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The Cardiology Working Group

JAMA. 1991;265(4):482-485.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

THERE is mounting concern over the continued escalation of medical costs. These have risen ahead of inflation over the past five decades. Medical costs will consume $600 billion dollars this year, over 11% of our gross national product. What may be an appropriate level of medical expenditure by a country is not, however, the issue here. What is of concern is whether we are receiving benefit commensurate with the high costs.

When an effort is initiated to contain medical costs, it should begin ideally with an assessment of what constitutes high-quality medical care. Knowing which medical interventions are effective and beneficial is essential before decisions can be made wisely on what can be eliminated in an effort to contain medical costs. Of course, it may turn out that even when all the redundant, duplicative, useless, or even harmful practices are identified and excluded, the remaining effective and beneficial practices may . . . [Full Text PDF of this Article]

Author Affiliations
From the Division of Health Policy, Research, and Education, Harvard University, Cambridge, Mass.

Footnotes
Reprint requests to Massachusetts General Hospital, Boston, MA 02114 (Alexander Leaf, MD).

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