Health affairs
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An emerging consensus supports online communication between patients and physicians in an existing relationship to improve the quality, timeliness, and efficiency of medical care. Patients are also seeking medical care online from physicians they have never met, ranging from one-time interactions for a second opinion to psychotherapy. These practices call for a new regulatory paradigm to ensure accountability, establish acceptable parameters for online medical practice, and distinguish online health care delivery from online health information. The new patient-physician encounters also challenge the medical profession and society to reexamine core assumptions that define medical practice and the patient-physician relationship.
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This study uses a nationally representative survey to identify the most expensive conditions in the United States and to examine the association between spending and disability. The most expensive conditions at a population level were ischemic heart disease and motor vehicle accidents; at the per capita level they were respiratory malignancies. There was not a significant association between rank order of treatment costs and disability; the conditions with the greatest disability relative to expenditures were mood disorders, chronic obstructive pulmonary disease, and arthropathies. We use the findings to discuss the role for cost-of-illness and burden-of-disease estimates in setting priorities.
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Despite a growing consensus that serious quality problems afflict U. S. health care, state and federal governments have done little to improve the quality of care. ⋯ We propose legislative requirements that any new expenditure of federal funds for health benefits be accompanied by public disclosure of performance information regarding quality, effectiveness, and safety. Such disclosure could yield diverse public and institutional benefits.