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The article offers information on the updated position paper on the policies relating to HIV infection in the U.S. The position paper on HIV policy has been established in collaboration with the HIV Medicine Association of the Infectious Diseases Society of America and the American College of Physicians. The updated HIV policy highlights major advances on the treatment of HIV infection, the expansion of HIV as a pandemic and the prevalence of HIV transmission in health care settings. Details on these updates emphasizing public health and clinical imperatives in identifying HIV infection are discussed.

The article focuses on informed decision making in medical care when clinical evidence and conventional wisdom collide. It also discusses the U.S. Agency for Healthcare Research & Quality (AHRQ) involvement in exploring issues that impact clinical decision making under the AHRQ Effective Health Care (EHC) Program.

The article describes the American Dental Association's (ADEA) official statement and recommendations on the roles and responsibilities of academic dental institutions in improving the oral health in the U.S. ADEA believes that with the collaboration of communities of dental education and dental practice and other health professions, the oral health care needs of the poor will be met. The association's believes that academic dental institutions are the fundamental of the country's oral health.

Deals with the position paper presented to the President's Committee on Health Education in Boston, Massachusetts on January 6, 1972 concerning health promotion in the U.S. Basis of the health promotion recommendations of the paper; Importance of having a massive consumer health education effort; Establishment of state health education training centers.

Advises on the need for a physically fit health care professionals in the U.S. Citation of a case wherein a basic life support-certified nurse is physically unfit to do the job; Impact of being physically unfit on patients; Affirmation that professionals must comply with the Americans with Disabilities Act.

Abstract: Health information technology (HIT) has become a significant tool in medical practice, and public and international health. Much has been written about HIT and its implications on policy development in the management, practice, and delivery of health care. To better understand the implications on policy development of HIT, a limited literature search was conducted using key terms and a simple search engine. Twelve peer‐reviewed published papers were chosen based on keywords and citation frequency from 2000 to 2012. Twelve papers were reviewed. The implications toward policy formulation based on the search terms and the number of citations the paper had from its initial appearance in the literature are presented. The range of citations is 379 to 2. Citation frequency improves over time and in this case, a low citation number reflects relatively recent publication. HIT is a significant tool in healthcare at all levels. Innovation since 2000 has rapidly outpaced technological innovation prior this decadal review. Policy formulation can be impacted by HIT as well as other innovation. However, the current policy framework is not adept to support the accelerated rate of change. The scholarly publications presented here highlight the impact HIT can have on policy and the need to amend the current policy framework. [ABSTRACT FROM AUTHOR]

Among OECD nations, the United States is an outlier in having the highest per capita health care costs in a system that unnecessarily exposes many individuals to financial hardship, physical suffering, and even death. President Obama and Congress are currently involved in a process to reform the flawed health care system. The OECD has contributed to that process by releasing a paper, "Health Care Reform in the United States," which describes some of the problems that must be addressed, but then provides proposed solutions that omit consideration of a more equitable and efficient universal public insurance program. The same omission is taking place in Washington, DC. By reinforcing proposals that support the private insurance industry, the source of much of the waste and inequities in health care, the authors of the OECD paper have failed in their responsibility to inform on policies rather than politics. [ABSTRACT FROM AUTHOR]

The Migrant Protection Protocols (MPP) and border closure to asylum seekers during the COVID-19 pandemic created a humanitarian crisis at the U.S.-Mexico border. This paper outlines the public health challenges and health care access barriers for asylum seekers living in a tent encampment in Matamoros, Mexico resulting from these policies. Thirty participants, including asylum seekers (n=20) and health care professionals (n=10) in the Matamoros asylum camp, were interviewed. Public health challenges included environmental exposures and inadequate infrastructure; poor sanitation and disease control; and limited safety, nutrition, education, and employment. Health care access barriers included lack of continuity of care and emergency services, resource insufficiencies, and interpersonal barriers. Policy responses to address these challenges include outlawing MPP and other immigration policies that infringe on human rights, collaborating with international partners, and implementing more creative and community-based approaches to asylum processing. [ABSTRACT FROM AUTHOR]

The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders' children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods. [ABSTRACT FROM AUTHOR]

