实际上，过去几年的支出模式存在冗余。然而，它给该国的财政造成了负担。2011年，医疗保健支出为3200亿美元，比2006年增加了500亿美元。2011年支出增长3.7%。这一比例已从2007年的5%下降。其中，肿瘤学支出约232亿美元(Bartholow, 2013)。呼吸道药物增加到8.8%，增加了210亿美元。其中，抗哮喘药物占了三分之二。调脂药物的销量增长了7.2%。抗糖尿病药物达到196亿美元(Bartholow, 2013)。增长10.7%。抗精神病药物的支出占182亿美元。研究发现，2011年，多发性硬化症治疗支出显著增加，占22.5% (Bartholow, 2013)。注意缺陷/多动障碍(ADHD)占17%，而非hiv靶向抗病毒药物占14.8%以上(Bartholow, 2013)。总体而言，药物使用率随就诊次数的增加而降低。但急诊科的入院人数显著增加。非急诊患者选择去急诊室而不是去看医生(Bartholow, 2013)。这是因为社会上失业率的高增长。非急诊医疗费用计入急诊医疗费用。这是卫生保健系统观察到的模式。
分析了不同医院开展养老服务的情况。特别关注照顾老年人的护理中心的费用。从这个分析中可以发现，在提高质量的同时降低成本的目标是一个非常艰巨的乌托邦式的任务(Litvak， & Long, 2000)。根据他们的健康状况，每个老年人都需要不同的护理。维持这种立场需要特定的干预措施，为患者开发治疗方案需要很高的成本。它的结论是，为减少该事务处的费用而采取的任何干预措施只会是有害的。在老年日托中心，成本优化是不可能的。另一项重要的结论是，任何减少照顾老年人所涉及的费用都只会减少这一进程所涉及的费用。通过对老年护理中心的分析，可以发现，在人口统计学上，参与老年护理的管理者根本没有意识到老年护理成本的必要性。因此，这些结果表明，只有增加资源的分配才能照顾老年人口。研究还表明，开发与现有系统完全不同的创新工具，可以为老年人提供更好的整体护理(Litvak， & Long, 2000)。在实现这一点之前，不可能降低向人民提供的保健质量方面的成本。迫切需要对该系统进行彻底的改革，以确保降低成本，同时提高为患者提供的护理质量(Litvak， & Long, 2000)。
In reality, there has been a redundancy in the spending patterns in the past few years. Nevertheless, it has been causing burden to the finances of the country. In 2011, the health care spending was $ 320 billion that had increased by 50 Billion dollars from 2006. Increase in spending has been 3.7% in the year 2011. This has been reduced from 5% from 2007. Of this, oncologies accounted for about $23.2 billion in spending (Bartholow, 2013). Respiratory agent drugs increased to 8.8% by 21 billion dollars. Anti asthmatic drugs accounted for two thirds of the opening. Lipid regulator drugs saw an increase of 7.2%. Antidiabetic agents reached $19.6 billion (Bartholow, 2013). This was up by 10.7%. Antipsychotics agents’ medication accounted for $18.2 billion in spending. It was found that in the year 2011, the spending increased significantly for treatment of multiple sclerosis which accounted for 22.5% (Bartholow, 2013). Attention-deficit/hyperactivity disorder (ADHD) accounted for 17% apart from this non- HIV–targeting antivirals accounted for more than 14.8% (Bartholow, 2013. Overall the medication utilization was decreased along with physician visit. But the emergency department admission increased significantly. People who had non-emergency conditions chose to visit the emergency room rather than going in for a doctor visit (Bartholow, 2013. This is because of the high rise in unemployment in the society. Non emergence medical care costs accounted towards the costs emergence care. This was the patterns that were observed by the health care system.
An analysis was conducted about the different hospitals who dealt with elderly care. Particular focus was given to the elderly care center costs that were involved in taking care of the seniors. It was found from this analysis that the goal of decreasing cost while improving quality was a herculean utopian task (Litvak, & Long, 2000). Each senior in the centers needed a different kind of care based on their health condition. Specific interventions were required to maintain this stance and it required high costs to develop the treatment for the patients. It concluded that any intervention that was taken to reduce the costs of the service would only be detrimental. Cost optimization was not possible in an elderly day care center. Another important conclusion that was drawn was any reduction in the cost involved in taking care of the senior of the population would only reduce the costs involved in the process. From analysis of the senior care center, it was proven that the managers who were involved in taking care of the seniors had fundamental lack of awareness of the necessity of costs involved in taking care of the seniors in the demography. Owing to this, these results indicated that there should only be an increase in the allocation of resources to take care of the elderly population. It also indicated that developing novel innovative tools that are completely different from the current system could provide with a better holistic care for the senior (Litvak, & Long, 2000). Until that is achieved, it is not possible to reduce costs in the quality of care provided to the people. There is an urgent need to overhaul the system to ensure cost reduction and also increase the quality of care provided to the patients (Litvak, & Long, 2000).