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Biblioteca

MARC Lista (tabellare)
Clinical applications of mifepristone (RU 486) and other antiprogestins [[electronic resource] ] : assessing the science and recommending a research agenda / / Committee on Antiprogestins: Assessing the Science, Division of Health Promotion and Disease Prevention, Institute of Medicine ; Molla S. Donaldson ... [et al.], editors
Clinical applications of mifepristone (RU 486) and other antiprogestins [[electronic resource] ] : assessing the science and recommending a research agenda / / Committee on Antiprogestins: Assessing the Science, Division of Health Promotion and Disease Prevention, Institute of Medicine ; Molla S. Donaldson ... [et al.], editors
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1993
Descrizione fisica xi, 288 p. : ill
Disciplina 615/.766
Altri autori (Persone) BenetLeslie Z
DonaldsonMolla S
Soggetto topico Mifepristone - Research
Abortifacients - Research
Progesterone - Antagonists - Research
Soggetto genere / forma Electronic books.
ISBN 1-280-19602-5
9786610196029
0-309-59835-4
0-585-02478-2
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Record Nr. UNINA-9910455915103321
Washington, D.C., : National Academy Press, 1993
Materiale a stampa
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Clinical applications of mifepristone (RU 486) and other antiprogestins [[electronic resource] ] : assessing the science and recommending a research agenda / / Committee on Antiprogestins: Assessing the Science, Division of Health Promotion and Disease Prevention, Institute of Medicine ; Molla S. Donaldson ... [et al.], editors
Clinical applications of mifepristone (RU 486) and other antiprogestins [[electronic resource] ] : assessing the science and recommending a research agenda / / Committee on Antiprogestins: Assessing the Science, Division of Health Promotion and Disease Prevention, Institute of Medicine ; Molla S. Donaldson ... [et al.], editors
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1993
Descrizione fisica xi, 288 p. : ill
Disciplina 615/.766
Altri autori (Persone) BenetLeslie Z
DonaldsonMolla S
Soggetto topico Mifepristone - Research
Abortifacients - Research
Progesterone - Antagonists - Research
ISBN 1-280-19602-5
9786610196029
0-309-59835-4
0-585-02478-2
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Record Nr. UNINA-9910778793703321
Washington, D.C., : National Academy Press, 1993
Materiale a stampa
Lo trovi qui: Univ. Federico II
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Clinical applications of mifepristone (RU 486) and other antiprogestins : assessing the science and recommending a research agenda / / Committee on Antiprogestins: Assessing the Science, Division of Health Promotion and Disease Prevention, Institute of Medicine ; Molla S. Donaldson ... [et al.], editors
Clinical applications of mifepristone (RU 486) and other antiprogestins : assessing the science and recommending a research agenda / / Committee on Antiprogestins: Assessing the Science, Division of Health Promotion and Disease Prevention, Institute of Medicine ; Molla S. Donaldson ... [et al.], editors
Edizione [1st ed.]
