Institute of Medicine (U.S.). Committee on Quality of Health Care in America's Books

Improving Diagnosis in Health Care

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Committee on Diagnostic Error in Health Care

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Improving Diagnosis in Health Care

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Committee on Diagnostic Error in Health Care

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

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473

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National Academies Press

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ISBN 10

0309377692

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9780309377690

Variation in Health Care Spending

Target Decision Making, Not Geography

By: Institute of Medicine,Board on Health Care Services,Committee on Geographic Variation in Health Care Spending and Promotion of High-Value Care

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Variation in Health Care Spending

Target Decision Making, Not Geography

By: Institute of Medicine,Board on Health Care Services,Committee on Geographic Variation in Health Care Spending and Promotion of High-Value Care

Health care in the United States is more expensive than in other developed countries, costing $2.7 trillion in 2011, or 17.9 percent of the national gross domestic product. Increasing costs strain budgets at all levels of government and threaten the solvency of Medicare, the nation's largest health insurer. At the same time, despite advances in biomedical science, medicine, and public health, health care quality remains inconsistent. In fact, underuse, misuse, and overuse of various services often put patients in danger. Many efforts to improve this situation are focused on Medicare, which mainly pays practitioners on a fee-for-service basis and hospitals on a diagnoses-related group basis, which is a fee for a group of services related to a particular diagnosis. Research has long shown that Medicare spending varies greatly in different regions of the country even when expenditures are adjusted for variation in the costs of doing business, meaning that certain regions have much higher volume and/or intensity of services than others. Further, regions that deliver more services do not appear to achieve better health outcomes than those that deliver less. Variation in Health Care Spending investigates geographic variation in health care spending and quality for Medicare beneficiaries as well as other populations, and analyzes Medicare payment policies that could encourage high-value care. This report concludes that regional differences in Medicare and commercial health care spending and use are real and persist over time. Furthermore, there is much variation within geographic areas, no matter how broadly or narrowly these areas are defined. The report recommends against adoption of a geographically based value index for Medicare payments, because the majority of health care decisions are made at the provider or health care organization level, not by geographic units. Rather, to promote high value services from all providers, Medicare and Medicaid Services should continue to test payment reforms that offer incentives to providers to share clinical data, coordinate patient care, and assume some financial risk for the care of their patients. Medicare covers more than 47 million Americans, including 39 million people age 65 and older and 8 million people with disabilities. Medicare payment reform has the potential to improve health, promote efficiency in the U.S. health care system, and reorient competition in the health care market around the value of services rather than the volume of services provided. The recommendations of Variation in Health Care Spending are designed to help Medicare and Medicaid Services encourage providers to efficiently manage the full range of care for their patients, thereby increasing the value of health care in the United States.

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207

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National Academies Press

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ISBN 10

030928872X

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9780309288729

Unequal Treatment

Confronting Racial and Ethnic Disparities in Health Care (with CD)

By: Institute of Medicine,Board on Health Sciences Policy,Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care

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Unequal Treatment

Confronting Racial and Ethnic Disparities in Health Care (with CD)

By: Institute of Medicine,Board on Health Sciences Policy,Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

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781

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ISBN 10

030908265X

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9780309082655

Complementary and Alternative Medicine in the United States

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee on the Use of Complementary and Alternative Medicine by the American Public

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Complementary and Alternative Medicine in the United States

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee on the Use of Complementary and Alternative Medicine by the American Public

Integration of complementary and alternative medicine therapies (CAM) with conventional medicine is occurring in hospitals and physicians offices, health maintenance organizations (HMOs) are covering CAM therapies, insurance coverage for CAM is increasing, and integrative medicine centers and clinics are being established, many with close ties to medical schools and teaching hospitals. In determining what care to provide, the goal should be comprehensive care that uses the best scientific evidence available regarding benefits and harm, encourages a focus on healing, recognizes the importance of compassion and caring, emphasizes the centrality of relationship-based care, encourages patients to share in decision making about therapeutic options, and promotes choices in care that can include complementary therapies where appropriate. Numerous approaches to delivering integrative medicine have evolved. Complementary and Alternative Medicine in the United States identifies an urgent need for health systems research that focuses on identifying the elements of these models, the outcomes of care delivered in these models, and whether these models are cost-effective when compared to conventional practice settings. It outlines areas of research in convention and CAM therapies, ways of integrating these therapies, development of curriculum that provides further education to health professionals, and an amendment of the Dietary Supplement Health and Education Act to improve quality, accurate labeling, research into use of supplements, incentives for privately funded research into their efficacy, and consumer protection against all potential hazards.

