Health System Reform in the United States

In 2010, the United States adopted its first-ever comprehensive set of health system reforms in the Affordable Care Act (ACA). Implementation of the law, though politically contentious and controversial, has now reached a stage where reversal of most elements of the law is no longer feasible. The controversial portions of the law that expand affordable health insurance coverage to most U.S. citizens and legal residents do not offer any important lessons for the global community. The portions of the law seeking to improve the quality, effectiveness, and efficiency of medical care as delivered in the U.S., hold lessons for the global community as all nations struggle to gain greater value from the societal resources they invest in medical care for their peoples. Health reform is an ongoing process of planning, legislating, implementing, and evaluating system changes. The U.S. set of delivery system reforms has much for reformers around the globe to assess and consider

Utilizing Data Mining Techniques and Ensemble Learning to Predict Development of Surgical Site Infections in Gynecologic Cancer Patients

Surgical site infections are costly to both patients and hospitals, increase patient mortality, and are the most common form of a hospital acquired infection. Gynecological cancer surgery patients are already at higher risk of developing an infection due to the suppression of their immune system. This research leverages popular data mining techniques to create a prediction model to identify high risk patients. Implemented techniques include logistic regression, naive Bayes, recursive partitioning and regression trees, random forest, feed forward neural network, k-nearest neighbor, and support vector machines with linear kernel. Weighted stacked generalization was implemented to improve upon the individual base level model’s performance. The chosen meta level classifiers were support vector machines with linear kernel, logistic regression, and k-nearest neighbor. The result is a model that identifies high-risk patients immediately following a surgical procedure with an AUC of 0.6864, accuracy of 0.6744, sensitivity of 0.7, and specificity of 0.6728

Oriental lore in the Tatler, Spectator, Guardian, and Freeholder of Addison and Steele

Thesis (M.A.)--Boston University, 1948. This item was digitized by the Internet Archive

The Road to Universal Health Coverage in Massachusetts: A Story in Three Parts

In 1988, the Massachusetts Legislature passed a new law, a “play or pay” employer mandate, requiring all employers with six or more workers to provide health insurance coverage for their employees. A few years later, with Medicaid identified as a “Budget Buster,” the Weld administration sought deregulation as the way to cut costs and expand access by establishing MassHealth, which dropped the employer mandate and expanded Medicaid, and eventually distinguished Massachusetts as the state with the greatest percent of covered citizens. But MassHealth enrollment has declined as premium costs have risen, and the Uncompensated Care Pool is once again faced with providing for large numbers of uninsured — a solution more expensive than providing health insurance. It appears that the Romney administration may be on the verge of launching another initiative

The ISCIP Analyst, Volume III, Issue 4

This repository item contains a single issue of The ISCIP Analyst, an analytical review journal published from 1996 to 2010 by the Boston University Institute for the Study of Conflict, Ideology, and Policy