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1993
Descrizione fisica xi, 288 p. : ill
Disciplina 615/.766
Altri autori (Persone) BenetLeslie Z
DonaldsonMolla S
Soggetto topico Mifepristone - Research
Abortifacients - Research
Progesterone - Antagonists - Research
ISBN 1-280-19602-5
9786610196029
0-309-59835-4
0-585-02478-2
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Nota di contenuto Clinical Applications of Mifepristone (RU 486) and Other Antiprogestins -- Copyright -- Preface -- Contents -- Summary -- CROSS-CUTTING RECOMMENDATIONS -- USES OF ANTIPROGESTINS: THE REPRODUCTIVE CYCLE -- Contraception -- Post-Coital Contraception -- Menses Induction -- Pregnancy Termination During the First Trimester -- Pregnancy Termination During the Second Trimester -- Cervical Ripening -- Labor Induction in Late Pregnancy -- OTHER POTENTIAL THERAPEUTIC USES OF ANTIPROGESTINS -- Endometriosis -- Uterine Leiomyomas (Fibroids) -- Breast Cancer -- Meningioma -- ANTIGLUCOCORTICOID EFFECTS OF ANTIPROGESTINS -- 1 Introduction -- BACKGROUND AND HISTORICAL PERSPECTIVES -- Finding an Antiprogestin -- THE IOM REPORT -- CROSS-CUTTING RECOMMENDATIONS -- REFERENCES -- 2 Uses of Antiprogestins: The Reproductive Cycle (Part I) -- CONTRACEPTION -- POST-COITAL CONTRACEPTION -- MENSES INDUCTION -- REFERENCES -- 3 Uses of Antiprogestins: The Reproductive Cycle (Part II) -- PREGNANCY TERMINATION DURING THE FIRST TRIMESTER -- Health Services Research -- PREGNANCY TERMINATION DURING THE SECOND TRIMESTER -- CERVICAL RIPENING -- LABOR INDUCTION IN LATE PREGNANCY -- Fetal Demise -- SUMMARY -- REFERENCES -- 4 Other Therapeutic Uses of Antiprogestins -- ENDOMETRIOSIS -- Utility of Mifepristone (RU 486) for Treatment of Endometriosis -- Summary -- UTERINE LEIOMYOMAS (FIBROIDS) -- Utility of Mifepristone for Treatment of Uterine Leiomyomas -- BREAST CANCER -- Mechanism of Action -- Clinical Issues -- Adjuvant Therapy and Chemoprevention -- Resistance -- Dose Issues -- Conclusions -- MENINGIOMAS -- Conclusions -- REFERENCES -- 5 Antiglucocorticoid Effects of Antiprogestins -- GLUCOCORTICOID FUNCTION -- THERAPEUTIC USE OF MIFEPRISTONE (RU 486) AS ANANTIGLUCOCORTICOID -- ADVERSE ANTIGLUCOCORTICOID EFFECTS OF ANTIPROGESTINS -- REFERENCES.
6 Animals as Models for Studying Antiprogestins -- REFERENCES -- APPENDIXES -- A Agenda for the IOM Workshop ''Antiprogestins: Assessing the Science," April 13-14, 1993 -- B Background Papers and Presentations (In Order of Presentation at IOM Workshop) -- B1 1993: RU 486-A DECADE ON TODAY AND TOMORROW -- ANTIHORMONES: THE 20 YEARS BEFORE RU 486 -- CHEMISTRY: NOVEL MOLECULES -- CELLULAR AND MOLECULAR MECHANISMS OF ACTION OF ANTIPROGESTINS: THE RECEPTOR AT THE CENTER -- Ligand Binding -- Receptor Transconformation -- Heat Shock Protein Binding -- Receptor Dimerization -- Binding to DNA -- Studies of Chromatin -- Gene Transcription -- PHYSIOPHARMACOLOGICAL REPRODUCTIVE EFFECTS -- REPRODUCTIVE MEDICINE (TABLE B1.4) -- Voluntary Early Pregnancy Interruption -- Pregnancy Interruption After Nine Weeks of Amenorrhea -- Initiation of Labor -- Contragestive and Contraceptive Methods Using RU 486 -- Emergency Post-Coital Contraception (Contraceptive or Contragestive According to When it is Applied) -- Late Luteal Phase Administration (Occasional Use) (Contragestive) -- Monthly Premenstrual, Late Luteal Phase Administration (Repeated Use) (Contragestive) -- Early Luteal Phase Administration (Once a Month) (Anti-Implantation) -- Endometrial Contraception" (Daily Delivery of Very Low Dose) (Contraceptive and Contragestive) -- Ovulation Suppression (Daily Delivery of a Low Dose) (Contraceptive) -- Male Contraception -- MEDICAL APPLICATIONS (TABLE B1.4) -- Uterine Diseases -- Endometriosis -- Fibroids -- Breast Cancer -- Meningioma -- ANTIGLUCOCORTICOSTEROID EFFECTS -- CONCLUSIONS -- Use for Voluntary Pregnancy Interruption -- Contraception -- Cancer -- Novel Antiprogestins: Biology and Chemistry -- ACKNOWLEDGMENTS -- REFERENCES -- B2 OVERVIEW AND BACKGROUND: MECHANISM OF ACTION OF ANTIPROGESTINS -- INTRODUCTION -- STRUCTURE AND FUNCTION OF THE PROGESTERONE RECEPTOR.
