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1950s
In the early 1950s, homes of patients were the most frequent
site of healthcare delivery and only the sickest people or the dying were hospitalized. Healthcare was paid for out of pocket. -
1966
The Medicare and Medicaid programs established in 1966 provided a clear stream of income for hospitals as they were reimbursed for providing health care under these programs. These programs promoted the explosion of costs in the healthcare industry. -
1984
In an effort to mandate cost containment, diagnosis-related groups (DRGs) were established in 1984 to provide a payment threshold
for reimbursement based on medical diagnosis. This program motivated hospitals to reduce stays and thus expenses: hospitals were reimbursed based on a fixed cost associated with the diagnosis, and early discharges resulted in lower expenditures and thus promoted profits. -
2004
Recognizing the need for improved patient safety, reduction in healthcare costs, and the need for seamless information exchange, in 2004 President Bush called for the development and implementation of the electronic health record (EHR) for all Americans by 2014. The US healthcare system is making progress on this goal. -
The Future - over the next 2 decades
The use of Electronic Health Record (EHRs) and the increase in information
exchange across regional health information organizations (RHIOs) will produce changes in quality, safety, benchmarking, and efficiency of healthcare delivery. Genetic testing will help to make treatment approaches more personalized and lead to better matching between disease and medical intervention.