Background: The Implementation Research Institute (IRI) provides two years of training in mental health implementation science for 10 new fellows each year. The IRI is supported by a National Institute of Mental Health (NIMH) R25 grant and the Department of Veterans Affairs (VA). Fellows attend two annual week-long trainings at Washington University in St. Louis. Training is provided through a rigorous curriculum, local and national mentoring, a 'learning site visit' to a federally funded implementation research project, pilot research, and grant writing. Methods: This paper describes the rationale, components, outcomes to date, and participant experiences with IRI. Results: IRI outcomes include 31 newly trained implementation researchers, their new grant proposals, contributions to other national dissemination and implementation research training, and publications in implementation science authored by the Core Faculty and fellows. Former fellows have obtained independent research funding in implementation science and are beginning to serve as mentors for more junior investigators. Conclusions: Based on the number of implementation research grant proposals and papers produced by fellows to date, the IRI is proving successful in preparing new researchers who can inform the process of making evidencebased mental healthcare more available through real-world settings of care and who are advancing the field of implementation science. [ABSTRACT FROM AUTHOR]

As of November 2020, the United States leads the world in confirmed coronavirus disease 2019 (COVID-19) cases and deaths. Over the past 10 months, the United States has experienced three peaks in new cases, with the most recent spike in November setting new records. Inaction and the lack of a scientifically informed, unified response have contributed to the sustained spread of COVID-19 in the United States. This paper describes major events and findings from the domestic response to COVID-19 from January to November 2020, including on preventing transmission, COVID-19 testing and contact tracing, ensuring sufficient physical infrastructure and healthcare workforce, paying for services, and governance. We further reflect on the public health response to-date and analyse the link between key policy decisions (e.g. closing, reopening) and COVID-19 cases in three states that are representative of the broader regions that have experienced spikes in cases. Finally, as we approach the winter months and undergo a change in national leadership, we highlight some considerations for the ongoing COVID-19 response and the broader United States healthcare system. These findings describe why the United States has failed to contain COVID-19 effectively to-date and can serve as a reference in the continued response to COVID-19 and future pandemics. [ABSTRACT FROM AUTHOR]

The article presents news briefs regarding community health nursing. A report which has been released by the Centers for Disease Control and Prevention (CDC) regarding the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) is discussed. Guidelines which have been provided by the American Nurses Association (ANA) regarding the way in which health care workers should respond to emergencies and disasters are mentioned.

Public health officials promoted COVID-19 vaccines to limit burdens placed on the U.S. healthcare system and end the pandemic. People in some closed religious communities refused to vaccinate and likely acquired temporary immunity through infection. This paper compares the death rates in Amish, Old Order Mennonites, and conservative Mennonite groups to a rate estimated for the U.S. population. Approximately two-thirds of the U.S. population was immunized against COVID-19, while few in the Amish/Mennonite community were. We find divergent patterns. Once vaccines became available, excess deaths declined in the general population and remained elevated among Amish and Mennonites. Vaccination campaigns must consider and value the cultural beliefs of closed religious communities to be effective. [ABSTRACT FROM AUTHOR]

This paper explores the issue of identifying prescription opioid abuse in the healthcare setting and potential strategies to address this nationwide problem. In particular, this article examines existing literature focusing on opioid abuse and possible prevention methods to address this epidemic in the U.S. Using literature reviews accompanied by interviews from healthcare professionals who shared their experiences about the problems they face in their practices, this study found that the complexity of opioid abuse requires a more universal approach and some form of intervention from the outside. One inspiration for a solution comes from the Mandatory Reporting of abuse for children implemented by many professionals in California. This paper suggests a variation of the Mandatory Reporting, adapted for opioid abuse that involves education and public involvement, harsher consequences for professionals for failure to report opioid abuse, as well as involvement from the federal government in the form of legislation. [ABSTRACT FROM AUTHOR]

The article presents comments to the article entitled "Measuring the Health of the U.S. Population," by David M. Cutler and Elizabeth Richardson. According to Theodore E. Keeler, the paper opens up a new way of looking at health in economic terms, both over time and across populations. He also thinks the use of the National Health Interview Survey Data to determine the effects of chronic illness on well-being is clever. According to Douglas Staiger, the authors are very clear about what is being measured. He also emphasizes the importance of the specifics of the health capital calculation.