The Hormone Binding Domain -- The DNA Binding Domain -- Transactivation Function -- Association with Other Proteins -- Phosphorylation of the Progesterone Receptor -- Progesterone-Receptor Function -- MECHANISMS OF ACTION OF PROGESTERONE ANTAGONISTS -- Binding of Antagonists to Progesterone Receptors -- Formation of Dimers and DNA Binding Complexes -- Effects of Antagonists on Transcriptional Activation -- Other Effects of Antagonists on Receptors -- SUMMARY AND FUTURE AREAS OF STUDY -- REFERENCES -- B3 THE USE OF ANTIPROGESTINS IN THE REPRODUCTIVE CYCLE -- USE OF ANTIPROGESTINS IN THE REPRODUCTIVE CYCLE -- Basic Concepts and Assumptions -- Assessment Issues in Evaluating Antiprogestins -- Potential Uses of Antiprogestins -- Follicular Phase Administration of RU 486 -- Other Strategies for Administration of RU 486 During the Menstrual Cycle -- TOXICITY -- QUESTIONS FOR FUTURE RESEARCH -- SUMMARY -- REFERENCES -- B4 POTENTIAL CONTRACEPTIVE EFFECTS OF ANTIGESTOGENS -- ABSTRACT -- INTRODUCTION -- PHYSIOLOGICAL STUDIES IN THE MENSTRUAL CYCLE -- POSSIBLE CONTRACEPTIVE USES OF MIFEPRISTONE -- Inhibition of Ovulation -- Post-Coital Contraception -- Endometrial Contraception -- Late Post-Coital Contraception -- FUTURE DEVELOPMENTS -- Basic Research -- Mode of Action -- Clinical Studies -- REFERENCES -- B5 USE OF ANTIPROGESTINS BEFORE 63 DAYS OF AMENORRHEA -- INTRODUCTION -- EFFECT OF MIFEPRISTONE DURING EARLY PREGNANCY -- TERMINATION OF EARLY PREGNANCY -- Mifepristone Alone -- Mifepristone in Combination with Prostaglandin -- Practical Guidelines for Clinical Use of Mifepristone in Combination with Prostaglandin -- FURTHER DEVELOPMENTS IN MEDICAL TERMINATION OF EARLY PREGNANCY -- CONCLUSIONS -- REFERENCES -- B6 USES OF ANTIPROGESTINS AFTER 63 DAYS OF AMENORRHEA -- RU 486 FOR SECOND-TERM PREGNANCY TERMINATION -- RU 486 FOR INTRAUTERINE FETAL DEATH (IUFD).
CERVICAL RIPENING WITH RU 486 PRIOR TO SURGICAL ABORTION -- RU 486 FOR LABOR INDUCTION -- REFERENCES -- B7 COMMENTS ON SESSION II -- USE OF MIFEPRISTONE AND PROSTAGLANDIN FOR FIRST-TRIMESTER ABORTION -- Need for Medical Supervision -- Acceptability of Medical Versus Surgical Abortion -- Number of Visits Required -- Appropriate Dose of Mifepristone -- Side Effects -- SECOND-TRIMESTER ABORTIONS -- CONTRACEPTION -- POST-COITAL CONTRACEPTION -- CERVICAL RIPENING -- SUMMARY -- B8 USE OF ANTIPROGESTINS IN THE MANAGEMENT OF ENDOMETRIOSIS AND LEIOMYOMA -- ABSTRACT -- INTRODUCTION -- ENDOMETRIOSIS -- Antiprogestin in the Treatment of Endometriosis -- Pilot Study -- Long-Term, Low-Dose Studies -- LEIOMYOMA (FIBROID TUMOR) -- Antiprogestin in the Management of Leiomyoma- Dose-Response Studies -- 50-mg Dose -- 25- and 5-mg Doses -- Outcome -- ACKNOWLEDGMENTS -- REFERENCES -- B9 ANTIPROGESTINS AND THE TREATMENT OF BREAST CANCER -- INTRODUCTION -- PROGESTERONE AND THE NORMAL BREAST -- PROGESTERONE AND BREAST CANCER -- Progestin Agonists and Tumor Induction -- Progestin Agonists and Growth of Established Tumors -- PROGESTERONE ANTAGONISTS AND THE TREATMENT OF BREAST CANCER -- Human Breast Cancer Cell Lines -- Animal Models of Mammary Cancer -- Human Clinical Trials -- PROGESTIN RESISTANCE -- SUMMARY AND FUTURE PROSPECTS -- REFERENCES -- B10 USES OF RU 486 AS AN ANTIGLUCOCORTICOID -- HOW DO GLUCOCORTICOIDS ACT? -- PHYSIOLOGIC ROLE OF GLUCOCORTICOIDS -- RU 486 AS AN ANTIGLUCOCORTICOID -- RESEARCH DIRECTIONS FOR ANTIGLUCOCORTICOIDS -- REFERENCES -- B11 PRIMATE MODELS FOR THE STUDY OF ANTIPROGESTINS IN REPRODUCTIVE MEDICINE -- PART I: ACTIVITY EXPRESSIONS OF ANTIPROGESTINS -- Progesterone Antagonists -- Antiglucocorticoid Activity -- Noncompetitive Antiestrogenic (Antiproliferative) Activity -- Sources of Antiprogestins.
