(Effectiveness versus efficiency) Thefounder and president of the Institute for Healthcare Improvement, Donald Berwick, is convinced that the U.S. health care system can reduce costs by 30 percent while improving overall quality—just by getting health care professionals to adopt improvements others already have discovered.

• Many children, possibly up to 30 percent, are being treated with new, broad spectrum, expensive, andpotentially unsafe antibiotics despite na¬ tional research and expert guidelines urging use of simple, inexpensive antibiotics as far better initial treatment.

• MRI scans in the first week of back pain rarely produce useful informa¬ tion compared with “watchful waiting, ” but many doctors order MRls for such patients.

• Simple, inexpensive medications such as aspirin and beta blocker drugs can significantly reduce the likelihood of dying from heart attacks, but only one in five eligible patients currently receives such medications.

• Inhaled steroid medications can prevent disability and complications among asthmatic patients, butfewer than one-third of eligible patients re¬ ceive such medication.

• One HMO-based study showed an 80 percent decrease in hospital days and emergency room visits for asthma care among patients trained to avoid asthma triggers, measure their own lung function, follow a consis¬ tent treatment plan, and make adjustments in their own medications.

Source: Ed Egger, “Best Outcomes May Be Salvation for Shriveling Managed Care Cost Savings,” Health Care Strategic Management (March 1999), pp, 12-13.

Indicate whether each selected finding mentioned represents effective¬ ness, efficiency, or both. If the finding represents either efficiency or both, indicate whether you consider it to be primarily cost understanding, cost containment, cost avoidance, or cost reduction. Justify each of your answers.

 LO.1