In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients.
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
The definitive guide to the knowledge and skills necessary to practice Hospital Medicine Presented in full color and enhanced by more than 700 illustrations, this authoritative text provides a background in all the important clinical, organizational, and administrative areas now required for the practice of hospital medicine. The goal of the book is provide trainees, junior and senior clinicians, and other professionals with a comprehensive resource that they can use to improve care processes and performance in the hospitals that serve their communities. Each chapter opens with boxed Key Clinical Questions that are addressed in the text and hundreds of tables encapsulate important information. Case studies demonstrate how to apply the concepts covered in the text directly to the hospitalized patient. Principles and Practice of Hospital Medicine is divided into six parts: Systems of Care: Introduces key issues in Hospital Medicine, patient safety, quality improvement, leadership and practice management, professionalism and medical ethics, medical legal issues and risk management, teaching and development. Medical Consultation and Co-Management: Reviews core tenets of medical consultation, preoperative assessment and management of post-operative medical problems. Clinical Problem-Solving in Hospital Medicine: Introduces principles of evidence-based medicine, quality of evidence, interpretation of diagnostic tests, systemic reviews and meta-analysis, and knowledge translations to clinical practice. Approach to the Patient at the Bedside: Details the diagnosis, testing, and initial management of common complaints that may either precipitate admission or arise during hospitalization. Hospitalist Skills: Covers the interpretation of common “low tech” tests that are routinely accessible on admission, how to optimize the use of radiology services, and the standardization of the execution of procedures routinely performed by some hospitalists. Clinical Conditions: Reflects the expanding scope of Hospital Medicine by including sections of Emergency Medicine, Critical Care, Geriatrics, Neurology, Palliative Care, Pregnancy, Psychiatry and Addiction, and Wartime Medicine.
Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
Large Animal Internal Medicine, 4th Edition features a problem-based approach with discussions of over 150 clinical signs. This is the first internal medicine reference that enables you to efficiently diagnose horses, cattle, sheep, and goats based on clinical observation and laboratory and diagnostic testing. With this user-friendly format, you can find essential information about specific diseases and reach a diagnosis by simply identifying the signs. - A unique problem-based approach with discussions of over 150 clinical signs and manifestations helps you quickly reach a diagnosis based on observations and laboratory tests. - Causes of Presenting Signs boxes provide easy access to complete lists of common, less common, and uncommon diseases associated with manifestations or signs of disease. - Complete lists of diseases associated with a given lab abnormality in Causes of Abnormal Laboratory Values boxes help you easily interpret abnormalities in clinical chemistry, hematology, blood proteins, and clotting tests. - An expert team of over 180 authors contributing information in their areas of expertise ensures you are using the most accurate and up-to-date information available. - Color plates accompanying Diseases of the Eye and Diseases of the Alimentary Tract enable you to visually recognize the clinical appearance of ophthalmologic conditions and alimentary tract disorders for quick and easy diagnosis and treatment. - NEW! Extensively updated content from expert authors clarifies the latest research and clinical findings on pain, the nervous system, toxicology, BVD, malignant catarrhal fever, bluetongue, and strong ions. - NEW! Vaccines and vaccination protocols keep you up-to-date with the information you need to prevent newly emerging diseases in large animals. - NEW! Expanded coverage of the veterinarian's role in animal welfare; equine abdominal ultrasound; DNA, genetic, and PCR testing; and colostrum supplements and replacers supplies you with the most current large animal internal medicine information. - NEW! Current information on foreign animal diseases dangerous to large animals in the US, including coverage of rinderpest, keeps you aware of diseases that can be transmitted from other countries.
The Principles and Practice of Narrative Medicine articulates the ideas, methods, and practices of narrative medicine. Written by the originators of the field, this book provides the authoritative starting place for any clinicians or scholars committed to learning of and eventually teaching or practicing narrative medicine.
The first medical specialty selection guide written by residents for students! Provides an inside look at the issues surrounding medical specialty selection, blending first-hand knowledge with useful facts and statistics, such as salary information, employment data, and match statistics. Focuses on all the major specialties and features firsthand portrayals of each by current residents. Also includes a guide to personality characteristics that are predominate with practitioners of each specialty. “A terrific mixture of objective information as well as factual data make this book an easy, informative, and interesting read.” --Review from a 4th year Medical Student
