Appearing in the March/April 1997 issue of Public Health Reports
The United States spends close to one trillion dollars annually on health care yet cannot evaluate the impact of this spending on its population. According to Allyson Pollock, a British physician, and Dorothy Rice, the former director of the National Center for Health Statistics, surveys are expensive, rely on information from individuals and samples, and usually do not follow or track people over time. Surveys cannot answer the critical question of causality--does a particular treatment provide results? Are our health dollars being spent effectively? Surveys are a poor tool to explore the relationship between people's health and the health services they receive.
The United States is the only industrial country that continues to rely on surveys of the population to learn whether and how medical care affects our health.
The authors assert that the United States should adopt national health data standards and track individuals over time. The advantages of collecting data directly from health care providers and payers far outweigh the potential downside of employing national uniform standardized datasets.
The authors note the critical importance of a relatively unnoticed provision ("Administrative Simplification") of The Health Insurance Portability and Accountability Act (PL 104-191) that was signed into law late last year.
What is this law and what would it do? In an accompanying commentary, the answer is offered up by Philip R. Lee, who just retired from the post of Assistant Secretary for Health, and James Scanlon, Director of the Division of Data Policy in the Office of the Assistant Secretary for Planning and Evaluation. They spell out how the Administration is proposing to implement the Act's provisions for national health data standards and health information privacy.
ARTICLE CONTACT: Allyson Pollock, Department of Public health Sciences, St. George's Hospital Medical School; tel. 01-44-181-725-2796; fax 01-44-181-725-3584; e-mail <pollock@sghms.ac.uk>. Other author: Dorothy Rice, former Director of the National Center for Health Statistics and Professor Emerita, University of California, San Francisco.
COMMENTARY CONTACT: James Scanlon, Division of Data Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services; tel. 202-690-7100; fax 202-690-5882; e-mail <jscanlon@osaspe.dhhs.gov>.