Sometimes, the system works

Time trends in outcome of subarachnoid hemorrhage: Population-based study and systematic review -- Lovelock et al. 74 (19): 1494 -- Neurology

It's an assumption that the high cost of intensive care, technology development and delivery results in improved care for patients. It's one of the features of all health care systems that I most admire: taking seemingly insurmountable and devastating diseases and working endlessly to find better ways to understand and treat disease. It's expensive with no guaranteed pay-off.

It's also an assumption that is under attack, as health care costs are increasingly scrutinized. In the zeal to cut costs, it's worthwhile to remember that sometimes, all of that technological advancement actually results in improved care. Subarachnoid hemorrhage, meaning an artery in your brain has burst, usually means death or worse, a twilight life without a well-functioning brain. All neurosurgeons are used to quoting the rule-of-thumb statistics to patients and their families to prepare them for an ordeal: "About half die before making it to the hospital, another half die in the hospital, and of those that survive, about two-thirds are severely disabled." The article above notes that while the incidence and severity of subarachnoid hemorrhage has not changed in 25 years, many many more people now survive (a 50% decrease in mortality), seemingly with less disability. What is that worth? Everything, if it is your family.