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Background: The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery.
The United States belongs to various organizations and networks that encompass countries on both sides of the Pacific Ocean. The East Asia Summit (EAS) is not among them. Should the US try to join? This paper answers that question with a qualified yes: Despite formidable difficulties affecting President Obama’s schedule of foreign travel, his administration should try to “ease” the US into the Summit, initially as a guest of the host country. Eventually, pending a review of the EAS’s prior performance and future prospects, the administration may wish to upgrade that status to membershi
OBJECTIVE: Some argue that health plans have minimal impacts on quality of care and that quality data collection should focus only on physician organizations. We investigate the relative impact of physician organizations and health plans on quality measures.
BACKGROUND: The CDC recommends routine voluntary HIV testing of all patients 13-64 years of age. Despite this recommendation, HIV testing rates are low even among those at identifiable risk, and many patients do not return to receive their results. OBJECTIVE: To examine the costs and benefits of strategies to improve HIV testing and receipt of results. DESIGN: Cost-effectiveness analysis based on a Markov model. Acceptance of testing, return rates, and related costs were derived from a randomized trial of 251 patients; long-term costs and health outcomes were derived from the literature.
Background: Sodium consumption raises blood pressure, increasing the risk for heart attack and stroke. Several countries, including the United States, are considering strategies to decrease population sodium intake.
Objective: To assess the cost-effectiveness of 2 population strategies to reduce sodium intake: government collaboration with food manufacturers to voluntarily cut sodium in processed foods, modeled on the United Kingdom experience, and a sodium tax.
Abstract Objective. To develop and evaluate a clinical decision support system (CDSS) named Assessment and Treatment in Healthcare: Evidenced-Based Automation (ATHENA)-Opioid Therapy, which encourages safe and effective use of opioid therapy for chronic, noncancer pain. Design. CDSS development and iterative evaluation using the analysis, design, development, implementation, and evaluation process including simulation-based and in-clinic assessments of usability for providers followed by targeted system revisions. Results.
Research on aging has indicated that whereas deliberative cognitive processes decline with age, emotional processes are relatively spared. To examine the implications of these divergent trajectories in the context of health care choices, we investigated whether instructional manipulations emphasizing a focus on feelings or details would have differential effects on decision quality among younger and older adults. We presented 60 younger and 60 older adults with health care choices that required them to hold in mind and consider multiple pieces of information.
Objectives: Model-based cost-effectiveness analyses support decision-making. To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. Methods: We developed a structured reporting format for model evaluation and conducted a structured literature review to characterize current model evaluation recommendations and practices. As an illustration, we applied the reporting format to evaluate a microsimulation of human papillomavirus and cervical cancer.
Background: Sodium consumption raises blood pressure, increasing the risk for heart attack and stroke. Several countries, including the United States, are considering strategies to decrease population sodium intake.
Objective: To assess the cost-effectiveness of 2 population strategies to reduce sodium intake: government collaboration with food manufacturers to voluntarily cut sodium in processed foods, modeled on the United Kingdom experience, and a sodium tax.
The Clean Development Mechanism (CDM) is the leading international carbon market and a driving force for sustainable development globally. But the eruption of controversy over offsets from Chinese wind power has exposed cracks at the core of how carbon credits are verified in developing economies. It has become almost impossible to determine whether offsets from Chinese wind are "additional" and that they in fact represent "real" reductions beyond business as usual.
Any comprehensive approach to children's mental health should consider services systems such as Child Welfare that provide services to children with high rates of emotional and behavioral disorders. This paper will review what is known about efficacious parent-focused interventions that can improve the lives of children in Child Welfare and explore possible reasons why such interventions are rarely used by Child Welfare agencies. Data from a pilot study suggest key features for increasing the implementation of efficacious practices to improve children's mental health.
Abstract:
Feature-tracking techniques are employed to investigate why there is a relative minimum in storminess during winter within the Pacific storm track (the midwinter suppression). It is found that the frequency and amplitude of disturbances entering the Pacific storm track from midlatitude Asia are substantially reduced during winter relative to fall and spring and that the magnitude of this reduction is more than sufficient to account for the midwinter supression.
OBJECTIVE: The aim of this review was to evaluate the impact of managed care on publicly insured children with special health care needs (CSHCN).
METHODS: We conducted a review of the extant literature. Using a formal computerized search, with search terms reflecting 7 specific outcome categories, we summarized study findings and study quality.
Accumulating evidence suggests that agricultural production could be greatly affected by climate change, but there remains little quantitative understanding of how these agricultural impacts would affect economic livelihoods in poor countries. Here we consider three scenarios of agricultural impacts of climate change by 2030 (impacts resulting in low, medium, or high productivity) and evaluate the resulting changes in global commodity prices, national economic welfare, and the incidence of poverty in a set of 15 developing countries.
There is widespread interest in the impacts of climate change on agriculture in Sub-Saharan Africa (SSA), and on the most effective investments to assist adaptation to these changes, yet the scientific basis for estimating production risks and prioritizing investments has been quite limited. Here we show that by combining historical crop production and weather data into a panel analysis, a robust model of yield response to climate change emerges for several key African crops.
The Quadrennial Defense Review (QDR) is a legislatively-mandated review of Department of Defense (DoD) strategy and priorities. The QDR will set a long-term course for DoD as it assesses the threats and challenges that the nation faces and re-balances its strategies, capabilities and forces to address today's conflicts and tomorrow's threats.
Executive summary (excerpt):
The mission of the Department of Defense is to protect the American people and advance our nation’s interests.
Norway has made a point of administering its petroleum resources using three distinct government bodies: a national oil company (NOC) engaged in commercial hydrocarbon operations; a government ministry to help set policy; and a regulatory body to provide oversight and technical expertise. In Norway's case, this institutional design has provided useful checks and balances, helped minimize conflicts of interest, and allowed the NOC, Statoil, to focus on commercial activities while other government agencies regulate oil operators including Statoil itself. Norway's relative success in managin