Background: Injury is the leading cause of death for persons aged 1-44 years in the United States. Injuries have a substantial economic cost. For that reason, regional systems of trauma care in which the more acutely injured patients are transported to Level-I (L-I) trauma centers (TCs) has been widely advocated. However, the cost of TC care is…

The purpose of this study was to develop a tool to evaluate the quality of a clinical information system (CIS) conceived by nurses and conduct a pilot test with the developed tool as an initial assessment. CIS quality is required for successful implementation in information technology (IT) environments. The study started with the realization that…

The rising costs of medical treatment in the United States are fueling a movement to outsource medical treatment. Estimates of the number of Americans traveling overseas for treatment range from 50,000 to 500,000. Charges for common procedures such as heart bypass can be $11,000 in Thailand compared to $130,000 in the United States. Knee…

Transitional care encompasses a broad range of services and environments designed to promote the safe and timely passage of patients between levels of health care and across care settings. High-quality transitional care is especially important for older adults with multiple chronic conditions and complex therapeutic regimens, as well as for their…

Osteoporosis is a skeletal disease characterized by loss of bone mass and density, which results in an increased risk of fractures. The disease is referred to as the "silent thief," because it is often not until a person falls and breaks a bone that patients and their physicians become aware of weakening bones. An estimated 1.5 million…

This is one in a series of reports to the President and Congress developed by the President's Information Technology Advisory Committee (PITAC) on key contemporary issues in information technology. This report argues that significant improvements in health care would be possible if modern clinical information systems were widely implemented and a…

Context: National data documenting the role that rural hospitals play in providing inpatient care to patients both younger than 65 and 65 years and older has previously been unavailable. Purpose: To present descriptive nationally representative data on the numbers and types of inpatients, and the care they received, in rural hospitals. Methods:…

Newborn screening has existed as a state-based public health service since the early 1960s. Every state and most territorial jurisdictions have comprehensive newborn screening programs in place, but in the United States a national newborn screening policy does not exist. This results in different administrative infrastructures, screening…

Underperformance among physicians is not well studied or defined; yet, the identification and remediation of physicians who are not performing up to acceptable standards is central to quality care and patient safety. Methods for estimating the prevalence of dyscompetence include evaluating available data on medical errors, malpractice claims,…

This document contains summaries of thirty-two research projects supported by the National Center for Health Services Research (NCHSR) under authority of the Emergency Medical Services (EMS) Systems Act. (Focus of these research projects is to describe, explain, and predict the performance of more than 200 EMS systems being established under Title…

This monograph derives from a conference sponsored by the Fogarty International Center for Advanced Study in the Health Sciences. The goals of the conference were (1) to establish channels of communication between health care evaluators from different disciplines and from different countries in the Americas, and (2) to promote an exchange of…

This publication presents abstracts, statistics, and references drawn from health manpower literature. It is divided into seven sections; the first section provides statistics on (1) estimated employment in selected health occupations that are potentially entry-level, (2) hospital indicators, and (3) percent distribution of personal health care…

Problems of the health care profession and suggestions for reform are presented in this book on the U.S. health care delivery system. The book is divided into four sections. Section I, "Health and Health Care Problems for the American People," provides a general discussion on health, disease, and illness, and the importance of health…

The reasons a skill mix among health workers is important to health care systems were examined. The analysis was based on a review of studies conducted primarily in the United States. "Skill mix" was defined as the mix of posts, grades, or occupations in an organization and the combinations of activities or skills needed for each job…

Focus in this preventive medicine monograph for health professionals is on consumer health education and the current and potential effects of mass communication on the quality of medical care. Following an introduction, the content is presented in four chapters. Chapter 1 covers the state of the art in consumer health education and discusses three…