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361

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National Academies Press

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ISBN 10

0309092701

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9780309092708

Primary Care

America's Health in a New Era

By: Institute of Medicine,Committee on the Future of Primary Care

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Primary Care

America's Health in a New Era

By: Institute of Medicine,Committee on the Future of Primary Care

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

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411

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0309175690

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9780309175692

Patient Safety

Achieving a New Standard for Care

By: Institute of Medicine,Board on Health Care Services,Committee on Data Standards for Patient Safety

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Patient Safety

Achieving a New Standard for Care

By: Institute of Medicine,Board on Health Care Services,Committee on Data Standards for Patient Safety

Americans should be able to count on receiving health care that is safe. To achieve this, a new health care delivery system is needed â€" a system that both prevents errors from occurring, and learns from them when they do occur. The development of such a system requires a commitment by all stakeholders to a culture of safety and to the development of improved information systems for the delivery of health care. This national health information infrastructure is needed to provide immediate access to complete patient information and decision-support tools for clinicians and their patients. In addition, this infrastructure must capture patient safety information as a by-product of care and use this information to design even safer delivery systems. Health data standards are both a critical and time-sensitive building block of the national health information infrastructure. Building on the Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Patient Safety puts forward a road map for the development and adoption of key health care data standards to support both information exchange and the reporting and analysis of patient safety data.

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551

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ISBN 10

0309090776

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9780309090773

Essential Health Benefits

Balancing Coverage and Cost

By: Institute of Medicine,Board on Health Care Services,Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans

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Essential Health Benefits

Balancing Coverage and Cost

By: Institute of Medicine,Board on Health Care Services,Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans

In 2010, an estimated 50 million people were uninsured in the United States. A portion of the uninsured reflects unemployment rates; however, this rate is primarily a reflection of the fact that when most health plans meet an individual's needs, most times, those health plans are not affordable. Research shows that people without health insurance are more likely to experience financial burdens associated with the utilization of health care services. But even among the insured, underinsurance has emerged as a barrier to care. The Patient Protection and Affordable Care Act (ACA) has made the most comprehensive changes to the provision of health insurance since the development of Medicare and Medicaid by requiring all Americans to have health insurance by 2016. An estimated 30 million individuals who would otherwise be uninsured are expected to obtain insurance through the private health insurance market or state expansion of Medicaid programs. The success of the ACA depends on the design of the essential health benefits (EHB) package and its affordability. Essential Health Benefits recommends a process for defining, monitoring, and updating the EHB package. The book is of value to Assistant Secretary for Planning and Evaluation (ASPE) and other U.S. Department of Health and Human Services agencies, state insurance agencies, Congress, state governors, health care providers, and consumer advocates.

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256

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ISBN 10

0309219140

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9780309219143

Retooling for an Aging America

Building the Health Care Workforce

By: Institute of Medicine,Board on Health Care Services,Committee on the Future Health Care Workforce for Older Americans

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Retooling for an Aging America

Building the Health Care Workforce

By: Institute of Medicine,Board on Health Care Services,Committee on the Future Health Care Workforce for Older Americans

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

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317

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ISBN 10

0309115876

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9780309115872

Race, Ethnicity, and Language Data

Standardization for Health Care Quality Improvement

By: Institute of Medicine,Board on Health Care Services,Subcommittee on Standardized Collection of Race/Ethnicity Data for Healthcare Quality Improvement

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Race, Ethnicity, and Language Data

Standardization for Health Care Quality Improvement

By: Institute of Medicine,Board on Health Care Services,Subcommittee on Standardized Collection of Race/Ethnicity Data for Healthcare Quality Improvement

The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.

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287

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National Academies Press

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ISBN 10

0309148669

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9780309148665

Performance Measurement

Accelerating Improvement

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

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Performance Measurement

Accelerating Improvement

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

Performance Measurement is the first in a new series of an ongoing effort by the Institute of Medicine (IOM) to improve health care quality. Performance Measurement offers a comprehensive review of available measures and introduces a new framework to examine these measures against the six aims of the health care system: health care should be safe, effective, patient-centered, timely, efficient, and equitable. This new book also addresses the gaps in performance measurement and introduces the need for measures that are longitudinal, comprehensive, population-based, and patient-centered. This book is directed toward all concerned with improving the quality and performance of the nation's health care system in its multiple dimensions and in both the public and private sectors.

