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Chapter 3: Assessing and Improving the Quality of Care in Cardiovascular Medicine

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Which of the following statements concerning health care expenditures in the United States is false?

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A. Health care expenditures accounted for nearly 17.5% of the gross domestic product in 2014

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B. The United States invested an estimated $3.0 trillion in health care in 2014

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C. Expenditures related to cardiovascular disease were estimated to be $656 billion in 2015

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D. The United States health system ranked lowest among 11 similar countries with respect to access, equity, quality, efficiency, and healthy lives, despite spending the most on health care

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E. Increasing the use of expensive medical care is associated with better quality of care and patient outcomes

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The answer is E. (Hurst’s the Heart, 14th Edition, Chap. 3) In the United States, health care expenditures accounted for nearly 17.5% of the gross domestic product in 2014 (an estimated $3 trillion) and are expected to reach 19.6% by 2024.1 Cardiovascular disease (CVD) remains the leading cause of death and disability,2 with an estimated annual total cost of $656 billion in 2015.3 In a recent report, the US health system ranked lowest among 11 countries with respect to access, equity, quality, efficiency, and healthy lives,4 despite spending the most on health care.5 It is often thought that high-quality health care is dependent on the continued discovery and delivery of novel diagnostic and therapeutic interventions. However, studies suggest that greater use of expensive medical care is actually associated with lower quality and worse outcomes.6,7 Woolf and Johnson8 have extended this concept to mathematically quantify the trade-off between the development of new interventions and the more consistent delivery of known therapies. They argue that despite tremendous scientific and technologic advancements, the failure to consistently deliver proven therapies dilutes and reduces the overall quality of a health care system. Thus, money spent on improving this actual delivery of care may be equally or even more critical than money spent on improving technology to result in improved quality of both routine and specialized health care.

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Which of the following factors influences the variability and appropriateness of health care delivery?

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A. Patients’ clinical status

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B. Sociodemographic factors

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C. Providers and facilities

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D. Geographic location

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E. All of the above

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The answer is E. (Hurst’s the Heart, 14th Edition, Chap. 3) A critical goal of efforts to disseminate high-quality care ...

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