Buzzword of the Week: The Dartmouth Atlas Project

My husband and I now laugh that we one had a real, marriage-stressing (for a few minutes, anyway) fight about the healthcare system. With myself on the provider side of medicine and him working in the health insurance industry, our views on how medical care should work are occasionally at odds. Discussing our jobs and views at length has motivated me to stay well informed when it comes to the inner workings of our healthcare system.

This week, I revisited a few of my favorite resources discussing healthcare spending in the U.S. which rekindled my interest in the Dartmouth Atlas Project. As nurse practitioners and physician assistants, we should all be aware of this valuable resource that analyzes healthcare spending trends and outcomes in the U.S. If you are new to the Dartmouth Atlas Project, here are the nuts and bolts.

What is the Dartmouth Atlas Project?

Healthcare spending is on the rise in the United States. While there is a lot of noise from quarter to quarter when we look at spending stats, if you take a step back and examen trends in long-term spending, the results are staggering. In 1970, the U.S. spent just over 7 percent of GDP on healthcare. Today, we spend 18 percent of GDP on healthcare. This means that nearly one out of every five dollars in the U.S. economy goes towards healthcare. We would like to think that this rise in health spending is accompanied by better health outcomes. Unfortunately, this isn’t true. Many other countries spend less on healthcare, and with better results.

The Dartmouth Atlas Project is a 20 year endeavor documenting how and where medical resources are used. Using Medicare data, it seeks to understand the inefficiencies of our system and how we can fix them. This information has helped politicians, healthcare analysts, and the media improve their understanding of our healthcare system and identified major areas for improvement. 

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How was the Dartmouth Atlas Project started?

The Dartmouth Atlas Project is the brainchild of Dr. John E. Wennberg. Wennberg was the first to study patterns of healthcare usage as well as variations in health cost and outcomes. Wennberg’s analysis revealed disturbing discrepancies in healthcare usage among different areas. For example, in Vermont, two areas of the state were performing just 13 tonsillectomies per 10,000 people while other areas were performing 151 tonsillectomies per 10,000 individuals. This discrepancy in the number of surgical procedures occurs across the country. His findings also indicated that higher healthcare spending was not associated with improved outcomes. The Dartmouth Atlas Project was founded to continue this kind of investigation into spending and health outcomes. Funding for the project is led by the Robert Wood Johnson Foundation.

What has the Dartmouth Atlas Project revealed about our healthcare system?

The Dartmouth Atlas Project’s most significant finding is that healthcare spending and usage varies dramatically across the country, and that areas with higher spending and greater healthcare usage don’t have better health outcomes. So, many healthcare services provided are unnecessary, they provide no benefit to patients.  Researchers estimate that these excess healthcare services make up about 30 percent of healthcare spending.

The Dartmouth Atlas Project offers an excellent online resource for viewing the project’s latest data. The site includes interactive maps so you can get up-to-date information about healthcare spending and usage at the local and national level.

How has the Dartmouth Atlas Project changed the way we deliver healthcare?

The first step to fixing any issue, in this case excess healthcare spending, is to identify the root cause of the problem. The Dartmouth Atlas Project has done just that. The project Dartmouth Atlas Project has identified that areas with a greater supply of healthcare services give more, often unnecessary care, and that physicians practice differently depending on where they live rather than based on the latest research.

Based on these findings, healthcare providers and policymakers are increasingly aware of the U.S. healthcare spending problem. Patients are also becoming increasingly aware that more is not always better when it comes to medical tests and procedures. This knowledge is arming individuals with the information they need to make better decisions when it comes to their health. Ultimately, this awareness serves to reduce unnecessary hospital admissions, tests, and surgeries driving down the cost of healthcare and improving health outcomes.


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