Perspective
Health Care 2009
A Strategy for Health Care Reform — Toward a Value-Based System
N Engl J Med 2009; 361:109-112July 9, 2009DOI: 10.1056/NEJMp0904131
- Article
Despite many waves of debate and piecemeal reforms, the U.S. health care system remains largely the same as it was decades ago. We have seen no convincing approach to changing the unsustainable trajectory of the system, much less to offsetting the rising costs of an aging population and new medical advances.
Today there is a new openness to changing a system that all agree is broken. What we need now is a clear national strategy that sets forth a comprehensive vision for the kind of health care system we want to achieve and a path for getting there. The central focus must be on increasing value for patients — the health outcomes achieved per dollar spent.1 Good outcomes that are achieved efficiently are the goal, not the false “savings” from cost shifting and restricted services. Indeed, the only way to truly contain costs in health care is to improve outcomes: in a value-based system, achieving and maintaining good health is inherently less costly than dealing with poor health.
True reform will require both moving toward universal insurance coverage and restructuring the care delivery system. These two components are profoundly interrelated, and both are essential. Achieving universal coverage is crucial not only for fairness but also to enable a high-value delivery system. When many people lack access to primary and preventive care and cross-subsidies among patients create major inefficiencies, high-value care is difficult to achieve. This is a principal reason why countries with universal insurance have lower health care spending than the United States. However, expanded access without improved value is unsustainable and sure to fail. Even countries with universal coverage are facing rapidly rising costs and serious quality problems; they, too, have a pressing need to restructure delivery.2-4
How can we achieve universal coverage in a way that will support, rather than impede, a fundamental reorientation of the delivery system around value for patients? There are several critical steps.
First, we must change the nature of health insurance competition. Insurers, whether private or public, should prosper only if they improve their subscribers' health. Today, health plans compete by selecting healthier subscribers, denying services, negotiating deeper discounts, and shifting more costs to subscribers. This zero-sum approach has given competition — and health insurers — a bad name. Instead, health plans must compete on value. We must introduce regulations to end coverage and price discrimination based on health risks or existing health problems. In addition, health plans should be required to measure and report their subscribers' health outcomes, starting with a group of important medical conditions. Such reporting will help consumers choose health plans on the basis of value and discourage insurers from skimping on high-value services, such as preventive care. Health insurers that compete this way will drive value in the system far more effectively than government monopolies can.
Second, we must keep employers in the insurance system. Employers have a vested interest in their employees' health. Daily interactions with their workforce enable employers to create value by developing a culture of wellness, enabling effective prevention and screening, and directing employees to high-value providers. Employers can also foster competition and drive broader system improvement in ways that are difficult for government entities to replicate. To motivate employers to stay in the system, we must reduce the extra amount they now pay through higher insurance costs to cover the uninsured and subsidize government programs. We must also create a level playing field for employers that offer coverage by penalizing employers that are free riders.
Third, we need to address the unfair burden on people who have no access to employer-based coverage, who therefore face higher premiums and greater difficulty securing coverage. This means first equalizing the tax deductibility of insurance purchased by individuals and through employers.
Fourth, to make individual insurance affordable, we need large statewide or multistate insurance pools, like the Massachusetts Health Insurance Connector, to spread risk and enable contracting for coverage and premiums equivalent to or better than those of the largest employer-based plans. Regional pools, instead of a national pool, will result in greater accountability to subscribers and closer interaction with regional provider networks, fostering value-based competition. We also need a reinsurance system that equitably spreads the cost of insuring Americans with very expensive health problems across both regional pools and employers.
Fifth, income-based subsidies will be needed to help lower-income people buy insurance. These subsidies can be partially offset through payments from employers that do not provide coverage but whose employees require public assistance.
Finally, once a value-based insurance market has been established, everyone must be required to purchase health insurance so that younger and healthier people cannot opt out. This will bring substantial new revenues into the system, lowering premiums for everyone and reducing the need for subsidies.
Although most U.S. health care reform efforts have focused on coverage, the far bigger long-term driver of success will come from restructuring the delivery system. That is where most of the value is created and most of the costs are incurred.
