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Objective. To estimate the cost of resources required to implement a set of Foundational Public Health Services (FPHS) as recommended by the Institute of Medicine. Study Design. A stochastic simulation model was used to generate probability distributions of input and output costs across 11 FPHS domains. We used an implementation attainment scale to estimate costs of fully implementing FPHS. Data Collection/Extraction Methods. We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the FPHS cost estimation methodology in their agencies during 2014-2015. Principal Findings. The average agency incurred costs of $48 per capita implementing FPHS at their current attainment levels with a coefficient of variation (CV) of 16 percent. Achieving full FPHS implementation would require $82 per capita (CV=19 percent), indicating an estimated resource gap of $34 per capita. Conclusions. Substantial variation in costs exists across communities in resources currently devoted to implementing FPHS, with even larger variation in resources needed for full attainment. Reducing geographic inequities in FPHS may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation. Key Words. Health care financing/insurance/premiums, health promotion/prevention/screening, geographic/spatial factors/small area variations, The United States faces mounting pressure to improve population health as medical costs rise, while American health status falls further behind that of other developed nations (IOM 2013). Enactment of [...]

Objectives. To quantify the cost savings of palliative care (PC) and identify differences in savings according to team structure, patient diagnosis, and timing of consult. Data Sources. Hospital administrative records on all inpatient stays at five hospital campuses from January 2009 through June 2012. Study Design. The analysis matched PC patients to non-PC patients (separately by discharge status) using propensity score methods. Weighted generalized linear model regressions of hospital costs were estimated for the matched groups. Data Collection. Data were restricted to patients at least 18 years old with inpatient stays of between 7 and 30 days. Variables available included patient demographics, primary and secondary diagnoses, hospital costs incurred for the inpatient stay, and when/if the patient had a PC consult. Principal Findings. We found overall cost savings from PC of $3,426 per patient for those dying in the hospital. No significant cost savings were found for patients discharged alive; however, significant cost savings for patients discharged alive could be achieved for certain diagnoses, PC team structures, or if consults occurred within 10 days of admission. Conclusions. Appropriately selected and timed PC consults with physician and RN involvement can help ensure a financially viable PC program via cost savings to the hospital. Key Words. Palliative care, hospital cost savings, Palliative care (PC) is a relatively new and rapidly growing health care specialty filling important gaps in treatment and care faced by seriously ill patients and their families. PC aims [...]

The Little Rock Region is home to more than 20 major hospital/medical facilities serving the state's 3 million people with renowned health care and medical research on a daily basis. [...]

In 2016, healthcare spending grew to $3.4 trillion and is expected to reach $5.5 trillion by the year 2025 (1). In response to this growth, the industry has been on [...]

WASHINGTON -- National health spending last year continued a trend of low growth, according to an analysis from the Office of the Actuary at the Centers for Medicare and Medicaid [...]