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383

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ISBN 10

0309100070

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9780309100076

Insuring America's Health

Principles and Recommendations

By: Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance

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Insuring America's Health

Principles and Recommendations

By: Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance

According to the Census Bureau, in 2003 more than 43 million Americans lacked health insurance. Being uninsured is associated with a range of adverse health, social, and economic consequences for individuals and their families, for the health care systems in their communities, and for the nation as a whole. This report is the sixth and final report in a series by the Committee on the Consequences of Uninsurance, intended to synthesize what is known about these consequences and communicate the extent and urgency of the issue to the public. Insuring America's Health recommends principles related to universality, continuity of coverage, affordability to individuals and society, and quality of care to guide health insurance reform. These principles are based on the evidence reviewed in the committee's previous five reports and on new analyses of past and present federal, state, and local efforts to reduce uninsurance. The report also demonstrates how those principles can be used to assess policy options. The committee does not recommend a specific coverage strategy. Rather, it shows how various approaches could extend coverage and achieve certain of the committee's principles.

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225

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0309091055

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9780309091053

Monitoring HIV Care in the United States

A Strategy for Generating National Estimates of HIV Care and Coverage

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee to Review Data Systems for Monitoring HIV Care

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Monitoring HIV Care in the United States

A Strategy for Generating National Estimates of HIV Care and Coverage

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee to Review Data Systems for Monitoring HIV Care

In September 2010, the White House Office of National AIDS Policy commissioned an Institute of Medicine (IOM) committee to respond to a two-part statement of task concerning how to monitor care for people with HIV. The IOM convened a committee of 17 members with expertise in HIV clinical care and supportive services, epidemiology, biostatistics, health policy, and other areas to respond to this task. The committee's first report, Monitoring HIV Care in the United States: Indicators and Data Systems, was released in March 2012. The report identified 14 core indicators of clinical HIV care and mental health, substance abuse, and supportive services for use by the Department of Health and Human Services (HHS) to monitor the impact of the National HIV/AIDS Strategy (NHAS) and the Patient Protection and Affordable Care Act (ACA) on improvements in HIV care and identified sources of data to estimate the indicators. The report also addressed a series of questions related to the collection, analysis, and dissemination of data necessary to estimate the indicators. In this second report, Monitoring HIV Care in the United States: A Strategy for Generating National Estimates of HIV Care and Coverage, the committee addresses how to obtain national estimates that characterize the health care of people with HIV within the context of the ACA, both before 2014 and after 2014, when key provisions of the ACA will be implemented. This report focuses on how to monitor the anticipated changes in health care coverage, service utilization, and quality of care for people with HIV within the context of the ACA.

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144

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ISBN 10

0309257158

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9780309257152

Substance Use Disorders in the U.S. Armed Forces

By: Institute of Medicine,Board on the Health of Select Populations,Committee on Prevention, Diagnosis, Treatment and Management of Substance Use Disorders in the U.S. Armed Forces

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Substance Use Disorders in the U.S. Armed Forces

By: Institute of Medicine,Board on the Health of Select Populations,Committee on Prevention, Diagnosis, Treatment and Management of Substance Use Disorders in the U.S. Armed Forces

Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.

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350

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National Academies Press

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ISBN 10

0309260558

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9780309260558

Controlling Costs and Changing Patient Care?

The Role of Utilization Management

By: Institute of Medicine,Committee on Utilization Management by Third Parties

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Controlling Costs and Changing Patient Care?

The Role of Utilization Management

By: Institute of Medicine,Committee on Utilization Management by Third Parties

Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.

