Effectiveness and Outcomes in Health Care : Proceedings of an Invitational Conference.

Effectiveness and Outcomes in Health Care
 Copyright
 ACKNOWLEDGMENTS
 PREFACE
 EFFECTIVENESS VERSUS EFFICACY
 METHODOLOGIES
 IMPACT UPON COSTS
 RISK ADJUSTMENTS AND OUTCOMES
 CONCLUSIONS
 Contents
 PART I INTRODUCTION
 1 Genesis of the Effectiveness Initiative and IOM\'s Role
 THE BROADER CONTEXT
 The Institute of Medicine\'s Contribution
 The IOM Clinical Workshop
 The Condition-Specific Workshops
 Effectiveness and Outcomes Conference
 Proceedings
 2 Promise and Limitations of Effectiveness and Outcomes Research
 IMPORTANCE OF EFFECTIVENESS RESEARCH
 Medicare Data Bases. KEY ASPECTS OF EFFECTIVENESS RESEARCHReliability and Validity of Data
 Longitudinal Studies
 Tracking the Patient
 Health Status Assessment
 Risk Stratification
 Prevention
 The Aging Process
 PRINCIPLES TO GUIDE FEDERAL EFFORTS
 Range of Study Designs
 Funding
 Balance of Approaches
 Coordination
 Technology Assessment
 Influencing Provider Behavior
 The Confluence of Biomedical, Health Services, and Effectiveness Research
 PART II OVERVIEW
 3 Research on the Effectiveness of Medical Treatment: New Challenges and Opportunities
 Medical Treatment Effectiveness Program. Implementation of the ProgramPriorities for Research
 New Patterns of Collaboration
 References
 4 The Health Care Financing Administration and the Effectiveness Initiative
 HCFA\'S INTEREST IN EFFECTIVENESS
 THE EFFECTIVENESS INITIATIVE
 FUTURE ACTIVITIES
 ACKNOWLEDGEMENTS
 5 The Effectiveness Initiative: Retrospective and Prospects
 THE GOVERNMENT\'S ROLE IN EFFECTIVENESS RESEARCH
 PROSPECTS
 6 The Social Perspective
 THE PRESENT SCENARIO
 COSTS OF HEALTH CARE
 VARIATIONS IN MEDICAL COSTS AND PRACTICE
 REASONS FOR THE EFFECTIVENESS INITIATIVE. HOW TO PROCEED IN EFFECTIVENESS AND OUTCOMES RESEARCH7 The Clinical Perspective
 ISSUES IN THE USEFULNESS OF EFFECTIVENESS RESEARCH
 MEETING PHYSICIANS\' NEEDS
 Accessibility of Results
 Aiding Patient Invol Vement
 Relation to Payment Mechanisms
 Unbalanced Regulation
 IMPACT OF THE EFFECTIVENESS INITIATIVE
 Reference
 8 The Legislative Perspective
 UNMET HEALTH CARE NEEDS
 GROWING AWARENESS OF EFFECTIVENESS RESEARCH
 THE CHALLENGE TO SCIENTISTS
 CONCLUSION
 PART III THE IOM CLINICAL CONDITION WORKSHOPS
 The IOM Condition Workshops: Introduction
 9 Breast Cancer. THE PROBLEM OF POOR COMPLIANCECONTROVERSIES
 Screening
 Treatment
 THE ROLE OF EFFECTIVENESS STUDIES IN BREAST CANCER
 References
 10 Hip Fracture
 PREVENTION
 TREATMENT
 IN-HOSPITAL CARE
 REHABILITATION
 CONCLUSION
 11 Claims Data and Effectiveness: Acute Myocardial Infarction and Other Examples
 STRENGTHS OF CLAIMS DATA
 GENERAL LIMITATIONS
 Limitations for Diagnostic Devices
 Limitations for Drugs
 Limitations for Therapies
 CONCLUSION
 References
 PART IV METHODOLOGICAL ISSUES AND WORK IN PROGRESS
 Use of Large Data Bases: Introduction.