ARE ALL CONSUMERS
EQUAL?
Navneet Kathuria, MD, MPH, MBA,
VP, Population Health and Clinical Quality,
Meridian Health
Overview

Definitions
 Health
 Population
 Consumer
 Provider
 Patient
Average Health Care Spending per Capita, 1980–2012
Adjusted for Differences in Cost of Living
Dollars ($US)
* 2011.
Source: OECD Health Data 2014.
Health Care Spending as a Percentage of GDP, 1980–2012
Percent
GDP refers to gross domestic product.
Source: OECD Health Data 2014.
Spending per Hospital Discharge, 2012
Adjusted for Differences in Cost of Living
Dollars ($US)
* 2011.
** 2010.
Source: OECD Health Data 2014.
Mortality Amenable to Health Care
Deaths per 100,000 population*
1997–98
150
2006–07
134
109
99
100
88
89
76
81
116
127
115
106
113
97
97
88
50
55
120
57
60
61
61
AUS
ITA
JPN
SWE
64
66
67
74
76
77
78
FIN
GER
GRE
IRL
79
80
83
DEN
UK
96
0
FR
NOR NETH AUT
* Countries’ age-standardized death rates before age 75; including ischemic heart disease,
diabetes, stroke, and bacterial infections. Analysis of World Health Organization mortality files
and CDC mortality data for U.S.
Source: Adapted from E. Nolte and M. McKee, “Variations in Amenable Mortality—Trends in 16
High-Income Nations,” Health Policy, published online Sept. 12, 2011.
NZ
US
Efficiency = Medicare Spending Per
Beneficiary (MSPB)
Navneet Kathuria, MD, MPH, MBA
013
07
07
07
1.04
VIRTUA WEST JERSEY HOSPITALS BERLIN
1.03
Efficiency = Medicare Spending
Per
1.03
Beneficiary (MSPB)
1.03
CAPITAL HEALTH MEDICAL CENTER - HOPEWELL
DEBORAH HEART AND LUNG CENTER
HUNTERDON MEDICAL CENTER
INSPIRA MEDICAL CENTER WOODBURY
1.03
KENNEDY UNIVERSITY HOSPITAL - STRATFORD DIV
1.03
06
OUR LADY OF LOURDES MEDICAL CENTER
1.03
06
MEMORIAL HOSPITAL OF SALEM COUNTY
1.02
06
INSPIRA MEDICAL CENTER ELMER
1.01
05
NEWTON MEDICAL CENTER
1.01
05
LOURDES MEDICAL CENTER OF BURLINGTON COUNTY
1.00
05
ST LUKE'S WARREN HOSPITAL
1.00
05
SHORE MEDICAL CENTER
0.99
04
CAPE REGIONAL MEDICAL CENTER INC
0.98
07
1.05 to 1.09
1.02 to 1.04
04
04
0.99 to 1.01
04
04
0.96 to 0.98
03
03
03
03
03
=> 1.10
Navneet Kathuria, MD, MPH, MBA
Daily Sugar Consumption
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Alcohol Consumption
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Top 10 causes
of disease
1900
vs. 2010
Top 10 Causes
of Death: 1900
vs. 2010.
Jones DS et al. N Engl J Med 2012;366:2333-2338.
Population Health
Navneet Kathuria, MD, MPH, MBA
Definition of Health
WHO – formulated in 1948, “state of complete
physical, mental and social well-being and not merely
the absence of disease or infirmity”
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Navneet Kathuria
Defining Populations









Geographic
State of Health
Disease State
Access method
Contracted Financial Risk
Gender
Age
Hair Color, Eye Color, etc
Genetic trait
Navneet Kathuria, MD, MPH, MBA
Patient - Consumer

Consumer
a
person who buys and uses up goods
 Original

meaning - expend by use
Patient
a
person who is under medical care or treatment
 a person or thing that undergoes some action
 Original
meaning – one who suffers
Navneet Kathuria
Patient - Consumer


The “empowered patient” movement encourages patients to
become hyper-informed and to take control over their care.
But providing greater information, access and autonomy — so
often successful in consumer settings — does it drive better
care or experience.
Treating patients as typical proactive, in control, well-informed
consumers requires them to take on increasingly complex
decisions and digest ever-larger amounts of information, the
consumer find themselves placed — often by design — in the
driver’s seat.
 High-deductible insurance plans
 Genetic testing
Navneet Kathuria
Patient - Consumer



Patients don’t want to be there: People seek out healthcare
when something is wrong and patients want to solve it and get
back to normal.
Patients aren’t equipped to be there: Even when patients are
willing to be decision makers, they may not have the tools. At a
time of unusual stress, the system asks them to absorb technical
information and make difficult decisions that require
specialized expertise.
Patients aren’t in it alone: To design for patients alone is to
forget that they are part of a complex system and aren’t often
independent decision-makers.
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Consumption

Consumer spending, consumer demand,
consumption, or consumption expenditure is the
purchasing of goods and services by individuals or
families. It is the largest part of aggregate demand
at the macroeconomic level. There are two
components of consumption in the basic model:
induced consumption (which is affected by the level
of income) and autonomous consumption (which is
not).
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The Holy Grail
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