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321

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National Academies Press

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ISBN 10

0309040450

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9780309040457

For-Profit Enterprise in Health Care

By: Institute of Medicine,Committee on Implications of For-Profit Enterprise in Health Care

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For-Profit Enterprise in Health Care

By: Institute of Medicine,Committee on Implications of For-Profit Enterprise in Health Care

[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

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580

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National Academies Press

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ISBN 10

0309036437

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9780309036436

Knowing What Works in Health Care

A Roadmap for the Nation

By: Institute of Medicine,Board on Health Care Services,Committee on Reviewing Evidence to Identify Highly Effective Clinical Services

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Knowing What Works in Health Care

A Roadmap for the Nation

By: Institute of Medicine,Board on Health Care Services,Committee on Reviewing Evidence to Identify Highly Effective Clinical Services

There is currently heightened interest in optimizing health care through the generation of new knowledge on the effectiveness of health care services. The United States must substantially strengthen its capacity for assessing evidence on what is known and not known about "what works" in health care. Even the most sophisticated clinicians and consumers struggle to learn which care is appropriate and under what circumstances. Knowing What Works in Health Care looks at the three fundamental health care issues in the United States-setting priorities for evidence assessment, assessing evidence (systematic review), and developing evidence-based clinical practice guidelines-and how each of these contributes to the end goal of effective, practical health care systems. This book provides an overall vision and roadmap for improving how the nation uses scientific evidence to identify the most effective clinical services. Knowing What Works in Health Care gives private and public sector firms, consumers, health care professionals, benefit administrators, and others the authoritative, independent information required for making essential informed health care decisions.

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279

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National Academies Press

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ISBN 10

0309113563

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9780309113564

Advancing Oral Health in America

By: Institute of Medicine,Board on Health Care Services,Committee on an Oral Health Initiative

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Advancing Oral Health in America

By: Institute of Medicine,Board on Health Care Services,Committee on an Oral Health Initiative

Though it is highly preventable, tooth decay is a common chronic disease both in the United States and worldwide. Evidence shows that decay and other oral diseases may be associated with adverse pregnancy outcomes, respiratory disease, cardiovascular disease, and diabetes. However, individuals and many health care professionals remain unaware of the risk factors and preventive approaches for many oral diseases. They do not fully appreciate how oral health affects overall health and well-being. In Advancing Oral Health in America, the Institute of Medicine (IOM) highlights the vital role that the Department of Health and Human Services (HHS) can play in improving oral health and oral health care in the United States. The IOM recommends that HHS design an oral health initiative which has clearly articulated goals, is coordinated effectively, adequately funded and has high-level accountability. In addition, the IOM stresses three key areas needed for successfully maintaining oral health as a priority issue: strong leadership, sustained interest, and the involvement of multiple stakeholders from both the public and private sectors. Advancing Oral Health in America provides practical recommendations that the Department of Health and Human Services can use to improve oral health care in America. The report will serve as a vital resource for federal health agencies, health care professionals, policy makers, researchers, and public and private health organizations.

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211

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ISBN 10

0309186307

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9780309186308

The Future of Drug Safety

Promoting and Protecting the Health of the Public

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on the Assessment of the US Drug Safety System

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The Future of Drug Safety

Promoting and Protecting the Health of the Public

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on the Assessment of the US Drug Safety System

In the wake of publicity and congressional attention to drug safety issues, the Food and Drug Administration (FDA) requested the Institute of Medicine assess the drug safety system. The committee reported that a lack of clear regulatory authority, chronic underfunding, organizational problems, and a scarcity of post-approval data about drugs' risks and benefits have hampered the FDA's ability to evaluate and address the safety of prescription drugs after they have reached the market. Noting that resources and therefore efforts to monitor medications' riskâ€"benefit profiles taper off after approval, The Future of Drug Safety offers a broad set of recommendations to ensure that consideration of safety extends from before product approval through the entire time the product is marketed and used.

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347

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National Academies Press

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ISBN 10

0309103045

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9780309103046

America's Children

Health Insurance and Access to Care

By: Institute of Medicine and National Research Council,Institute of Medicine,Committee on Children, Health Insurance, and Access to Care

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America's Children

Health Insurance and Access to Care

By: Institute of Medicine and National Research Council,Institute of Medicine,Committee on Children, Health Insurance, and Access to Care

America's Children is a comprehensive, easy-to-read analysis of the relationship between health insurance and access to care. The book addresses three broad questions: How is children's health care currently financed? Does insurance equal access to care? How should the nation address the health needs of this vulnerable population? America's Children explores the changing role of Medicaid under managed care; state-initiated and private sector children's insurance programs; specific effects of insurance status on the care children receive; and the impact of chronic medical conditions and special health care needs. It also examines the status of "safety net" health providers, including community health centers, children's hospitals, school-based health centers, and others and reviews the changing patterns of coverage and tax policy options to increase coverage of private-sector, employer-based health insurance. In response to growing public concerns about uninsured children, last year Congress voted to provide $24 billion over five years for new state insurance initiatives. This volume will serve as a primer for concerned federal policymakers and regulators, state agency officials, health plan decisionmakers, health care providers, children's health advocates, and researchers.

