Discusses the difficulties involved in determining the cost of clinical research in light of the changing health care market. These include confusion about terminology, lack of specificity, estimation of the cost of complications, duration of patient participation, and the assignment of personnel and infrastructure costs. (MDM)

Strong Memorial Hospital, Rochester, New York, initiated a hospital-funded applied-research program linking patient care and academic interests of clinicians with hospital management to improve patient outcomes while lowering costs. The program is projected to produce substantial cost savings while improving patient care quality. (GLR)

Central criticisms concerning the academic medicine community concern health care system complexity, integration of technological advancement, ethics, physician-client relationships, and the importance of the individual student. Medical education cannot solve the problems but can contribute to solutions by preparing students to engage them.…

Current problems in health care delivery, including inadequate access to care and high costs, and potential solutions are examined. Additional emphasis on health promotion and disease prevention, increased biomedical research, the dissemination and implementation of findings, and better physician preparation to deal with the problems are…

This study was designed to determine whether opportunities exist to reduce patient morbidity and health care costs by utilizing health care services before diseases progress to advanced stages. Hospital admissions were categorized based on the timing of the initial hospitalizations of patients admitted with any of 14 diagnoses. (Author/MLW)

Evaluation of the University of South Florida Medical School's new (1990) preventive health requirements for matriculants showed that expensive requirements had the lowest rate of compliance and inexpensive ones, the highest rates. Enforcement measures significantly improved compliance. Cost was seen as a major deterrent to compliance. (Author/DB)

This paper reports on experiences and concerns of the Hospital of the University of Pennsylvania as a participating primary care site in a Medicaid managed care program (HealthPASS). Discussed are the modification of existing activities to meet increased care demands and administrative demands, and characteristics of HealthPASS that have impeded…

Five global health-related dilemmas requiring action are discussed, including (1) worldwide population aging; (2) rising worldwide poverty; (3) ethical dilemmas of new technologies; (4) need for adequate and affordable health care systems; and (5) need to allocate scarce resources to meet infinite health care demands. Five actions are recommended,…

This paper proposes structural reforms in the U.S. health care system based on the need for (1) workable, affordable solutions; (2) preserving and strengthening the biomedical research enterprise; (3) increased minority participation in science and the health professions; and (4) a culture of character emphasizing health promotion and disease…