Big Data promises to heal many of the complex problems in healthcare. Departing from conventional ways of thinking about what constitutes relevant health data and how to analyze it, data-intensive resourcing entails different practices of collecting, sorting, circulating, and interpreting data, while making it available to multiple users. In the process, big data and the infrastructures instilled to support it are creating new forms of value and reordering relationships as distinctions between medical and nonmedical data and research and care are blurred. This paper situates big data in healthcare within social-political and economic conditions in the U.S., and charts emerging assemblages in order to make visible the cultural work that big data does in healthcare. [ABSTRACT FROM AUTHOR]

In this paper we propose an empirically implementable measure of aggregate-level efficiency along the lines of Debreu’s (1951) coefficient of resource utilization but restricted to the production side. The efficiency measure is based on directional distance functions, which allows the overall measure of efficiency to be decomposed into measures of technical and “structural” efficiency. The latter measure, which captures inefficiencies associated with the organization of production within an industry, is further decomposed into measures of scale and mix efficiency. The measures developed in the paper are illustrated using U.S. hospital data. The illustration sheds light on the efficacy of certificate of need (CON) regulations. [ABSTRACT FROM AUTHOR]

Fraud and abuse have led to significant additional expense in the health care system of the United States. This paper aims to provide a comprehensive survey of the statistical methods applied to health care fraud detection, with focuses on classifying fraudulent behaviors, identifying the major sources and characteristics of the data based on which fraud detection has been conducted, discussing the key steps in data preprocessing, as well as summarizing, categorizing, and comparing statistical fraud detection methods. Based on this survey, some discussion is provided about what has been lacking or under-addressed in the existing research, with the purpose of pinpointing some future research directions. [ABSTRACT FROM AUTHOR]

The 2nd American Samueli Institute symposium was held January 22-25, 2004. The focus of this meeting was an exposition of optimal healing environments (OHE) in American health care. Fifty-five (55) invited guests participated; most had written one of the papers in this Supplement. The conduct of the meeting revolved around small group discussions and two plenary sessions. The ensuing dialogue refined and organized the definitions, components, and research protocols associated with creating and implementing an OHE. This Supplement contains both the invited papers and an abstract of the plenary session discussions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article reports on the announcement of Vision Care Section of the American Public Health Association in the U.S. of its awards program for 1987. The association solicits nominations in the three categories of awards including distinguished achievement, outstanding student and outstanding paper or project. The distinguished achievement award is the highest honor bestowed by the Vision Care Section, designed to recognize the leaders in vision care and public health. The outstanding student award provides recognition to a student who has demonstrated the ability in the promotion of vision care in the public health field. The paper or project award is designed to recognize an individual, institution, or group that have significantly contributed to the advancement of vision care.

The widespread adoption of science-based prevention requires local infrastructures for prevention service delivery. Communities That Care (CTC) is a tested prevention service delivery system that enables a local coalition of community stakeholders to use a science-based approach to prevention and improve the behavioral health of young people. This paper uses data from the Community Youth Development Study (CYDS), a community-randomized trial of CTC, to examine the extent to which better internal team functioning of CTC coalitions increases the community-wide adoption of science-based prevention within 12 communities, relative to 12 matched comparison communities. Specifically, this paper examines the potential of both a direct relationship between coalition functioning and the community-wide adoption of science-based prevention and a direct relationship between functioning and the coalition capacities that ultimately enable the adoption of science-based prevention. Findings indicate no evidence of a direct relationship between four dimensions of coalition functioning and the community-wide adoption of a science-based approach to prevention, but suggest a relationship between coalition functioning and coalition capacities (building new member skills and establishing external linkages with existing community organizations) that enable science-based prevention. [ABSTRACT FROM AUTHOR]

Health planning in this paper is considered as a developmental process in which different types of planning appear at different times. These types are discussed and the place in the complex health care system developing in the United States is assessed. [ABSTRACT FROM AUTHOR]

Predictions that measles would be eradicated through vaccination have not been fulfilled. The reasons for this failure are analyzed in this paper, and the possibilities for successful action against measles are outlined. [ABSTRACT FROM AUTHOR]

Mass care on an epic scale -- we thought we had seen it all during Hurricanes Katrina, Rita, Ike and then Sandy. However, catastrophic scales reached a new level during Hurricane Harvey. How did the response and recovery to Harvey differ from previous hurricane events and what lessons were (and were not) learned? This paper examines the impact on the delivery of medical care to the vulnerable populations in Harvey's path. [ABSTRACT FROM AUTHOR]

The article presents author's comments on the Health Services Research exploiting the membership on a committee that advises Medicare on administered pricing system for physician services in Medicare Part B. It mentions that the traditional fee-for-service Medicare program depends on administered prices. It focuses on the Specialty Society Relative Value Scale Update Committee (RUC) and the U.S. Centers for Medicare & Medicaid Services (CMS).