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216

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National Academies Press

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ISBN 10

0309173930

ISBN 13

9780309173933

An Update on Research Issues in the Assessment of Birth Settings

Workshop Summary

By: Board on Children, Youth, and Families,Institute of Medicine,National Research Council

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An Update on Research Issues in the Assessment of Birth Settings

Workshop Summary

By: Board on Children, Youth, and Families,Institute of Medicine,National Research Council

More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to determine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). An Update on Research Issues in the Assessment of Birth Settings is the summary of a workshop convened in March, 2013, to review updates to the 1982 report. Health care providers, researchers, government officials, and other experts from midwifery, nursing, obstetric medicine, neonatal medicine, public health, social science, and related fields presented and discussed research findings that advance our understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. These settings include conventional hospital labor and delivery wards, birth centers, and home births. This report identifies datasets and relevant research literature that may inform a future ad hoc consensus study to address these concerns.

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131

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ISBN 10

0309287405

ISBN 13

9780309287401

Workshop on Disability in America

A New Look: Summary and Background Papers

By: Institute of Medicine,Board on Health Sciences Policy,Committee on Disability in America: A New Look

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Workshop on Disability in America

A New Look: Summary and Background Papers

By: Institute of Medicine,Board on Health Sciences Policy,Committee on Disability in America: A New Look

Beginning in late 2004, the IOM began a project to take a new look at disability in America. It will review developments and progress since the publication of the 1991 and 1997 Institute reports. For technical contracting reasons, the new project was split into two phases. During the limited first phase, a committee appointed by IOM planned and convened a 1-day workshop to examine a subset of topics as background for the second phase of project. As was agreed upon with the sponsor of the workshop, the Centers for Disease Control and Prevention (CDC), the topics were: methodological and policy issues related to the conceptualization, definition, measurement, and monitoring of disability and health over time; trends in the amount, types, and causes of disability; disability across the age spectrum and in the context of normal aging; and secondary health conditions. The phase-one workshop was held in Washington, D.C. on August 1, 2005. Its participants included researchers, clinicians, social service professionals, policy experts, and consumer representatives and advocates. The meeting agenda and list of participants are included in Appendix A. Workshop on Disability in America: A New Look- Summary and Background Papers summarizes the workshop presentations and discussions. The background papers prepared for the workshop are included in Appendixes B through O. Some papers were submitted and circulated in advance of the meeting, whereas others were first presented at the meeting. The analyses, definitions, and views presented in the papers are those of the paper authors and are not necessarily those of the IOM committee. Likewise, the discussion summary is limited to the views of the workshop participants.

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National Academies Press

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ISBN 10

0309164745

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9780309164740

Approaching Death

Improving Care at the End of Life

By: Committee on Care at the End of Life,Institute of Medicine

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Approaching Death

Improving Care at the End of Life

By: Committee on Care at the End of Life,Institute of Medicine

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done.

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0309518253

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9780309518253

New Medical Devices

Invention, Development, and Use

By: Institute of Medicine,National Academy of Engineering

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New Medical Devices

Invention, Development, and Use

By: Institute of Medicine,National Academy of Engineering

In the past 50 years the development of a wide range of medical devices has improved the quality of people's lives and revolutionized the prevention and treatment of disease, but it also has contributed to the high cost of health care. Issues that shape the invention of new medical devices and affect their introduction and use are explored in this volume. The authors examine the role of federal support, the decision-making process behind private funding, the need for reforms in regulation and product liability, the effects of the medical payment system, and other critical topics relevant to the development of new devices.

