Health Care/Policy Perspective

Kathleen T Grimm, MD MHSc July 16, 2014

Objectives

A Big Reason for Paradigm Shift

The Largesse of the Challenge

The Momentum

U.S. Health Costs Rising More Steeply, 1970-2008

Determinants of Health and Their Contribution to Premature Death

Adapted from: McGinnis JM, Williams Russo P, Knickman JR. “ The case for more active policy attention to health promotion” Health Affairs‐

(Millwood) 2002;21(2):78 93‐ .

The Buffalo Community

Objectives

A Big Reason for Paradigm Shift

The Largesse of the Challenge

The Momentum

•We have learned that more and more health care does not explicitly improve health

•Health can’t be defined in one dimension alone- it is in the context of a person’s life

Objectives

A Big Reason for Paradigm Shift

The Largesse of the Challenge

The Momentum

“For nearly 15 years we’ve had the secret to delivering better care at lower cost in America. The information has sat, hidden away in the medical literature, and barely mentioned among physicians. It’s a remarkable story of bias. The neglect of this information by the medical community tells you a lot about our failings as a profession and the poor training we receive. It’s also a powerful commentary on the values of our society and the biases built into our society’s view of health and healthcare”.

Philly.com’s The Field Clinic blog.

Dr. Jeffrey Brenner: “I believe ACE scores should become a vital sign, as important as height, weight, and blood pressure

Generating Hypotheses About Care Needs of High Utilizers: Lessons from Patient Interviews

Theme 1: Childhood instability

Theme 2: Difficult relationships and encounters with health care providers during adulthood

Theme 3: Importance of positive relationships with health care providers

POPULATION HEALTH MANAGEMENT Volume 16, Supplement 1, 2013