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J Thorac Cardiovasc Surg 2007;133:601-602
© 2007 The American Association for Thoracic Surgery

Statistics for the Rest of Us

The cost and value of cardiothoracic procedures

Albert Starr, MD*, Gary L. Grunkemeier, PhD

Providence Heart and Vascular Institute, Providence Health System, Portland, Ore.

Received for publication April 17, 2006; accepted for publication April 24, 2006.

* Address for reprints: Albert Starr, MD, Director, Providence Heart and Vascular Institute, 9155 SW Barnes, Suite 240, Portland, OR 97225. (Email: Astarr@starrwood.com).

The first 20% of the full text of this article appears below.

GoThe United States has the highest per capita expenditure for medical care in the world.1Go This is very likely due in part to the greater per capita delivery of new expensive high technology in medicine. The delivery of medical care in the United States is addressed through a profound and increasing redistribution of wealth. In 2003, 46% of our $1.68 trillion health bill was paid by public funds (32% federal, 13% state and local) and only 54% from private funds (private health insurance, out-of-pocket payments).2Go The delivery system must be held accountable for these societal costs and keep track of the value it adds to the American economy. This financial stewardship must be added to our long-term follow-up systems.

Cardiothoracic surgery . . . [Full Text of this Article]


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