Table of Contents:
  • 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.