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ISBN 10

0309038464

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9780309038461

America's Uninsured Crisis

Consequences for Health and Health Care

By: Institute of Medicine,Board on Health Care Services,Committee on Health Insurance Status and Its Consequences

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America's Uninsured Crisis

Consequences for Health and Health Care

By: Institute of Medicine,Board on Health Care Services,Committee on Health Insurance Status and Its Consequences

When policy makers and researchers consider potential solutions to the crisis of uninsurance in the United States, the question of whether health insurance matters to health is often an issue. This question is far more than an academic concern. It is crucial that U.S. health care policy be informed with current and valid evidence on the consequences of uninsurance for health care and health outcomes, especially for the 45.7 million individuals without health insurance. From 2001 to 2004, the Institute of Medicine (IOM) issued six reports, which concluded that being uninsured was hazardous to people's health and recommended that the nation move quickly to implement a strategy to achieve health insurance coverage for all. The goal of this book is to inform the health reform policy debateâ€"in 2009â€"with an up-to-date assessment of the research evidence. This report addresses three key questions: What are the dynamics driving downward trends in health insurance coverage? Is being uninsured harmful to the health of children and adults? Are insured people affected by high rates of uninsurance in their communities?

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237

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0309127890

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9780309127899

Future Directions for the National Healthcare Quality and Disparities Reports

By: Institute of Medicine,Board on Health Care Services,Committee on Future Directions for the National Healthcare Quality and Disparities Reports

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Future Directions for the National Healthcare Quality and Disparities Reports

By: Institute of Medicine,Board on Health Care Services,Committee on Future Directions for the National Healthcare Quality and Disparities Reports

As the United States devotes extensive resources to health care, evaluating how successfully the U.S. system delivers high-quality, high-value care in an equitable manner is essential. At the request of Congress, the Agency for Healthcare Research and Quality (AHRQ) annually produces the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). The reports have revealed areas in which health care performance has improved over time, but they also have identified major shortcomings. After five years of producing the NHQR and NHDR, AHRQ asked the IOM for guidance on how to improve the next generation of reports. The IOM concludes that the NHQR and NHDR can be improved in ways that would make them more influential in promoting change in the health care system. In addition to being sources of data on past trends, the national healthcare reports can provide more detailed insights into current performance, establish the value of closing gaps in quality and equity, and project the time required to bridge those gaps at the current pace of improvement.

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246

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0309149851

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9780309149853

A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on a National Surveillance System for Cardiovascular and Select Chronic Diseases

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A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on a National Surveillance System for Cardiovascular and Select Chronic Diseases

Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data-including population surveys, cohort studies, disease registries, administrative health data, and vital statistics-contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels. The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.

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ISBN 10

0309212197

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9780309212199

Preventing Medication Errors

By: Institute of Medicine,Board on Health Care Services,Committee on Identifying and Preventing Medication Errors

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Preventing Medication Errors

By: Institute of Medicine,Board on Health Care Services,Committee on Identifying and Preventing Medication Errors

In 1996 the Institute of Medicine launched the Quality Chasm Series, a series of reports focused on assessing and improving the nation's quality of health care. Preventing Medication Errors is the newest volume in the series. Responding to the key messages in earlier volumes of the seriesâ€"To Err Is Human (2000), Crossing the Quality Chasm (2001), and Patient Safety (2004)â€"this book sets forth an agenda for improving the safety of medication use. It begins by providing an overview of the system for drug development, regulation, distribution, and use. Preventing Medication Errors also examines the peer-reviewed literature on the incidence and the cost of medication errors and the effectiveness of error prevention strategies. Presenting data that will foster the reduction of medication errors, the book provides action agendas detailing the measures needed to improve the safety of medication use in both the short- and long-term. Patients, primary health care providers, health care organizations, purchasers of group health care, legislators, and those affiliated with providing medications and medication- related products and services will benefit from this guide to reducing medication errors.

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481

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National Academies Press

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ISBN 10

0309101476

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9780309101479

Interprofessional Education for Collaboration

Learning How to Improve Health from Interprofessional Models Across the Continuum of Education to Practice: Workshop Summary

By: Institute of Medicine,Board on Global Health,Global Forum on Innovation in Health Professional Education

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Interprofessional Education for Collaboration

Learning How to Improve Health from Interprofessional Models Across the Continuum of Education to Practice: Workshop Summary

By: Institute of Medicine,Board on Global Health,Global Forum on Innovation in Health Professional Education

