Medical care
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Despite ethical implications, there are anecdotal reports of health practitioners withholding services from patients who do not pay their bills. We surveyed physicians about their attitudes and experiences regarding nonpaying patients. ⋯ A majority of primary care practitioners responding to our survey would be willing to withhold medical care from patients who do not pay their bills; some have actually done so despite ethical and legal mandates to the contrary. Physicians should be educated about the importance of the patient-physician relationship and their ethical obligations to patients.
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Defining comparative effectiveness research (CER) was the first order of business for the Institute of Medicine Committee on Initial Priorities for CER. The Institute of Medicine committee approached the task of defining CER by identifying the common theme in the 6 extant definitions. The definition follows: "Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. ⋯ Defining CER requires us to decide what we want from decisions about health care. Definitions also serve a bureaucratic function: they can set boundaries that delineate which research is eligible for CER program funding. Definitions--and the funding that advances their goals--can reshape the research environment.
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The modifications introduced to the inpatient prospective payment system on October 1, 2008, to disallow payment for 8 secondary conditions, if not present on admission (POA), constitute a significant shift that is expected to be followed by similar steps by private payers. ⋯ The estimates provided in this study should enable hospitals to identify how improvements in care can also result in cost savings. Focusing this study on CC cases enables hospitals to address highest cost cases that consume crucial resources in their CC settings.