Purpose: As of 2016, an estimated 15.5 million cancer survivors were living in the United States and the number of cancer survivors is expected to increase to 20.3 million by 2026. Numerous clinical studies have shown that comorbidities, such as obesity and diabetes, and unhealthy lifestyle choices, such as physical inactivity and heavy smoking, negatively influence overall quality of life and long-term survival of cancer survivors. Accordingly, survivorship programs seek to focus on overall wellness, including symptom management, monitoring for late effects of treatment, monitoring for recurrence, helping patients adapt healthy behaviors, and quality of life. This paper provides a broad overview of public health efforts to address the needs of cancer survivors.Methods: To describe a range of examples of survivorship initiatives in comprehensive cancer control, we analyzed documents from comprehensive cancer control programs and coalitions and solicited detailed examples from several national partners.Results: Comprehensive cancer control programs, coalitions, and partners are undertaking myriad initiatives to address cancer survivorship and building upon evidence-based interventions to promote healthy behaviors for cancer survivors across the country.Conclusion: A coordinated public health approach to caring for the growing population of cancer survivors can help address the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families. [ABSTRACT FROM AUTHOR]

Opioids are highly addictive drugs that place patients at risk for abuse, misuse, dependence, and death. Over the last 20 years, there has been a dramatic rise in opioid-related-deaths in the United States. This paper explores ten observational studies that discuss the clinical, economic, and social impact of the opioid crisis in the United States. The purpose of this literature review was to better understand the recent findings on the opioid crisis and explore the extent of the issue. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine relationships between internationally educated nurses’ (IENs’) performance in a registered nurse competency assessment process and the outcomes of their nursing registration applications. Assessments of nursing practice competencies, IEN applicant characteristics and registration outcomes were explored.Design/methodology/approach This is a secondary statistical analysis of a subset of IEN application data from a previous study in combination with assessment data from an additional database. Application data between 2008 and 2011 were analyzed using univariate/bivariate analyses and regression models to explore the relationship of performance in the assessment process and outcomes of the registration process.Findings Competency categories IEN applicants had difficulties with (from least to most) were Professional Responsibility and Accountability, Ethical Practice, Self-Regulation, Service to the Public, Knowledge-Based Practice: Specialized Body of Knowledge and Knowledge-Based Practice: Competent Application of Knowledge. IENs educated in the UK and USA had the highest scores and odds of meeting competencies. Applicants educated in India and Asia had lower scores and odds ratios. All national entry-to-practice examination and registration eligibility competencies were significantly related to registration outcomes. Applicants passing the exam had higher competency scores while applicants ineligible for registration had lower competency scores.Research limitations/implications Limitations include integrity of data extracted from active databases, IEN motivation to complete the RN registration process and conversion of assessment scales for research analysis.Originality/value Results inform regulation policies that improve IEN registration processes and may be informative to regulators, assessment centers, educational institutions and IENs. [ABSTRACT FROM AUTHOR]

Objectives: To examine: (1) what elements of patient-centered medical homes (PCMHs) are typically provided to low-income populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for low-income groups.Data Sources/study Setting: Existing literature on PCMH utilization among health care organizations serving low-income populations.Study Design: Systematic review and meta-analysis.Data Collection/extraction Methods: We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low-income populations. A total of 434 studies were reviewed. Thirty-three articles met eligibility criteria.Principal Findings: Patient-centered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range -0.965 to 1.42). PCMH patients had better clinical outcomes (d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms (d = -0.248), but there were apparent limitations in study quality.Conclusions: Evidence shows that the PCMH model can increase health outcomes among low-income populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed. [ABSTRACT FROM AUTHOR]

Multi-institutional arrangements in the health care industry have grown rapidly over the past 10 years. This paper provides a literature review and a research proposal concerning the managerial aspects of this phenomenon. [ABSTRACT FROM AUTHOR]

