Continuum-based health care delivery refers to a system and to models of health care delivery that incorporate and apply holistic, comprehensive objectives and sophisticated management technologies, information technologies, and clinical technologies into the delivery of health care. The costs of the development and the application of these technologies are substantial (Kibbe & Carver, 2000). Thus, the funders of health care delivery, as well as patients, expect that the efficiencies that are introduced into the health care delivery system will be highly correlated with the clinical outcomes that are delivered by the system. The key factor is the extent to which quality improvements are commensurate with the costs (Garrett, 2006).
As is true of most complex and important issues, there are multiple approaches to their assessment. In this case, one approach to the assessment of the issue is to consider it in a narrow context of benefits and costs that are relevant to the issue within the health care delivery system in the United States. A second approach is to consider the issue in a cross-national context. In such an approach the issue would assess the quality/cost ratio in the health care delivery system in the United States in relation to comparable ratios in other national health care delivery systems (Umbdenstock & Jesuele, 2008).
Considered in the national context to the extent that continuum-based health care delivery has been implemented in the United States, the costs have proved to be commensurate with clinical quality (Towner, 2008). Considered in a cross-national context, the ratio in the United States is not a good as it is in some other countries. The positive quality-cost relationship, however, exists cross-nationally (Alexander, Weiner, Shortell, & Baker, 2007).
Alexander, J. A., Weiner, B. J., Shortell, S. M., & Baker, L. C. (2007, Spring). Does Quality Improvement
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