This article explores the current state of the creation and use of evidence by managers for cost containment in hospitals. We assert that hospitals do not know enough about what things cost, and until they get evidence on costs, it is not likely that much can be done to narrow the chasm between common practice and best practice. Part of the problem is that managers do not seek out available evidence that exists, and part of the problem is a lack of sufficient research efforts to generate evidence for managers to use. The article strives to help direct future efforts by researchers and managers in the area of evidence-based cost containment research by presenting a framework for priorities that managers and researchers can use to increase the amount of research done to generate evidence and to increase the use of evidence by health care managers.
Steven A. Finkler, Ph.D., CPA, is Director of the Specialization in Public Finance and Financial Management, and Professor of Public and Health Administration, Accounting and Financial Management, Program in Health Policy and Management, The Wagner School, New York University, New York.
David M. Ward, Ph.D., is Chairman and Associate Professor, Department of Health Administration and Policy, Medical University of South Carolina, Charleston, South Carolina.
The authors are indebted to Douglas Conrad, Tony Kovner, and the anonymous journal reviewers for their helpful comments. This article was written for presentation at the Agenda Setting for Health Care Management Research Conference held at the Wagner School, New York University, in January 2003, sponsored by the Agency for Health Research and Quality (AHRQ) and with support from Wellpoint Health Networks.