2000 [4], yielded another 20 years of economic productivity, as many work till age 65 and beyond. And, the diminution in disability made possible by medical interventions improved economic productivity without reservation. We, as physicians, have always suspected that our treatments allow patients to lead more economically productive lives. But relatively little information has been written on the subject. Nonetheless, studies on healthcare costs are giving us objective information upon which to base suppositions that medical interventions create financial gain [5–7].