Why Not the Best? Results From the National Scorecard on U.S. Health System Performance, 2011

Assesses the U.S. healthcare system's average performance in 2007-09 as measured by forty-two indicators of health outcomes, quality, access, efficiency, and equity compared with the 2006 and 2008 scorecards and with domestic and international benchmarks

Complex Care Management Program Overview

This report includes brief updates on various forms of complex care management including: Aetna - Medicare Advantage Embedded Case Management ProgramBrigham and Women's Hospital - Care Management ProgramIndependent Health - Care PartnersIntermountain Healthcare and Oregon Health and Science University - Care Management PlusJohns Hopkins University - Hospital at HomeMount Sinai Medical Center -- New York - Mount Sinai Visiting Doctors Program/ Chelsea-Village House Calls ProgramsPartners in Care Foundation - HomeMeds ProgramPrinceton HealthCare System - Partnerships for PIECEQuality Improvement for Complex Chronic Conditions - CarePartner ProgramSenior Services - Project Enhance/EnhanceWellnessSenior Whole Health - Complex Care Management ProgramSumma Health/Ohio Department of Aging - PASSPORT Medicaid Waiver ProgramSutter Health - Sutter Care Coordination ProgramUniversity of Washington School of Medicine - TEAMcar

Is the Health Care System Working for Adolescents? Perspectives From Providers in Boston, Denver, Houston, and San Francisco

Assesses healthcare system services for adolescents in four urban areas. Includes provider perspectives on how health insurance, managed care, and other factors facilitate or impede access. Discusses innovative programs, and offers recommendations

Systematic review of transition models for young people with long-term conditions: A report for NHS Diabetes.

Aims For many young people with Type 1 diabetes, transition from paediatric to adult care can result in a marked deterioration in glycaemic control. A systematic review assessed the effectiveness of transition models, or components of models, for managing the transition process in young people with long-term conditions, including Type 1 diabetes. This involved identifying (i) the main barriers and facilitators in implementing a successful transition programme, and (ii) the key issues for young people with long-term conditions and professionals involved in the transition process. Methods The following databases were searched from inception to August 2012: MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, Social Services Abstracts, Academic Search Complete, Social Science Citation Index, Cochrane and Campbell Libraries. Selected studies included young people aged 11 to 25 diagnosed with long-term conditions who were in transition from paediatric to adult secondary health care services. Results 16 systematic reviews and 13 primary studies were included from 9992 records retrieved. No single transition model was uniquely effective. The most successful transitions centred around: young person-focused; age and developmentally appropriate content and delivery; self-management education; family participation; paediatric and adult collaboration; designated transition clinics; transition co-ordinator; young person’s portfolio; specific professionals training; multidisciplinary approach; structured process embedded in service delivery. There were no distinctive characteristics of condition-specific Type 1 diabetes services. Conclusion This important and timely review summarises the key factors that need to be considered for the development of transition programmes for young people with long-term conditions, including those with Type 1 diabetes

Enhancing Value in Medicare: Demonstrations and Other Initiatives to Improve the Program

Examines Medicare's efforts to be more proactive in the purchase of appropriate, high-quality, and efficient health care for its beneficiaries, and provides an overview of Medicare pilot programs and initiatives in chronic care and provider performance

The Heart of the Matter: The Relationship Between Communities, Cardiovascular Services and Racial and Ethnic Gaps in Care

As part of an initiative to address racial/ethnic disparities in the diagnosis and treatment of heart disease, examines factors behind the segmentation of healthcare access and service patterns by income and insurance status and its effect on minorities

Smallpox and Bioterrorism: Why the Plan to Protect the Nation Is Stalled and What to Do

The Iraq war is over, no weapons of mass destruction (WMD) have yet been found, and the president's smallpox plan, though sound, is running out of steam. Instead of being well on the way to protecting the nation's civilian population by vaccinating up to 10 million health, emergency, and public safety workers, we are stalled at 37,971 vaccinated civilians while the military has successfully and safely vaccinated more than 450,000 people. Moreover, whether or not WMD are found in Iraq, it is only one of a number of nations on the list of suspects. Of all biological weapons, smallpox has the greatest potential for doing widespread harm. Given that the risk of death or serious harm to anyone from any form of terrorism is very low, we should live our daily lives normally, not in fear. However, to do that we need to be sure that our government is taking effective steps to reduce the chances of terrorism and, when it occurs, to minimize its consequences. Even though there is enough vaccine for everyone, we are ill prepared to rapidly contain smallpox after a bioterrorist release. Although Centers for Disease Control and Prevention (CDC) guidelines have recently improved, they continue to overstate the risk of side effects of the vaccine and erroneously suggest that, after an attack, the techniques used decades ago to eradicate smallpox will work well today. Medicine and public health are very risk-averse professions in our risk-averse culture. We have not yet realized the complexity and difficulty of vaccinating millions of Americans rapidly after an attack. Nor have we come to grips with the need to make rapid, possibly draconian, post-attack decisions based on limited data of uncertain quality. That type of decisionmaking runs counter to the culture of public health. The Bush administration needs to revitalize our preparations for a smallpox bioterrorist event

Barnes Hospital Bulletin

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