LEADER 04923nam 2200661Ia 450 001 9910778505803321 005 20230331005015.0 010 $a1-280-21210-1 010 $a9786610212101 010 $a0-309-54363-0 010 $a0-585-14444-3 035 $a(CKB)110986584751012 035 $a(EBL)3377046 035 $a(SSID)ssj0000144571 035 $a(PQKBManifestationID)11160324 035 $a(PQKBTitleCode)TC0000144571 035 $a(PQKBWorkID)10146478 035 $a(PQKB)11398257 035 $a(MiAaPQ)EBC3377046 035 $a(Au-PeEL)EBL3377046 035 $a(CaPaEBR)ebr10063006 035 $a(CaONFJC)MIL21210 035 $a(OCoLC)940510383 035 $a(EXLCZ)99110986584751012 100 $a19900907d1990 uy 0 101 0 $aeng 135 $aur|n|---||||| 181 $ctxt 182 $cc 183 $acr 200 00$aEffectiveness and outcomes in health care$b[electronic resource] $eproceedings of an invitational conference by the Institute of Medicine, Division of Health Care Services /$fKim A. Heithoff and Kathleen N. Lohr, editors 210 $aWashington, D.C. $cNational Academy Press$d1990 215 $a1 online resource (245 p.) 300 $aDescription based upon print version of record. 311 $a0-309-07882-2 311 $a0-309-04342-5 320 $aIncludes bibliographical references. 327 $aEffectiveness 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 327 $aKEY 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 327 $aImplementation 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 327 $aHOW 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 327 $aTHE 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 327 $a12 The Role of Large Data Bases in Effectiveness Research 606 $aMedical care$xEvaluation$xResearch$vCongresses 606 $aMedicare$vCongresses 615 0$aMedical care$xEvaluation$xResearch 615 0$aMedicare 676 $a362.1/028/7 701 $aHeithoff$b Kim A$01548597 701 $aLohr$b Kathleen N.$f1941-$01506302 712 02$aInstitute of Medicine (U.S.).$bDivision of Health Care Services. 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910778505803321 996 $aEffectiveness and outcomes in health care$93805745 997 $aUNINA