Recommended Core Measures for Evaluating the Patient-Centered Medical Home: Cost, Utilization, and Clinical Quality

Outlines the process of the Patient-Centered Medical Home Evaluators' Collaborative for identifying core standardized measures and their recommended principles and measures for evaluating cost and utilization and clinical quality

Quality of Preventive Health Care for Young Children: Strategies for Improvement

Looks at early childhood developmental services, including assessment, education, intervention, and coordination of care. Recommendations include national standards for preventive care, and improvements in health provider training

Achieving Better Quality of Care for Low-Income Populations: The Roles of Health Insurance and the Medical Home in Reducing Health Inequities

Outlines the importance of having both insurance and a medical home in reducing health and healthcare disparities for low-income adults, including access to care, preventive screenings, and satisfaction with quality of care. Makes policy recommendations

Modelling the cost effectiveness of interferon beta and glatiramer acetate in the management of multiple sclerosis

OBJECTIVE: To evaluate the cost effectiveness of four disease modifying treatments (interferon betas and glatiramer acetate) for relapsing remitting and secondary progressive multiple sclerosis in the United Kingdom. DESIGN: Modelling cost effectiveness. SETTING: UK NHS. PARTICIPANTS: Patients with relapsing remitting multiple sclerosis and secondary progressive multiple sclerosis. MAIN OUTCOME MEASURES: Cost per quality adjusted life year gained. RESULTS: The base case cost per quality adjusted life year gained by using any of the four treatments ranged from £42 000 ($66 469; 61 630) to £98 000 based on efficacy information in the public domain. Uncertainty analysis suggests that the probability of any of these treatments having a cost effectiveness better than £20 000 at 20 years is below 20%. The key determinants of cost effectiveness were the time horizon, the progression of patients after stopping treatment, differential discount rates, and the price of the treatments. CONCLUSIONS: Cost effectiveness varied markedly between the interventions. Uncertainty around point estimates was substantial. This uncertainty could be reduced by conducting research on the true magnitude of the effect of these drugs, the progression of patients after stopping treatment, the costs of care, and the quality of life of the patients. Price was the key modifiable determinant of the cost effectiveness of these treatments

Socioeconomic disadvantage in childhood as a predictor of excessive gestational weight gain and obesity in midlife adulthood.

BackgroundLower childhood socioeconomic position is associated with greater risk of adult obesity among women, but not men. Pregnancy-related weight changes may contribute to this gender difference. The objectives of this study were to determine the associations between: 1. childhood socioeconomic disadvantage and midlife obesity; 2. excessive gestational weight gain (GWG) and midlife obesity; and 3. childhood socioeconomic disadvantage and excessive GWG, among a representative sample of childbearing women.MethodsWe constructed marginal structural models for seven measures of childhood socioeconomic position for 4780 parous women in the United States, using National Longitudinal Survey of Youth (1979-2010) data. Institute of Medicine definitions were used for excessive GWG; body mass index ≥30 at age 40 defined midlife obesity. Analyses were separated by race/ethnicity. Additionally, we estimated controlled direct effects of childhood socioeconomic disadvantage on midlife obesity under a condition of never gaining excessively in pregnancy.ResultsLow parental education, but not other measures of childhood disadvantage, was associated with greater midlife obesity among non-black non-Hispanic women. Among black and Hispanic mothers, childhood socioeconomic disadvantage was not consistently associated with midlife obesity. Excessive GWG was associated with greater midlife obesity in all racial/ethnic groups. Childhood socioeconomic disadvantage was not statistically significantly associated with excessive GWG in any group. Controlled direct effects were not consistently weaker than total effects.ConclusionsChildhood socioeconomic disadvantage was associated with adult obesity, but not with excessive gestational weight gain, and only for certain disadvantage measures among non-black non-Hispanic mothers. Prevention of excessive GWG may benefit all groups through reducing obesity, but excessive GWG does not appear to serve as a mediator between childhood socioeconomic position and adult obesity in women

Expressiveness and Robustness of First-Price Position Auctions

Since economic mechanisms are often applied to very different instances of the same problem, it is desirable to identify mechanisms that work well in a wide range of circumstances. We pursue this goal for a position auction setting and specifically seek mechanisms that guarantee good outcomes under both complete and incomplete information. A variant of the generalized first-price mechanism with multi-dimensional bids turns out to be the only standard mechanism able to achieve this goal, even when types are one-dimensional. The fact that expressiveness beyond the type space is both necessary and sufficient for this kind of robustness provides an interesting counterpoint to previous work on position auctions that has highlighted the benefits of simplicity. From a technical perspective our results are interesting because they establish equilibrium existence for a multi-dimensional bid space, where standard techniques break down. The structure of the equilibrium bids moreover provides an intuitive explanation for why first-price payments may be able to support equilibria in a wider range of circumstances than second-price payments

Issues in Forest Restoration: Public perceptions of forest restoration in the southwest: A synthesis of selected surveys and literature

The restoration of forest ecosystems is an important, yet sometimes controversial, practice. In recent years numerous studies have explored how the public perceives forest health, restoration, and fire; however, few analyses have summarized and compared results across studies. The purpose of this publication is to identify consistencies in the results of recent studies, assess the publics overall understanding of forest restoration issues, and evaluate areas of continuing controversy. The information presented here is a synthesis of public survey research conducted throughout the country, with a primary focus on research conducted in the Southwest. We integrated a broad spectrum of literature in our evaluation, including peer-reviewed publications, gray literature, and unpublished studies. Each source was selected based on its focus and content area