Medical care--is more always better?

@article{Fisher2003MedicalCM,
  title={Medical care--is more always better?},
  author={Elliott S. Fisher},
  journal={The New England journal of medicine},
  year={2003},
  volume={349 17},
  pages={
          1665-7
        }
}
  • E. Fisher
  • Published 23 October 2003
  • Political Science, Medicine
  • The New England journal of medicine
During the past decade, the Department of Veterans Affairs (VA) undertook a major reform of its health care system, one that is increasingly relevant as the United States confronts rapidly rising h... 
Resistance to changing roles in the medical team.
The role of nurse practitioners in patient care can be expanded without sacrificing quality or safety.
Can Health Care Rationing Ever Be Rational?
TLDR
A 77-year-old decisionally incapacitated long-term nursing home resident with chronic schizophrenia who was admitted to the hospital with a bacterial pneumonia developed respiratory failure soon after admission and was intubated and placed on mechanical ventilation.
Chronic disease and the healthcare crisis
TLDR
The development of appropriate healthcare practices for chronic disease is central to solving the healthcare crisis and this paper is concerned with that need.
Higher health care quality and bigger savings found at large multispecialty medical groups.
TLDR
This belief that integrated delivery systems offer better care at lower cost has contributed to growing interest in accountable care organizations by comparing the costs and quality of care provided to Medicare beneficiaries in twenty-two health care markets by physicians who did and did not work within large multispecialty group practices affiliated with the Council of Accountable Physician Practices.
Lost in Translation: Physicians' Struggle With Cost-Reduction Programs
  • H. Beckman
  • Medicine, Political Science
    Annals of Internal Medicine
  • 2011
TLDR
This article suggests that it is the inability of stakeholders to find a common language to effectively communicate interests, needs, and proposed interventions that often derails progress toward common goals.
The Accelerated Benefits Demonstration and Evaluation Project: Impacts on Health and Employment at Twelve Months Volume 1
This final report of the Accelerated Benefits (AB) Demonstration found that participants made extensive use of program services, AB health care benefits increased health care use and reduced reported
Does it matter that medical graduates don’t get jobs as doctors? Yes
  • G. Winyard
  • Medicine
    BMJ : British Medical Journal
  • 2008
TLDR
Last year’s shortfall in training places looks set to be repeated, but Graham Winyard believes this is a betrayal of students’ expectations, and Alan Maynard thinks it is inevitable if patients are to get the best care.
Controlling health costs and improving health care quality for retirees.
TLDR
A policy forum discussion on how changes in government programs will affect the delivery of health care in the United States and whether the coming changes that are made to control costs will ultimately improve quality of care delivered are summarized.
Controlling U.S. health spending: opportunities for academic health centers.
  • G. Anderson
  • Medicine, Political Science
    Academic medicine : journal of the Association of American Medical Colleges
  • 2006
TLDR
Examining the factors that explain the level and rate of increase in health care spending in the United States finds including more people with multiple chronic conditions in clinical trials could make the findings of the clinical trials applicable to a larger patient population and thereby reduce the substantial geographic variation of health care.
Competition in health care: what does it mean for nurse managers?
  • A. Maynard
  • Medicine, Political Science
    Journal of nursing management
  • 2005
The English Government has launched a series of radical market-orientated reforms whose goal is to get the National Health Service to 'act smarter' by undermining with public-private competition the
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 14 REFERENCES
REGIONAL DISPARITIES IN MEDICARE EXPENDITURES: AN OPPORTUNITY FOR REFORM
Characterizes the enormous geographic disparity in Medicare spending across the U.S. (even after adjustment for demographics) as the fundamental problem in the program. Reviews alternative approaches
Effect of the transformation of the Veterans Affairs Health Care System on the quality of care.
TLDR
The quality of care in the VA health care system substantially improved after the implementation of a systemwide reengineering and, during the period from 1997 through 2000, was significantly better than that in the Medicare fee-for-service program.
Geography and the debate over Medicare reform.
TLDR
A new approach to Medicare reform is proposed based on the principles of shared decision making and the promotion of centers of medical excellence and it is suggested that this proposal be tested in a major demonstration project.
The "New VA": A National Laboratory for Health Care Quality Management
  • K. Kizer
  • Medicine, Political Science
    American journal of medical quality : the official journal of the American College of Medical Quality
  • 1999
TLDR
The VHA's new operational structure and its approach to quality improvement provide a unique national laboratory for health care QM, according to a structure-, process, and outcomes-focused quality management account-ability framework (QMAF).
Regionalization and the underuse of angiography in the Veterans Affairs Health Care System as compared with a fee-for-service system.
TLDR
There is underuse of needed angiography after acute myocardial infarction in both the VA and Medicare systems, but the rate of underuse is significantly higher in the VA, and differences appear to be associated with limited on-site availability of cardiac procedures in the regionalized VA health care system.
Continuity of outpatient medical care in elderly men. A randomized trial.
TLDR
It is concluded that continuity of outpatient provider care for men aged 55 years and older results in more patient satisfaction, shorter hospitalizations, and fewer emergent hospital admissions.
The Implications of Regional Variations in Medicare Spending. Part 2: Health Outcomes and Satisfaction with Care
TLDR
The researchers examined costs and outcomes of care for hip fracture, colorectal cancer, and acute myocardial infarction using end-of-life care spending as an indicator of Medicare spending and carried out a cohort study in four parallel populations using a natural randomization approach.
Rationing intensive care--physician responses to a resource shortage.
TLDR
It is suggested that physicians can respond to moderate resource limitations by more efficient use of intensive-care resources.
The Implications of Regional Variations in Medicare Spending. Part 1: The Content, Quality, and Accessibility of Care
TLDR
A cohort study in four parallel cohorts using end-of-life care spending as an indicator of Medicare spending and examined costs and outcomes of care for hip fracture, colorectal cancer, and acute myocardial infarction to determine whether the increased spending in high-cost regions results in better care or improved health.
Avoiding the unintended consequences of growth in medical care: how might more be worse?
TLDR
4 ways in which inadequate information and improper reasoning may allow harmful practices to be adopted are identified-a constrained model of disease, excessive extrapolation, a missing level of analysis, and the assumption that more is better.
...
1
2
...