title: Examining quality and efficiency of the U.S. healthcare system.
abstract: OBJECTIVE
  The fundamental concern of this research study is to learn the quality and efficiency of U.S. healthcare services. It seeks to examine the impact of quality and efficiency on various stakeholders to achieve the best value for each dollar spent for healthcare. The study aims to offer insights on quality reformation efforts, contemporary healthcare policy and a forthcoming change shaped by the Federal healthcare fiscal policy and to recommend the improvement objective by comparing the U.S. healthcare system with those of other developed nations.
  
  
  METHODS
  The US healthcare system is examined utilizing various data on recent trends in: spending, budgetary implications, economic indicators, i.e., GDP, inflation, wage and population growth. Process maps, cause and effect diagrams and descriptive data statistics are utilized to understand the various drivers that influence the rising healthcare cost. A proposed cause and effect diagram is presented to offer potential solutions, for significant improvement in U.S. healthcare.
  
  
  RESULTS
  At present, the US healthcare system is of vital interest to the nation's economy and government policy (spending). The U.S. healthcare system is characterized as the world's most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable. Major drivers of the healthcare costs are institutionalized medical practices and reimbursement policies, technology-induced costs and consumer behavior.
  
  
  CONCLUSIONS
  Reviewing many articles, congressional reports, internet websites and related material, a simplified process map of the US healthcare system is presented. The financial process map is also created to further understand the overall process that connects the stakeholders in the healthcare system. Factors impacting healthcare are presented by a cause and effect diagram to further simplify the complexities of healthcare. This tool can also be used as a guide to improve efficiency by removing the "waste" from the system. Trend analyses are presented that display the crucial relationship between economic growth and healthcare spending.
  
  
  CONCLUSIONS
  There are many articles and reports published on the US healthcare system. However, very few articles have explored, in a comprehensive manner, the links between the economic indicators and measures of the healthcare system and how to reform this system. As a result of the US healthcare system's complex structure, process map and cause-effect diagrams are utilized to simplify, address and understand. This study linked top-level factors, i.e., the societal, government policies, healthcare system comparison, potential reformation solutions and the enormity of the recent trends by presenting serious issues associated with U.S. healthcare.
authors.affiliation: Opus College of Business, University of St. Thomas, Minneapolis, Minnesota, USA. skumar@stthomas.edu
authors.forename: Sameer
authors.initials: S
authors.lastname: Kumar
authors.forename: Neha S
authors.initials: NS
authors.lastname: Ghildayal
authors.forename: Ronak N
authors.initials: RN
authors.lastname: Shah
mesh_terms: D017598:Efficiency, Organizational; D017048:Health Care Costs; D005102:Health Expenditures; D006282:Health Personnel; D006298:Health Services Administration / Q000191:economics* / Q000592:standards*; D006801:Humans; D007343:Insurance Carriers / Q000191:economics; D007348:Insurance, Health / Q000458:organization & administration; D008483:Medical Assistance / Q000458:organization & administration; D019300:Medical Errors / Q000191:economics; D011787:Quality of Health Care / Q000458:organization & administration*; D012111:Residence Characteristics; D014481:United States; D014493:United States Department of Veterans Affairs