Every year, the Global Forum undertakes two workshops whose topics are selected by the more than 55 members of the Forum. It was decided in this first year of the Forum's existence that the workshops should lay the foundation for future work of the Forum and the topic that could best provide this base of understanding was "interprofessional education." The first workshop took place August 29-30, 2012, and the second was on November 29-30, 2012. Both workshops focused on linkages between interprofessional education (IPE) and collaborative practice. The difference between them was that Workshop 1 set the stage for defining and understanding IPE while Workshop 2 brought in speakers from around the world to provide living histories of their experience working in and between interprofessional education and interprofessional or collaborative practice. A committee of health professional education experts planned, organized, and conducted a 2-day, interactive public workshop exploring issues related to innovations in health professions education (HPE). The committee involved educators and other innovators of curriculum development and pedagogy and will be drawn from at least four health disciplines. The workshop followed a high-level framework and established an orientation for the future work of the Global Forum on Innovations in Health Professional Education. Interprofessional Education for Collaboration: Learning How to Improve Health from Interprofessional Models Across the Continuum of Education to Practice summarizes the presentations and small group discussions that focused on innovations in five areas of HPE: 1. Curricular innovations - Concentrates on what is being taught to health professions' learners to meet evolving domestic and international needs; 2. Pedagogic innovations - Looks at how the information can be better taught to students and WHERE education can takes place; 3. Cultural elements - Addresses who is being taught by whom as a means of enhancing the effectiveness of the design, development and implementation of interprofessional HPE; 4. Human resources for health - Focuses on how capacity can be innovatively expanded to better ensure an adequate supply and mix of educated health workers based on local needs; and 5. Metrics - Addresses how one measures whether learner assessment and evaluation of educational impact and care delivery systems influence individual and population health.

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181

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ISBN 10

0309263492

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9780309263498

Building a Better Delivery System

A New Engineering/Health Care Partnership

By: Institute of Medicine,National Academy of Engineering

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Building a Better Delivery System

A New Engineering/Health Care Partnership

By: Institute of Medicine,National Academy of Engineering

In a joint effort between the National Academy of Engineering and the Institute of Medicine, this books attempts to bridge the knowledge/awareness divide separating health care professionals from their potential partners in systems engineering and related disciplines. The goal of this partnership is to transform the U.S. health care sector from an underperforming conglomerate of independent entities (individual practitioners, small group practices, clinics, hospitals, pharmacies, community health centers et. al.) into a high performance "system" in which every participating unit recognizes its dependence and influence on every other unit. By providing both a framework and action plan for a systems approach to health care delivery based on a partnership between engineers and health care professionals, Building a Better Delivery System describes opportunities and challenges to harness the power of systems-engineering tools, information technologies and complementary knowledge in social sciences, cognitive sciences and business/management to advance the U.S. health care system.

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276

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0309133580

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9780309133586

The Healthcare Imperative

Lowering Costs and Improving Outcomes: Workshop Series Summary

By: Institute of Medicine,Roundtable on Evidence-Based Medicine

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The Healthcare Imperative

Lowering Costs and Improving Outcomes: Workshop Series Summary

By: Institute of Medicine,Roundtable on Evidence-Based Medicine

The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.

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852

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ISBN 10

0309144337

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9780309144339

Health Professions Education

A Bridge to Quality

By: Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit

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Health Professions Education

A Bridge to Quality

By: Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

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192

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ISBN 10

0309087236

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9780309087230

Rewarding Provider Performance

Aligning Incentives in Medicare

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

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Rewarding Provider Performance

Aligning Incentives in Medicare

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.

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273

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National Academies Press

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ISBN 10

0309102162

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9780309102162

In the Nation's Compelling Interest

Ensuring Diversity in the Health-Care Workforce

By: Institute of Medicine,Board on Health Sciences Policy,Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Health Care Workforce

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In the Nation's Compelling Interest

Ensuring Diversity in the Health-Care Workforce

By: Institute of Medicine,Board on Health Sciences Policy,Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Health Care Workforce

The United States is rapidly transforming into one of the most racially and ethnically diverse nations in the world. Groups commonly referred to as minorities-including Asian Americans, Pacific Islanders, African Americans, Hispanics, American Indians, and Alaska Natives-are the fastest growing segments of the population and emerging as the nation's majority. Despite the rapid growth of racial and ethnic minority groups, their representation among the nation's health professionals has grown only modestly in the past 25 years. This alarming disparity has prompted the recent creation of initiatives to increase diversity in health professions. In the Nation's Compelling Interest considers the benefits of greater racial and ethnic diversity, and identifies institutional and policy-level mechanisms to garner broad support among health professions leaders, community members, and other key stakeholders to implement these strategies. Assessing the potential benefits of greater racial and ethnic diversity among health professionals will improve the access to and quality of healthcare for all Americans.