PART II: NONCOMPETITIVE ANTIESTROGENIC ACTIVITY OF PROGESTERONE ANTAGONISTS -- Initial Evidence of Noncompetitive Antiestrogenic Activity of Mifepristone -- Dose-Dependent Blockade of the Proliferative Action of Estradiol Endometrium by Mifepristone -- Mifepristone-Induced Elevations of Estrogen Receptor in Primate Endometrium -- REFERENCES -- B12 ANTIPROGESTOGENS: PERSPECTIVES FROM A GLOBAL RESEARCH PROGRAM -- ABSTRACT -- INTRODUCTION -- COMPOUNDS -- Progesterone Synthesis Inhibitors -- Progesterone-Receptor Blockers -- ANIMAL MODELS -- Receptor Binding -- Plasma Protein Binding -- Pregnant Guinea Pig Model -- MECHANISMS OF ACTION -- Prostaglandin Metabolism -- Myometrial Gap Junctions -- Estrogen and Progesterone Receptors -- POSSIBLE USES -- PROSPECTS -- ACKNOWLEDGMENT -- REFERENCES -- C Observers at the Workshop on Antiprogestins: Assessing the Science April 13-14, 1993 -- Index.
Record Nr. UNINA-9910817002103321
Washington, D.C., : National Academy Press, 1993
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Collaboration among competing managed care organizations for quality improvement [[electronic resource] ] : summary of a conference, November 13, 1997 / / The National Roundtable on Health Care Quality, Division of Health Care Services, Institute of Medicine ; Molla S. Donaldson, editor
Collaboration among competing managed care organizations for quality improvement [[electronic resource] ] : summary of a conference, November 13, 1997 / / The National Roundtable on Health Care Quality, Division of Health Care Services, Institute of Medicine ; Molla S. Donaldson, editor
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1999
Descrizione fisica 1 online resource (61 p.)
Disciplina 362.1/04258/0973
Altri autori (Persone) DonaldsonMolla S
Soggetto topico Managed care plans (Medical care) - United States
Soggetto genere / forma Electronic books.
ISBN 1-280-18610-0
9786610186105
0-309-59291-7
0-585-08241-3
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Record Nr. UNINA-9910455943403321
Washington, D.C., : National Academy Press, 1999
Materiale a stampa
Lo trovi qui: Univ. Federico II
Opac: Controlla la disponibilità qui
Collaboration among competing managed care organizations for quality improvement [[electronic resource] ] : summary of a conference, November 13, 1997 / / The National Roundtable on Health Care Quality, Division of Health Care Services, Institute of Medicine ; Molla S. Donaldson, editor
Collaboration among competing managed care organizations for quality improvement [[electronic resource] ] : summary of a conference, November 13, 1997 / / The National Roundtable on Health Care Quality, Division of Health Care Services, Institute of Medicine ; Molla S. Donaldson, editor
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1999
Descrizione fisica 1 online resource (61 p.)
