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Medical care ratio (MCR), also known as medical cost ratio, medical loss ratio, and medical benefit ratio, is a metric used in managed health care and health insurance to measure medical costs as a percentage of premium revenues. [1]
Health care cost as percent of GDP (total economy of a nation). [2] [3] Graph below is life expectancy versus healthcare spending of rich OECD countries. US average of $10,447 in 2018. [7] See: list of countries by life expectancy.
Length of stay is commonly used as a quality metric. [4] The prospective payment system in U.S. Medicare for reimbursing hospital care promotes shorter length of stay by paying the same amount for procedures, regardless of days spent in the hospital.
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As such, the ICER facilitates comparison of interventions across various disease states and treatments. In 2009, NICE set the nominal cost-per-QALY threshold at £50,000 for end-of-life care because dying patients typically benefit from any treatment for a matter of months, making the treatment's QALYs small. [3]
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In the United Kingdom, the National Institute for Health and Care Excellence (NICE), which advises on the use of health technologies within the National Health Service, used "£ per QALY" to evaluate their utility since its founding in 1999. [9] In 1989, the state of Oregon attempted to reform its Medicaid system by incorporating the QALY metric.
A complete compilation of cost-utility analyses in the peer-reviewed medical and public health literature is available from the Cost-Effectiveness Analysis Registry website. [ 6 ] A 1995 study of the cost-effectiveness of reviewed over 500 life-saving interventions found that the median cost-effectiveness was $42,000 per life-year saved. [ 7 ]