Tom Robertson, Executive Director of the Vizient Research Institute sits down with Mark Wietecha, CEO of the Children’s Hospital Association to discuss the similarities and differences between adult medicine and pediatrics, with particular attention to settings involving tertiary care, research and education. Mark describes epidemiological differences between adult and pediatric populations and discusses the implications for health system design. The session closes with a conversation around social determinants of health and the poignant topic of end-of-life care.
Mark Wietecha, MS, MBA
Children’s Hospital Association
Vizient Research Institute
[01:40] Health care affordability is impacted by the costs associated with investments in technological advancements that were made over the last 50 years.
[04:41] Healthcare costs can’t be carried at the social level which causes non-affordability at the individual level.
[07:15] The same exact medical service, when provided by several different sources, will yield an extremely wide variation of cost to the patient. Markets create health disparities.
[10:01] A core challenge of health care is that it was created in a culture of capitalism, which creates a competitive system.
[13:26] Under a rate-regulated model, the mindset of the provider community could shift to worrying about total cost of care.
[14:21] Large children’s hospitals in downtown areas tend to receive kids who can’t get care anywhere else
[16:04] Models need to take into account social and relational acuity, which may be far more important for children, and some adults, than medical acuity.
[17:01] In a rate-regulated world, providers will naturally go where cost is lowest in their portfolio.
[30:16] One thing we could learn from pediatric medicine is that intervention and early investment are part of a road map to thriving in life.
[35:52] In order to get closer to an accessible and affordable system, we must look at the whole person and whole community.
Links | Resources:
Mark Wietecha biographical information