Quality of Care--When is "Good," Good Enough?
This article is posted in:
Quality of Care--How Good Is Good Enough? Harold C. Sox; Sheldon Greenfield JAMA. 2010;303(23):2403-2404 (doi:10.1001/jama.2010.810 [Extract]:
outcomes
Cost is the Big Item in the Value Equation of Health Care and Here's Why
This article is posted in:The main tension about healthcare centers around medical need, quality, access and cost-efficiency, i.e., affordability. To increase "value," one must raise quality, improve access and/or lower the cost of care.
The Guiding Principle: Measure to Manage
This article is posted in:The modus operandi in managing care is that 'one cannot manage what one does not measure and the obverse, one cannot measure what one does not manage.' Consider the final equalizer in health care method comparisons—outcomes….who's measuring? Who's managing?
The Managed Care-Pharma Interface-Part I: The Issues
This article is posted in:The issues of appropriateness, compliance, cost-effectiveness, patient selection and symbiosis (ACCESS) are vital to both health care and pharmaceutical industries and define their possible relationship. "At this moment, Medicare’s rules – yes, the same Medicare that’s slated to go broke in a decade or so – forbid it to consider cost in its coverage decisions.
The Managed Care-Pharma Interface-Part IV: Post-Marketing Facilitation
This article is posted in:Raymond V. Gilmartin, the former Chairman, President and Chief Executive Officer of Merck & Co., Inc. (1994-2005) in a speech January 19, 2000 gave commentary about the Pharmaceutical and Medicine Manufacturing (PMM) industry. While the original reference ar Merck.com has been pulled, the following is faithful to his statements. Mr. Gilmartin defends U.S.
Does A Good Doctor Treat A Patient's Economic Aches and Pains?
This article is posted in:Doctors are relatively uninformed about health care systems, outcomes research or health care economics, specifically the costs of care and cost-benefit. Is that a critical knowledge gap? 58,294 U.S. medical graduates completed the Association of American Medical Colleges (AAMC) annual, 2003-2007 Medical School Graduation Questionnaire. The data were used to compare medical school curricula that varied in the intensity of teaching about health care systems.
If/When Reform Fails to Reform
This article is posted in:"If Reform Fails", a recent NY Times editorial, states that the status quo is immoral, impractical and unsustainable. What can we expect now that the House approved "Health Overhaul, Sending Landmark Bill to Obama"? No proposition I have seen identifies, in a practical way what does or does not work for patients and those practicing on the front lines of medicine. Blame the patient?
Healthcare Reform in the U.S.
This article is posted in:The United States is the only wealthy, industrialized country that does not ensure that all of its citizens have healthcare coverage. Insuring America's Health: Principles and Recommendations, Institute of Medicine at the National Academies of Science, January 14, 2004, last accessed Tuesday, February 2, 2010
Quality Assessment--First, Is the Recommended Diagnostic Test or Treatment Efficacious?
This article is posted in:Why doesn't Dr. Jones' opinion about therapeutic efficacy really matter? What if the patient won't or can't take the test or medicine? Why, in the calculus of health care quality assessment isn't medication compliance, affordability, taste, frequency of dosing, or even opportunity costs* taken into account when insurance companies decide what to pay for or to cost-share? For that matter why don't these issues weigh in on public policy and health-care reform?
