Choosing a Health Care Provider: The Role of Quality Information

Reviews research on the adequacy of the information available on provider quality; the type of information consumers seek in choosing physicians, physician groups, and hospitals; and their attitudes about, awareness of, and use of that information

Precaution, governance and the failure of medical implants: the ASR(TM) hip in the UK

Hip implants have provided life-changing treatment, reducing pain and improving the mobility and independence of patients. Success has encouraged manufacturers to innovate and amend designs, engendering patient hopes in these devices. However, failures of medical implants do occur. The failure rate of the Articular Surface Replacement metal-on-metal hip system, implanted almost 100,000 times world-wide, has re-opened debate about appropriate and timely implant governance. As commercial interests, patient hopes, and devices’ governance converge in a socio-technical crisis, we analyse the responses of relevant governance stakeholders in the United Kingdom between 2007 and 2014. We argue that there has been a systemic failure of the governance system entrusted with the safety of patients fitted with medical implants. Commercial considerations of medical implants and the status quo of medical implant governance have been given priority over patient safety despite the availability of significant failure data in an example of uncertainty about what constitutes appropriate precautionary action

Organizing for Higher Performance: Case Studies of Organized Delivery Systems

Offers lessons learned from healthcare delivery systems promoting the attributes of an ideal model as defined by the Fund: information continuity, care coordination and transitions, system accountability, teamwork, continuous innovation, and easy access

Regulatory withdrawal of medicines marketed with uncertain benefits : the bevacizumab case study

Acknowledgements Professor Elizabeth Roughead is funded by a Future Fellowship from the Australian Research Council. The views expressed are those of the authors, the sponsor had no role in the preparation of the manuscript.Peer reviewedPublisher PD

Making a Business Case for Reducing Racial and Ethnic Disparities in Health Care: Key Issues and Observations

Offers lessons from RWJF's Finding Answers program around issues involved in laying out financial reasons for providers, caregivers, and others to adopt ongoing, effective interventions to improve quality of care for minority patients

Breaking the Barriers to Specialty Care: Practical Ideas to Improve Health Equity and Reduce Cost - Helping Patients Engage in Specialty Care

Tremendous health outcome inequities remain in the U.S. across race and ethnicity, gender and sexual orientation, socio-economic status, and geography—particularly for those with serious conditions such as lung or skin cancer, HIV/AIDS, or cardiovascular disease.These inequities are driven by a complex set of factors—including distance to a specialist, insurance coverage, provider bias, and a patient's housing and healthy food access. These inequities not only harm patients, resulting in avoidable illness and death, they also drive unnecessary health systems costs.This 5-part series highlights the urgent need to address these issues, providing resources such as case studies, data, and recommendations to help the health care sector make meaningful strides toward achieving equity in specialty care.Top TakeawaysThere are vast inequalities in access to and outcomes from specialty health care in the U.S. These inequalities are worst for minority patients, low-income patients, patients with limited English language proficiency, and patients in rural areas.A number of solutions have emerged to improve health outcomes for minority and medically underserved patients. These solutions fall into three main categories: increasing specialty care availability, ensuring high-quality care, and helping patients engage in care.As these inequities are also significant drivers of health costs, payers, health care provider organizations, and policy makers have a strong incentive to invest in solutions that will both improve outcomes and reduce unnecessary costs. These actors play a critical role in ensuring that equity is embedded into core care delivery at scale.Part 4: "Helping Patients Engage in Specialty Care"Specialty care actors are increasingly addressing the social determinants of health with community outreach, patient navigation, and patient support services

The struggling infectious diseases fellow: Remediation challenges and opportunities

Remediation of struggling learners is a challenge faced by all educators. In recognition of this reality, and in light of contemporary challenges facing infectious diseases (ID) fellowship program directors, the Infectious Diseases Society of America Training Program Directors\u27 Committee focused the 2018 National Fellowship Program Directors\u27 Meeting at IDWeek on Remediation of the Struggling Fellow. Small group discussions addressed 7 core topics, including feedback and evaluations, performance management and remediation, knowledge deficits, fellow well-being, efficiency and time management, teaching skills, and career development. This manuscript synthesizes those discussions around a competency-based framework to provide program directors and other educators with a roadmap for addressing common contemporary remediation challenges