Place patients at the center of the acute health care system, says Ayanian

November 4, 2016

The acute health care system – what patients seek when they encounter an unexpected health problem – is currently plagued by "inefficiency, fragmentation, redudancy, and often long waits," write Keith E. Kocher and John Z. Ayanian in their October 30 article for The Conversation: “A fractured system: Where do you go when you suddenly need health care?”

Patients must decide between an array of providers, from community clinics to hospital emergency rooms. And upon arrival, care does not always come in a timely manner. Kocher and Ayanian propose a number of reforms to make the acute health care system simpler, cheaper, and more efficient.

Better communication and planning between providers can help. The authors point to the Netherlands for an example of doctors’ offices cooperating to provide after-hours care. Kocher and Ayanian also recommend making providers accountable for the quality of care. For instance, patient bills could be linked to the quality and timeliness of the care received.

“The focus should be on getting the most value for the services that patients receive when they seek care for their unexpected health needs. This includes getting proper care quickly at reasonable cost.” While the acute health care system is messy today, we can make it easier to navigate, they conclude. “Fundamentally, solutions begin by placing the patient at the center of the system.”

Dr. John Z. Ayanian is the Alice Hamilton Professor of Medicine at the Medical School, professor of health management and policy at the School of Public Health, and professor of public policy at the Ford School. He is director of U-M's Institute for Healthcare Policy and Innovation