Using Evidence-Based Practices to Improve Healthcare in the United States - Master of Public Administration


Although the United States is one of the most technologically advanced nations on earth, its healthcare system ranks last out of 11 developed countries. This is according to data published in an extensive Commonwealth survey. More worryingly, the United States has consistently ranked last in this annual survey since 2004. As such, stakeholders in the United States healthcare industry should take urgent measures to improve service delivery and patient outcomes. To learn more, checkout this infographic created by Rutgers University’s Online Master of Public Administration.

How Healthcare Costs in the United States Compared to Healthcare Costs in the UK

Figures from the Commonwealth survey show that health care spending in the United States stood at $8,508 per person in 2013. Even worse, this expenditure grew by 5.3% to $9,523 in 2014, meaning Americans require an increasingly larger amount of money to access medical care. In comparison, health care expenditures in the UK were just $3,405 per person over the same period. Unsurprisingly, the UK’s healthcare system was ranked the top among 11 developed Commonwealth nations in 2013.

Healthcare Costs in the United States Versus Costs in OECD Countries

The aim of the Organization for Economic Co-operation and Development (OECD) is to develop and implement policies that enhance economic and social well-being among its member countries. Currently, the OECD has 34 member countries including the UK, Canada, France, Germany, Japan, and Australia. As such, the OECD is a good economic block for comparing healthcare expenses against the United States. With this in mind, the United States spends up to 52% of its healthcare budget on outpatient care costs. In the OECD region, outpatient care costs account for a paltry 33% of its healthcare budget. This translates to a healthcare expenditure difference of 19% in favor of the OECD region.
In addition, the average allocation for in-patient care across the OECD region is 18% of the total healthcare budget. The United States spends up to 28% of its healthcare sector budget on in-patient care. Finally, the OECD region spends about 6% of its healthcare budget on long-term care, whereas the United States spends 12% of its health sector budget for the same purpose. From these figures, it is clear that the United States far outspends the OECD region in terms of outpatient care and inpatient care, as well as long-term health care provisions.

Differences Between the United States and the OECD Health Care Costs

There are several reasons why healthcare in the United States is more expensive than in the OECD. To start with, healthcare practitioners in the United States perform more screenings compared to physicians in other countries. Additionally, physicians in the United States generally use more costly imaging equipment when compared to doctors in other developed Commonwealth countries. For instance, doctors in the United States perform an average of 107 MRI and 240 CT scans exams per 1,000 people in the general population. In comparison, doctors across the OECD region only perform 52 MRI exams and 120 CT scans per 1,000 people in the general population. As such, the United States spends $1,026 per capita on pharmaceutical products, which is 50% higher ($515) than in the OECD region. In general, medical practitioners in the United States perform more medical procedures and tests than the number of procedures performed in other developed countries.

How to Improve Health Care Services Without Increasing Costs

At present, a third of all hospitals in the United States are not meeting the National Database of Nursing Quality Indicators (NDNQI) benchmarks, meaning there is a lot of room for improvement. Fortunately, the implementation of evidence-based practices (EBP) can improve outcomes among patients and lower medical care costs substantially.

EBP Effect on Deep Vein Thrombosis Cases

A good example of an area where EBP can enhance service delivery is in the treatment of deep vein thrombosis (DVT), which affects 900,000 patients annually. When researchers implemented EBP measures to prevent DVT in surgical patients across four hospitals, they were able to cut costs by a staggering $1.5 million. More importantly, hospital administrators can channel these savings elsewhere, such as purchasing much needed equipment or medications.

EBP Effect on Blood Transfusions

EBP has also been quite effective in improving patient outcomes in blood transfusion cases. A good example is a case where medical personnel were required to review carefully their decision to perform blood transfusions based solely on the medical guidelines. Surprisingly, the number of blood transfusions performed during the observation period (between 2009 and 2013) fell by 24%. In addition, this simple change in treatment procedure resulted in purchasing cost savings of $1.6 million annually. This means medical personnel are prone to making unnecessary blood transfusion recommendations when they review medical diagnoses without following the relevant medical guidelines.

Effect of EBP on Heart Failure

In 2011, as many as 20% of heart failure patients treated and discharged from the Stanford Health Care facility were returning with complications within a period of 30 days. This was troubling because heart-related medical issues can be fatal. To resolve this problem, administrators at the Stanford Health Care facility developed and deployed a data dashboard that enables medical practitioners to track metrics such as emergency room usage, medication reconciliation and readmission rates in real-time. Before implementation of this data-driven approach, there was a three-month lag between events occurring and physicians receiving actionable data on these issues. Fortunately, the real-time dashboard reduced the readmission rate for heart failure patients by 6%, which is a significant improvement in treatment outcomes.
While the United States boasts some of the best healthcare facilities in the world, its healthcare system is far from the best. In fact, the US health care system has always ranked last in a survey of 11 Commonwealth countries since 2004. Worse still, health care costs in the United States are rising despite being higher than health care costs in countries with better healthcare systems such as the UK. This is mainly because American physicians perform more medical tests and procedures compared to physicians in other countries. For example, doctors in the United States perform 107 MRI exams per 1,000 people in the general population. Physicians in OECD countries only perform 52 MRI exams per 1,000 people in the general population. Fortunately, healthcare facilities in the United States can easily improve healthcare services without necessarily increasing costs by adopting evidence-based practices.

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