Care of the Patient with Severe Chronic Illness-An Online Report on the Medicare Program is a key critical report completed in 2006 by the Dartmouth Atlas Project. It reports that: “Almost one-third of Medicare spending for chronically ill is unnecessary… A fundamental problem, and one that contributes to both overspending and worse outcomes, is that most acute care hospitals have become first-line providers of services to chronically ill elderly people, whose care would be better managed, safer and less expensive outside the hospital setting. . . . Staggering variations in how hospitals care for chronically ill elderly patients indicate serious problems with quality of care and point toward unnecessary spending by Medicare. Lower utilization of acute care hospitals and physician visits could actually lead to better results for patients and prolong the solvency of the Medicare program.” The study calls for overhauling how the nation manages chronic illness, and proposes that hospitals take leadership in redesigning how they care for the chronically ill.
The Dartmouth Atlas Project works to accurately describe how medical resources are distributed and used in the United States. The project offers comprehensive information and analysis about national, regional, and local markets, as well as individual hospitals and their affiliated physicians, in order to provide a basis for improving health and health systems. Through this analysis, the project has demonstrated glaring variations in how health care is delivered across the United States. The project is run by the Center for the Evaluative Clinical Sciences at Dartmouth Medical School, Hanover, N.H.