Background. One in 5 people in the United States live with disability; however, the public health needs of this community have been largely overlooked. Although U.S. law mandates the availability of accessible medical exam equipment, people with mobility disabilities (PWMD) frequently encounter barriers that require self-advocacy to receive basic primary care. Objective. The purpose of this study was to qualitatively explore the impact of healthcare access barriers—specifically, the experiences of the need to self-advocate and factors that inform decisions to make accommodation requests—for PWMD. Methods. Qualitative semistructured interviews were performed across two phases of data collection with each of the 6 participants. Interpretative phenomenological analysis was used to highlight the essence of participants' experiences in making decisions to request healthcare accommodation. Results. Participants included a purposive sample of self-advocates with physical disabilities (3 men and 3 women). While individual approaches to self-advocacy varied, participants identified a process of "recognizing the normalization of disability discrimination and disability stigma" which necessitates the development of "agency in self-advocacy." This process has a lasting impact on people that includes a shared embodied experience of disability, as well as a sense of empowerment based on their collective and individual identities. Conclusions. Findings have implications for supporting individual disability consumer advocacy efforts as well as the need to address the normalization of disability discrimination within healthcare systems levels. [ABSTRACT FROM AUTHOR]

ddressing asthma from a public health perspective is a relatively new concept for which the literature provides little guidance. A public health approach seeks to decrease the burden of asthma and improve health outcomes at the population level, such as communities, cities, or states, by reaching large numbers of individuals with effective interventions and at reasonable cost. Projects designed to achieve a measureable impact at the population level are fundamentally different from projects or interventions designed to improve outcomes among individuals. This paper uses the experience of the Controlling Asthma in American Cities Project and a review of the relevant literature to explore some of the unique questions and considerations that are implicit when planning large-scale asthma projects intended to improve population outcomes. The paper is intended to inform decision making by local and state government agencies, managed care organizations, health systems, community coalitions, and funders. Analysis of asthma and other chronic disease projects aiming to achieve population-level impact is an area for continued public health research. [ABSTRACT FROM AUTHOR]

This expository paper describes an innovative Scripps designed supported employment program, using an evidence-based practice model based on recovery by Scripps Behavioral Health Services staff to fill a gap in the continuum of care for Behavioral Health Services. The A-Visions Program was also developed to increase offerings to mental health consumers (typically those with serious and persistent mental illness) struggling to find help in an under funded, fragmented mental health system of care. The program has grown since its inception and has received commendations from external stakeholders. This paper reviews the prevalence of mental illness in the United States, a review of the classic and recent evidence-based literature, a comprehensive description of the program (including analyses of outcome measures), a plan to spread this innovation across the Scripps enterprise, and conclusions. Due to the success of the program in providing essential services to individuals with serious mental illness, the authors recommend replication in other Scripps facilities. The author makes a strong case for the spread of this innovation, as these services typically are not a part of the mental health care continuum. These program development strategies are replicable in other mental health programs. [ABSTRACT FROM AUTHOR]

Introduction: Sustainable service delivery is a major challenge in the HIV response that is often not adequately addressed in project implementation. Sustainable strategies must be built into project design and implementation to enable HIV efforts to continue long after donor-supported projects are completed. Case description: This paper presents the experiences in operational sustainability of Family Health International's Zambia Prevention, Care and Treatment Partnership in Zambia, which is supported by the US President's Emergency Plan for AIDS Relief through United States Agency for International Development (October 2004 to September 2009). The partnership worked with Zambia's Ministry of Health to scale up HIV clinical services in five of the country's nine provinces, reaching 35 districts and 219 facilities. It provided technical and financial support from within the ministry's systems and structures. By completion of the project, 10 of the 35 districts had graduated beyond receiving ongoing technical support. Discussion and evaluation: By working within the ministry's policies, structures and systems, the partnership was able to increase the ministry's capacity to add a comprehensive HIV service delivery component to its health services. Ministry structures were improved through renovations of health facilities, training of healthcare workers, procurement of essential equipment, and establishment of a quality assurance plan to ensure continued quality of care. The quality assurance tools were implemented by both the ministry and project staff as the foundation for technical graduation. Facilities that met all the quality criteria for more than six months were graduated from project technical support, as were districts where most supported facilities met the criteria. The district health offices then provided ongoing supervision of services. This predetermined "graduation" exit strategy, with buy in of the provincial and district health offices, set the stage for continued delivery of high-quality HIV services. Conclusions: Achieving operational sustainability in a resource-limited setting is feasible. Developing and institutionalizing a quality assurance/quality improvement system is the basis on which facilities and districts can move beyond project support and, therefore, sustain services. Quality assurance/quality improvement tools should be based on national standards, and project implementation should use and improve existing health system structures. [ABSTRACT FROM AUTHOR]