Disciplina 362.1/04258/0973
Altri autori (Persone) DonaldsonMolla S
Soggetto topico Managed care plans (Medical care) - United States
ISBN 0-309-18435-5
1-280-18610-0
9786610186105
0-309-59291-7
0-585-08241-3
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Record Nr. UNINA-9910778649003321
Washington, D.C., : National Academy Press, 1999
Materiale a stampa
Lo trovi qui: Univ. Federico II
Opac: Controlla la disponibilità qui
Collaboration among competing managed care organizations for quality improvement : summary of a conference, November 13, 1997 / / The National Roundtable on Health Care Quality, Division of Health Care Services, Institute of Medicine ; Molla S. Donaldson, editor
Collaboration among competing managed care organizations for quality improvement : summary of a conference, November 13, 1997 / / The National Roundtable on Health Care Quality, Division of Health Care Services, Institute of Medicine ; Molla S. Donaldson, editor
Edizione [1st ed.]
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1999
Descrizione fisica 1 online resource (61 p.)
Disciplina 362.1/04258/0973
Altri autori (Persone) DonaldsonMolla S
Soggetto topico Managed care plans (Medical care) - United States
ISBN 0-309-18435-5
1-280-18610-0
9786610186105
0-309-59291-7
0-585-08241-3
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Nota di contenuto Collaboration Among Competing Managed Care Organizations for Quality Improvement -- Copyright -- PREFACE AND ACKNOWLEDGMENTS -- Contents -- SUMMARY -- Why Do Organizations Collaborate? -- Antitrust Issues -- Standard Setting -- Information Collection and Exchange -- Selecting High-Quality Providers -- Lobbying and Working with Government -- Conclusion -- SESSION 1: CONCEPTUAL ISSUES IN COLLABORATION -- INTRODUCTION TO COLLABORATION -- Potential Areas for Collaboration -- Issues for the Conference -- LEGAL ISSUES IN COLLABORATION -- Some Rudiments of Antitrust Law -- Specific Pitfalls to Be Avoided -- Group Boycotts. -- Other Naked Restraints. -- Standard Setting -- Information Collection and Exchange -- Selecting High-Quality Providers -- Lobbying and Working with Government -- Conclusion -- COLLABORATION FOR QUALITY IMPROVEMENT AMONG MANAGED HEALTH CARE ORGANIZATIONS: WHAT CAN BE LEARNED F ... -- Why Do Organizations Collaborate? -- Why Do Organizations Refuse to Collaborate? -- How Are These Examples Relevant to Health Care? -- SESSION 2: PANEL PRESENTATIONS -- LESSONS FROM THE ELECTRONICS INDUSTRY -- ANTITRUST REGULATION -- THE LIMITS OF COMPETITION -- THE MEDICAL DIRECTOR'S PERSPECTIVE -- SESSION 3: EXAMPLES OF COLLABORATION -- HEALTH CARE EDUCATION RESEARCH FOUNDATION -- THE EMPLOYERS' MANAGED HEALTH CARE ASSOCIATION -- PACIFIC BUSINESS GROUP ON HEALTH -- THE FOUNDATION FOR HEALTHY COMMUNITIES -- THE NATIONAL RURAL HEALTH ASSOCIATION -- Barriers to Collaboration -- BIOGRAPHIES OF SPEAKERS -- CONFERENCE AGENDA.
Record Nr. UNINA-9910816117803321
Washington, D.C., : National Academy Press, 1999
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Lo trovi qui: Univ. Federico II
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Health data in the information age [[electronic resource] ] : use, disclosure, and privacy / / Molla S. Donaldson and Kathleen N. Lohr, editors ; Committee on Regional Health Data Networks, Division of Health Care Services, Institute of Medicine
Health data in the information age [[electronic resource] ] : use, disclosure, and privacy / / Molla S. Donaldson and Kathleen N. Lohr, editors ; Committee on Regional Health Data Networks, Division of Health Care Services, Institute of Medicine
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1994
Descrizione fisica 1 online resource (271 p.)