The current delivery system is not organized around value for patients, which is why incremental reforms have not lived up to expectations. Our system rewards those who shift costs, bargain away or capture someone else's revenues, and bill for more services, not those who deliver the most value. The focus is on minimizing the cost of each intervention and limiting services rather than on maximizing value over the entire care cycle. Moreover, without comprehensive outcome measurement, it is hard to know what improves value and what does not.
To achieve a value-based delivery system, we need to follow a series of mutually reinforcing steps. First, measurement and dissemination of health outcomes should become mandatory for every provider and every medical condition. Results data not only will drive providers and health plans to improve outcomes and efficiency but also will help patients and health plans choose the best provider teams for their medical circumstances.
Outcomes must be measured over the full cycle of care for a medical condition, not separately for each intervention. Outcomes of care are inherently multidimensional, including not only survival but also the degree of health or recovery achieved, the time needed for recovery, the discomfort of care, and the sustainability of recovery.5 Outcomes must be adjusted for patients' initial conditions to eliminate bias against patients with complex cases.
We need to measure true health outcomes rather than relying solely on process measures, such as compliance with practice guidelines, which are incomplete and slow to change. We must also stop using one or a few measures as a proxy for a provider's overall quality of care. Performance on a measure such as mortality within 30 days after acute myocardial infarction, for example, says little about a provider's care for patients with cancer. Active involvement of the federal government will be needed to ensure universal, consistent, and fair measurement throughout the country, like that already achieved in areas such as organ transplantation.
Since implementing outcome measurement will take time, an interim step should be to require every provider team to report its experience or the volume of patients treated for each medical condition, along with the procedure or treatment approach used. Experience reporting by providers will help patients and their doctors find the providers with the expertise that meets their needs.
Second, we need to radically reexamine how to organize the delivery of prevention, wellness, screening, and routine health maintenance services. The problem is not only that the system underinvests in these services relative to the value they can create but also that primary care providers are asked to deliver disparate services with limited staff to excessively broad patient populations. As a result, delivery of such care is fragmented and often ineffective and inefficient. We need structures for the delivery of specified prevention and wellness service bundles to defined patient populations with unified reimbursement. Employers with on-site health clinics are achieving extraordinary success in providing such services, highlighting the need for new delivery channels beyond conventional settings.
Third, we need to reorganize care delivery around medical conditions. Our system of uncoordinated, sequential visits to multiple providers, physicians, departments, and specialties works against value. Instead, we need to move to integrated practice units that encompass all the skills and services required over the full cycle of care for each medical condition, including common coexisting conditions and complications. Such units should include outpatient and inpatient care, testing, education and coaching, and rehabilitation within the same actual or virtual organization. This structure, organized around the patient's needs, will result in care with much higher value and a far better experience for patients. Government policies creating artificial obstacles to integrated, multidisciplinary care (e.g., the Stark laws) should be modified or eliminated. In a value-based system, the abuses that gave rise to such legislation will decline substantially.
Fourth, we need a reimbursement system that aligns everyone's interests around improving value for patients. Reimbursement must move to single bundled payments covering the entire cycle of care for a medical condition, including all providers and services. Bundled payments will shift the focus to restoring and maintaining health, providing a mix of services that optimizes outcomes, and reorganizing care into integrated practice structures. For chronic conditions, bundled payments should cover extended periods of care and include responsibility for evaluating and addressing complications.
Fifth, we must expect and require providers to compete for patients, based on value at the medical-condition level, both within and across state borders. This will allow excellent providers to grow and serve more patients while reducing hyperfragmentation and duplication of services. In order to achieve high value, providers need a sufficient volume of cases of a given medical condition to allow for the development of deep expertise, integrated teams, and tailored facilities. We may need to institute minimum-volume thresholds for complex medical conditions in order to jump-start consolidation and spur geographic expansion of qualified providers. At the same time, strict antitrust scrutiny must be applied to avoid excessive concentration among a small number of providers or health plans in a region.
Sixth, electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems.
Finally, consumers must become much more involved in their health and health care. Unless patients comply with care and take responsibility for their health, even the best doctor or team will fail. Simply forcing consumers to pay more for their care is not the answer. New integrated care delivery structures, together with bundled reimbursement for full care cycles, will enable vast improvements in patient engagement, as will the availability of good outcome data.
