Tuesday, November 10, 2009

Another Reminder that Integrated Delivery Systems Are Not All That

The Disease Management Care Bog is not in the habit of handicapping health care legislation, but it did check in with one of the information markets. The prospect of passage seems to be less than the prevailing spin would suggest.

If one rationale of health care reform is to disseminate the superior performance of integrated delivery systems (IDS), readers may want to check out this largely underreported study in the latest issue of the American Journal of Managed Care. While the 'definition' of a delay in radiation treatment following surgery for breast cancer remains hazy, two months not only 'seems' like a long time but there are data that suggests it can affect survival. According to Taffet Gold et al, IDS' overall rate of a 14% delay of two months or more is no better or worse than what has been reported in other settings.

Of course, this is just one study and there is considerable literature in support of IDS. Ultimately, however, we still don't know if the importation of IDS into areas of the U.S. that are struggling with high cost or low quality or high variation would be the panacea some would like. The American Journal of Managed Care article above reminds us of that inconvenient truth.

Image from Wikipedia Commons

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