Disciplina 651.5/04261
Altri autori (Persone) DonaldsonMolla S
LohrKathleen N. <1941->
Soggetto topico Medical records - Access control
Confidential communications - Physicians
Medical informatics
Soggetto genere / forma Electronic books.
ISBN 1-280-21136-9
9786610211364
0-309-53821-1
0-585-00234-7
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Record Nr. UNINA-9910455877403321
Washington, D.C., : National Academy Press, 1994
Materiale a stampa
Lo trovi qui: Univ. Federico II
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Health data in the information age [[electronic resource] ] : use, disclosure, and privacy / / Molla S. Donaldson and Kathleen N. Lohr, editors ; Committee on Regional Health Data Networks, Division of Health Care Services, Institute of Medicine
Health data in the information age [[electronic resource] ] : use, disclosure, and privacy / / Molla S. Donaldson and Kathleen N. Lohr, editors ; Committee on Regional Health Data Networks, Division of Health Care Services, Institute of Medicine
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1994
Descrizione fisica 1 online resource (271 p.)
Disciplina 651.5/04261
Altri autori (Persone) DonaldsonMolla S
LohrKathleen N. <1941->
Soggetto topico Medical records - Access control
Confidential communications - Physicians
Medical informatics
ISBN 1-280-21136-9
9786610211364
0-309-53821-1
0-585-00234-7
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Record Nr. UNINA-9910778800603321
Washington, D.C., : National Academy Press, 1994
Materiale a stampa
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Health data in the information age : use, disclosure, and privacy / / Molla S. Donaldson and Kathleen N. Lohr, editors ; Committee on Regional Health Data Networks, Division of Health Care Services, Institute of Medicine
Health data in the information age : use, disclosure, and privacy / / Molla S. Donaldson and Kathleen N. Lohr, editors ; Committee on Regional Health Data Networks, Division of Health Care Services, Institute of Medicine
Edizione [1st ed.]
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1994
Descrizione fisica 1 online resource (271 p.)
Disciplina 651.5/04261
Altri autori (Persone) DonaldsonMolla S
LohrKathleen N. <1941->
Soggetto topico Medical records - Access control
Confidential communications - Physicians
Medical informatics
ISBN 1-280-21136-9
9786610211364
0-309-53821-1
0-585-00234-7
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Nota di contenuto Health Data in the Information Age -- Copyright -- Preface -- Acknowledgments -- Contents -- Summary -- THE PROBLEM -- INSTITUTE OF MEDICINE STUDY -- USES AND USERS OF INFORMATION IN HDOS -- Databases -- Key Attributes of Databases -- Other Characteristics of Databases -- Ensuring the Quality of Data -- PUBLIC DISCLOSURE OF DATA ON HEALTH CARE PROVIDERS AND PRACTITIONERS -- Key Factors in Public Disclosure -- Analyses and Disclosure of Results -- Describing Analytic Methods -- Minimizing Potential Harms -- Releasing Data -- STRENGTHENING QUALITY ASSURANCE AND QUALITY IMPROVEMENT PROGRAMS THROUGH DATA FEEDBACK -- CONFIDENTIALITY AND PRIVACY OF PERSONAL DATA -- Privacy and Privacy Rights -- Privacy Rights -- Confidentiality -- Security -- A National Identification System or Dossier -- Personal Identifiers and the Social Security Number -- An "Ideal" Identifier -- Relevance to HDOs of Existing Laws on Confidentiality and Privacy -- Recommendations Regarding Protection of Patient and Person-identifiable Data -- Preemptive Legislation -- Data Protection Units -- Release of Person-Identified Data -- Policies Relating to Access and Disclosure -- Universal Person-Identifiers -- THE FUTURE -- 1 Introduction -- ADVANCING THE PROSPECTS FOR COMPREHENSIVE HEALTH DATABASES AND NETWORKS -- The Problem -- The Opportunity -- HEALTH DATABASE ORGANIZATIONS -- THE INSTITUTE OF MEDICINE STUDY -- The Study Committee and Its Charge -- Questions Confronting the Study Committee -- STUDY ACTIVITIES -- ORGANIZATION OF THE REPORT -- COMMENT -- 2 Health Databases and Health Database Organizations: Uses, Benefits, and Concerns -- DEFINITIONS -- Database -- Key Attributes of Databases -- Other Characteristics of Databases -- Data Network -- Health Database Organization -- The Concept of HDOs -- HDOs Under Development -- THE BENEFITS OF HEALTH DATABASES -- Broad-based Benefits.