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430

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ISBN 10

030909125X

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9780309091251

Review of the Disability Evaluation Study Design

Third Interim Report

By: National Research Council,Institute of Medicine,Commission on Behavioral and Social Sciences and Education,Committee on National Statistics

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Review of the Disability Evaluation Study Design

Third Interim Report

By: National Research Council,Institute of Medicine,Commission on Behavioral and Social Sciences and Education,Committee on National Statistics

The Social Security Administration (SSA) has been engaged in a major effort to redesign the process for determining disability for cash benefits and medical assistance under its Social Security Disability Insurance (SSDI), Title II of the Social Security Act and the Supplemental Security Income (SSI), Title XVI of the Social Security Act. Because of the complexity and far-reaching impact of its efforts, SSA concluded that the redesign effort requires extensive research, testing, and validation, as well as further development of some of its components before national implementation. The effect of the new determination process on the number and characteristics of future beneficiaries also needs further study. The agency asked the National Academies to provide ongoing independent and unbiased review of, and recommendations on, its current and proposed research as it relates to the development of a revised disability decision process including the approach, survey design, and content of the complex multiyear Disability Evaluation Study (DES). The present report is the third in a series of short interim reports of the National Academies' Committee to Review the SSA's Disability Decision Process. This third interim report relates directly to one of the contract tasks-review of the design, approach, and content of the DES, as proposed by SSA's contractor for the survey, Westat, Inc. This report is limited to a brief review of the sample design (including that of the pilot study), instruments and procedures, and response rates goals developed by Westat and provided by SSA in June 1999 to the committee for its review and recommendations. It also comments on the proposed timeline for initiation of each phase of the survey.

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0309068304

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9780309068307

Health Data in the Information Age

Use, Disclosure, and Privacy

By: Institute of Medicine,Committee on Regional Health Data Networks

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Health Data in the Information Age

Use, Disclosure, and Privacy

By: Institute of Medicine,Committee on Regional Health Data Networks

Regional health care databases are being established around the country with the goal of providing timely and useful information to policymakers, physicians, and patients. But their emergence is raising important and sometimes controversial questions about the collection, quality, and appropriate use of health care data. Based on experience with databases now in operation and in development, Health Data in the Information Age provides a clear set of guidelines and principles for exploiting the potential benefits of aggregated health dataâ€"without jeopardizing confidentiality. A panel of experts identifies characteristics of emerging health database organizations (HDOs). The committee explores how HDOs can maintain the quality of their data, what policies and practices they should adopt, how they can prepare for linkages with computer-based patient records, and how diverse groups from researchers to health care administrators might use aggregated data. Health Data in the Information Age offers frank analysis and guidelines that will be invaluable to anyone interested in the operation of health care databases.

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272

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National Academies Press

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ISBN 10

0309049954

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9780309049955

Technology and Health Care in an Era of Limits

By: Institute of Medicine,Committee on Technology Innovation in Medicine

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Technology and Health Care in an Era of Limits

By: Institute of Medicine,Committee on Technology Innovation in Medicine

The U.S. health care system is in a state of flux, and changes currently under way seem capable of exerting sizable effects on medical innovation. This volume explores how the rapid transition to managed care might affect the rate and direction of medical innovation. The experience with technological change in medicine in other nations whose health care systems have "single-payer" characteristics is thoroughly examined. Technology and Health Care in an Era of Limits examines how financing and care delivery strategies affect the decisions made by hospital administrators and physicians to adopt medical technologies. It also considers the patient's stake in the changing health care economy and the need for a stronger independent contribution of patients to the choice of technology used in their care. Finally, the volume explores the impact of changes in the demand for medical technology in pharmaceutical, medical device, and surgical procedure innovation.

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296

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0309046955

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9780309046954

Care Without Coverage

Too Little, Too Late

By: Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance

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Care Without Coverage

Too Little, Too Late

By: Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

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213

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ISBN 10

0309083435

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9780309083430

Clinical Practice Guidelines We Can Trust

By: Institute of Medicine,Board on Health Care Services,Committee on Standards for Developing Trustworthy Clinical Practice Guidelines

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Clinical Practice Guidelines We Can Trust

By: Institute of Medicine,Board on Health Care Services,Committee on Standards for Developing Trustworthy Clinical Practice Guidelines

Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.

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217

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ISBN 10

0309164222

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9780309164221

Book's by Institute of Medicine (U.S.). Committee on Quality of Health Care in America

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