title: Health Care Rationing in a Just Society: The Clinical Effectiveness Model.
abstract: Representing 18% of gross domestic product, and projected to increase to 20% by 2022, health care costs in the United States are an unsustainable expense. The clinical effectiveness model of cost containment is an ethical and self-sustaining paradigm that can assist bending the health care-cost curve. As envisioned by Buyx et al, clinically effective care is aimed at making the practice of medicine more explicitly evidence based with the goals of improving clinical success, efficiency, and value. I provide a vision for applying the clinical effectiveness model to the American health care system. I illustrate its use with 2 examples from the practice of child neurology: DOC-band (helmet therapy) for the treatment of positional plagiocephaly-relatively inexpensive but ineffective, and adrenocorticotropic hormone for the treatment of infantile spasms-expensive but effective.
authors.affiliation: Division of Neurology, Nationwide Children's Hospital-The Ohio State University, Columbus, OH; The Center for Pediatric Bioethics, Nationwide Children's Hospital, Columbus, OH. Electronic address: weisleder.1@osu.edu.
authors.forename: Pedro
authors.initials: P
authors.lastname: Weisleder
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000191:economics / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000191:economics*; D019317:Evidence-Based Medicine / Q000191:economics / Q000379:methods; D015276:Health Care Rationing / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D018803:Models, Economic; D049068:Plagiocephaly, Nonsynostotic / Q000191:economics / Q000628:therapy; D013036:Spasms, Infantile / Q000188:drug therapy / Q000191:economics; D014481:United States
chemical_list: D000324:Adrenocorticotropic Hormone