Differential Benefits as a Function of Users and Uses -- USERS OF INFORMATION IN HDOS -- USES OF DATABASES -- Assessing Access to Care and Use of Services -- Assessing Costs and Identifying Opportunities for Savings -- Evaluating Quality and Outcomes of Care -- Hospital-specific Mortality Rate Studies -- Effectiveness and Outcomes Research -- Quality Assurance and Quality Improvement Programs -- Planning and Monitoring Patient Care -- Enhancing Administrative Efficiency -- Operating Managed Care Programs -- Strategic Planning and Selective Contracting -- Strategic Planning -- Selective Contracting -- Other Business-related Uses -- Tracking Injury and Illness, Preventive Care, and Health Behaviors -- Promoting Regional and Community Health Planning, Education, and Outreach -- Health Planning and Education -- Community Outreach -- Other Uses for HDO Databases -- Comment -- ENSURING THE QUALITY OF DATA -- SUMMARY -- 3 Public Disclosure of Data on Health Care Providers and Practitioners -- PREVIOUS STUDIES -- IMPORTANT PRINCIPLES OF PUBLIC DISCLOSURE -- IMPORTANT ELEMENTS OF PUBLIC DISCLOSURE -- Topics for HDO Analysis and Disclosure -- Who Is Identified -- Vulnerability to Harm -- Methodological and Technical Issues -- How Information Is Publicly Disclosed -- COMMITTEE FINDINGS AND CONCLUSIONS -- RECOMMENDATIONS -- Advocacy of Analyses and Public Disclosure of Results -- Minimizing Potential Harms -- Advocacy of Data Release -- Promoting Wide Applications of Health-related Data -- Requiring Recipients to Protect Data Privacy and Confidentiality -- Using Valid Analytic Techniques -- Related Issues -- Privacy Protections for Person-identifiable Data -- Constrained Staff Capabilities -- Obligations to Correct Analyses or Retract Information -- STRENGTHENING QUALITY ASSURANCE AND QUALITY IMPROVEMENT PROGRAMS -- Data Feedback.
Quality Assurance and Quality Improvement -- Privileging -- Peer Review Information -- Public Disclosure and Feedback -- SUMMARY -- APPENDIX 3A -- Actual Numbers, Computed Values, and Risk Adjustment -- Certainty, Probability, and Correct Inferences -- The Educational Content of Public Information Dissemination -- 4 Confidentiality and Privacy of Personal Data -- HISTORICAL PERSPECTIVES AND GENERAL OBSERVATIONS ON DISCLOSURE OF INFORMATION -- SOURCES OF CONCERNS ABOUT PRIVACY AND THE CONFIDENTIALITY OF HEALTH RECORDS -- Health Care Records -- Electronic Records -- DEFINITIONS -- Privacy -- Informational Privacy -- Recordkeeping Privacy -- Privacy Rights -- Balancing Benefits of HDOs Against Loss of Informational Privacy -- Federal and State Privacy Protection -- Confidentiality -- Confidentiality Obligations in Health Care -- Disclosure of Health Information -- Weaknesses of Legal Protection for Confidentiality -- Security -- Health-Related Information -- EXPANDED DEFINITIONS -- HARM FROM DISCLOSURE AND REDISCLOSURE OF HEALTH RECORD INFORMATION -- Common" Disclosures -- Inadvertent Release -- ''Routine" Releases or Uses in Accordance with Prevailing Practices -- Rerelease to Third Parties Without the Subject's Knowledge or Consent (Secondary Use) -- Covert Acquisition and Use of Data for Illegal or Unethical Purposes -- Release of Inaccurate Data -- PRIVACY INTERESTS AND HDOS -- Foreseen and Unforeseen Circumstances -- A National Identification System or Dossier -- Personal Identifiers and the Social Security Number -- An Ideal Personal Identifier -- Issues Relating to the SSN -- SSN Uses for Other Than Medical Payments -- Shortfalls of the SSN as an Identifier -- Confidentiality of Research Uses of HDO Databases -- RELEVANCE OF EXISTING LAWS TO HDOS -- Laws Governing Insurance Support Organizations -- Laws Governing Consumer Reporting Agencies.
