Health affairs
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We examined the impact of implementing a comprehensive electronic health record (EHR) system on ambulatory care use in an integrated health care delivery system with more than 225,000 members. Between 2004 and 2007, the annual age/sex-adjusted total office visit rate decreased 26.2 percent, the adjusted primary care office visit rate decreased 25.3 percent, and the adjusted specialty care office visit rate decreased 21.5 percent. Scheduled telephone visits increased more than eightfold, and secure e-mail messaging, which began in late 2005, increased nearly sixfold by 2007. Introducing an EHR creates operational efficiencies by offering nontraditional, patient-centered ways of providing care.
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Payment reforms clearly are an important change agent in our efforts to improve the health care delivery system. For broader health care delivery reform to take root and work, however, payment reform cannot be imposed in a vacuum. To maximize the chances of success and minimize the possibility of unintended consequences, the appropriate culture and structure of our health care institutions first must be in place.
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Chronic conditions are not just a problem for industrialized countries; they also affect more than a billion people in low- and middle-income countries. This Perspective shows how some middle-income countries are beginning to respond to the growing cost and prevalence of noncommunicable chronic diseases (NCDs). The primary message here, however, is that low-income countries will need substantial international assistance to confront the growing cost and burden of disease associated with NCDs. Evidence from middle-income countries suggests that there are low-cost, cost-effective ways to prevent and treat NCDs in low-income countries.
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Start-up companies in the biotechnology and medical device sectors are important sources of health care innovation. This paper describes the role of venture capital in supporting these companies and charts the growth in venture capital financial support. ⋯ Entries and exits in one sector also appear to influence entry in the other. These findings have important implications for developing innovative technologies and ensuring competitive markets in the life sciences.
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Comparative Study
Health spending in OECD countries: obtaining value per dollar.
In 2005 the United States spent $6,401 per capita on health care-more than double the per capita spending in the median Organization for Economic Cooperation and Development (OECD) country. Between 1970 and 2005, the United States had the largest increase (8.3 percent) in the percentage of gross domestic product (GDP) devoted to health care among all OECD countries. ⋯ S. population in 2005. The United States was equally likely to be in the top and bottom halves for sixteen quality measures compiled by the OECD.