In Australia we have become preoccupied with the potential adverse impact of our ageing population on our health and social systems. The projected cost of having increasing proportions of our population in the over 70s, retired, chronically ill category of the demographic profile is emerging as a major challenge for governments and private insurers: so much so in fact that the government is now urging older people to stay at work longer. In America, new approaches to the management and self-management of chronic diseases have been invoked to encourage and support older people to improve their quality of life and reduce their recourse to and dependence upon health care technologies, clinical interventions and health care management systems. Unless this is achieved, it is argued, the cost of looking after this emerging ‘bubble’ of elderly people will become increasingly unsustainable as fewer and fewer (proportionately) younger people work to pay the taxes that support ageing, retired, sick and dependent populations. This paper argues that we are at real risk of having our economic wealth and productivity impeded and truncated by the financial burden of looking after high demand and high cost dependants at the aged end of the social demographic. This paper offers an alternative view of our ageing population, as well as highlighting some of the assets we have in our elderly populations, and providing suggestions as to an alternative view of the phenomenon of ageing that incorporates elements such as flexible working arrangements and the application of new, enabling technologies. This approach to our ageing population dilemma is predicated on a concept of lifelong learning and social participation along with better preventive and early intervention systems of health care. [ABSTRACT FROM AUTHOR]

The introduction of the Medical Reserve Corps (MRC) programme in President Bush's 2002 State of the Union address was in response to the need to provide a platform for local medical and health professionals to volunteer in their local communities in times of need. In such times, local community-based MRC units would work with existing public health and emergency management resources to create programmes to organise and recruit volunteers to support community needs. Now over five years old, the MRC programme has grown from 166 units as part of a demonstration project to almost 700 local units with more than 127,000 volunteers. In addition, the programme has evolved into a community health response resource that is used throughout the year, not just during times of great need. This paper will discuss the background and concept of the MRC programme, as well as describe how interested individuals and communities can get involved. The paper will also highlight the types of activities in which MRC units are involved and lessons learned. [ABSTRACT FROM AUTHOR]

Health information technology research has historically suffered from the persistence of paper-based systems as a barrier to research and refinement of information models. While the field of (non-medical) information science offers a potentially rich source of data, there exist relatively few theoretical links between medical and non-medical information models. This paper argues that the establishment of an integrated translational research pathway is not only useful, but is a critical and necessary step in the realization of a national health information infrastructure in the USA. [ABSTRACT FROM AUTHOR]

This paper investigates the switching behavior of enrollees in U.S. managed care plans through treatment effect analyses of the disaggregated expenditures of the plan switchers and stayers prior to switching. Propensity score matching methods are used to estimate the average treatment effects on the treated where switching is the treatment. Analyses on subsamples provide detailed insights into pre-switch consumption behavior. The results, which are based on a national representative data set from the Medical Expenditure Panel Survey, indicate that switchers (from HMO to non-HMO) spend more on hospitalization, utilize less cholesterol checks and flu shots before switching. The other type of switchers (from non-HMO to HMO) spends less on prescribed medicine and office-based physician visits, while female switchers use less breast exams, Pap smears and mammograms prior to switching. The findings suggest that the non-HMO private managed care plans provide better coverage on hospitalization, office-based physician visits and prescribed medicine than the HMO plans. [ABSTRACT FROM AUTHOR]

Purpose – Healthcare is an ever-growing segment of the American economy. Transparency facilitates better decision-making and better outcomes measures. The purpose of this paper is to present the human and economic results of increasing transparency. Design/methodology/approach – The ASIMP Working Group on Healthcare Transparency represents a diverse yet conscilient group of practitioners, researchers, regulators, economists, and academics. Given the need for re-envisioning healthcare to include more accountability, evidence of efficacy and transparency, this integrative medicine (ASIMP) working group is suitable to address the above purpose. Findings – Substantial opportunity exists to reduce morbidity and mortality, suffering and excess death, unnecessary costs and risks. Greater transparency facilitates the transition to safer, more effective, more humane healthcare. Research limitations/implications – This paper starts from a need to improve clinical outcomes and value for resources devoted. Best efforts of a national working group are presented. The implications of the report, when tested, will determine the enduring value of this work. Practical implications – Consumers and business, administrators and practitioners can improve care at lower cost by increasing transparency. This will accelerate the diffusion of effective approaches that are not yet in widespread use despite replication of efficacy. Originality/value – This is the first time an integrative approach has been compared with conventional healthcare models, particularly with regard to the role of transparency in heaithcare management. [ABSTRACT FROM AUTHOR]