HDOs as Governmental Entities: General Confidentiality Protections in Public Law -- Constitutional Law -- Legislative Charter -- Freedom of Information Acts -- Fair Information Practices -- OPTIONS FOR PROTECTING PRIVACY AND CONFIDENTIALITY OF HEALTH-RELATED DATA IN HDOS -- Uniform Legislation -- Federal Preemptive Legislation -- Uniform State Legislation -- Options for Consent and Participation Rights -- HDO Access to Data -- Other Consent and Participation Rights -- Disclosure Options -- Disclosure-Oriented Options (Weak Options) -- Confidentiality-Oriented Options (Strong Options) -- Governance Options as an Approach to Privacy Protections -- State-Based Systems -- Private-Sector Systems -- Mixed Governance Systems -- Other Administrative Options to Protect Privacy and Confidentiality -- COMMITTEE RECOMMENDATIONS -- Overview and General Principles -- Preemptive Legislation -- Arguments for Federal Legislation -- Attaching Privacy Protection to Data -- Uniform Requirements -- Specific Elements of Federal Legislation -- Exemption from Compulsory Reporting and Compulsory Process -- Data Protection Units -- Establishing a Data Protection Board -- Developing Administrative Policies and Procedures -- Overseeing Data Integrity -- Release of Person-identified Data -- Policies Relating to Access and Disclosure -- Consent -- Release of Person-identified Data -- The Standing of Other HDOs -- The Standing of Persons, Parents, and Legal Representatives -- The Special Standing of Research -- Special Patient Care Considerations -- Prohibition on Access to Person-identifiable Data -- Implications of Recommendations Denying Access -- Employer Access -- Universal Person Identifiers -- COMMENT -- The New Privacy -- SUMMARY -- References -- Appendixes -- A Fact-Finding for the Committee on Regional Health Data Networks -- PARTICIPANTS AND GUESTS AT COMMITTEE MEETINGS.
Expert Presentations and Briefings -- Invited Guests and Observers -- Institute of Medicine Staff -- SITE VISITS -- Memphis, Tennessee: July 26-28, 1992 -- Cleveland, Ohio: August 2-4, 1992 -- Des Moines, Iowa: August 26-28, 1992 -- Seattle, Washington: September 9-11, 1992 -- Rochester and Albany, New York: September 21-23, 1992 -- Albany -- Rochester -- Basic Findings of Site Visits -- B Committee on Regional Health DataNetworks Biographical Sketches -- Glossary -- Acronyms -- Index.
Record Nr. UNINA-9910826074603321
Washington, D.C., : National Academy Press, 1994
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Measuring the quality of health care [[electronic resource] ] : a statement by the National Roundtable on Health Care Quality, Division of Health Care Services, Institute of Medicine / / Molla S. Donaldson, editor
Measuring the quality of health care [[electronic resource] ] : a statement by the National Roundtable on Health Care Quality, Division of Health Care Services, Institute of Medicine / / Molla S. Donaldson, editor
Pubbl/distr/stampa Washington, D.C., : National Academy Press, 1999
Descrizione fisica 1 online resource (42 p.)
Altri autori (Persone) DonaldsonMolla S
Soggetto topico Medical care - United States - Evaluation
Public health - United States - Evaluation
Soggetto genere / forma Electronic books.
ISBN 1-280-18609-7
9786610186099
0-309-57068-9
0-585-08244-8
Formato Materiale a stampa
Livello bibliografico Monografia
Lingua di pubblicazione eng
Record Nr. UNINA-9910455942303321
Washington, D.C., : National Academy Press, 1999
Materiale a stampa
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