Comprehensive reform will require simultaneous progress in all these areas because they are mutually reinforcing. For example, outcome measurement not only will improve insurance-market competition but also will drive the restructuring of care delivery. Delivery restructuring will be accelerated by bundled reimbursement. Electronic medical records will facilitate both delivery restructuring and outcome measurement.
Moving ahead now on all these fronts is also important in order to align every stakeholder's interest with value, or reform will once again fail. However, a health care strategy, like any good strategy, involves a sequence of steps over time rather than an attempt to change everything at once. Road maps will be needed for rolling out changes in each area while giving the actors time to adjust.
Some new organizations (or combinations of existing ones) will be needed: a new independent body to oversee outcome measurement and reporting, a single entity to review and set HIT standards, and possibly a third body to establish rules for bundled reimbursement. Medicare may be able to take the lead in some areas; for example, Medicare could require experience reporting by providers or combine Parts A and B into one payment.
The big question is whether we can move beyond a reactive and piecemeal approach to a true national health care strategy centered on value. This undertaking is complex, but the only real solution is to align everyone in the system around a common goal: doing what's right for patients.
Dr. Porter reports receiving lecture fees from the American Surgical Association, the American Medical Group Association, the World Health Care Congress, Hoag Hospital, and the Children's Hospital of Philadelphia, receiving director's fees from Thermo Fisher Scientific, and having an equity interest in Thermo Fisher Scientific, Genzyme, Zoll Medical, Merck, and Pfizer. No other potential conflict of interest relevant to this article was reported.
This article (10.1056/NEJMp0904131) was published on June 3, 2009, at NEJM.org.
Source Information
From Harvard Business School, Boston.
- References
References
1
Porter ME, Teisberg EO. Redefining health care: creating value-based competition on results. Boston: Harvard Business School Press, 2006.
2
Teperi J, Porter ME, Vuorenkoski L, Baron JF. The Finnish health care system: a value-based perspective. Helsinki: Sitra, March 2009.
3
Porter ME, Yasin ZM, Baron JF. Global health partner: obesity care. Boston: Harvard Business School Publishing, 2009.
4
Porter ME, Guth C, Dannemiller E. The West German Headache Center: integrated migraine care. Boston: Harvard Business School Publishing, 2007.
5
Porter ME
Web of Science | Medline
- Citing Articles (173)
Citing Articles
1
Johan Mesterton, Peter Lindgren, Anna Ekenberg Abreu, Lars Ladfors, Monica Lilja, Sissel Saltvedt, Isis Amer–Wåhlin. (2016) Case mix adjustment of health outcomes, resource use and process indicators in childbirth care: a register-based study. BMC Pregnancy and Childbirth 16:1
CrossRef2
Jochen Schmitt, Katrin Arnold, Diana Druschke, Enno Swart, Xina Grählert, Ulf Maywald, Andreas Fuchs, Andreas Werblow, Maryan Schemken, Jörg Reichert, Mario Rüdiger. (2016) Early comprehensive care of preterm infants—effects on quality of life, childhood development, and healthcare utilization: study protocol for a cohort study linking administrative healthcare data with patient reported primary data. BMC Pediatrics 16:1
CrossRef3
Reza Mofidi, Peng Wong, Tracey Gatenby, Simon Milburn. (2016) Value based healthcare and delivery of vascular surgery services in the United Kingdom. Reviews in Vascular Medicine 6-7, 1-9
CrossRef4
Rabih Chattat, Giovanni Ottoboni, Anita Zeneli, Maria Alejandra Berardi, Veronica Cossu, Marco Maltoni. (2016) The Italian version of the FAMCARE scale: a validation study. Supportive Care in Cancer 24:9, 3821-3830
CrossRef5
Cabot, Richard C.Rosenberg, Eric S.Harris, Nancy LeeShepard, Jo-Anne O.Cort, Alice M.Ebeling, Sally H.McDonald, Emily K.Bazari, HasanPalmer, William E.Baron, Jason M.Armstrong, Katrina (2016) Case 24-2016. New England Journal of Medicine 375:6, 567-574
Full Text6
Charles C. Lee, Kristopher T. Kimmell, Amy Lalonde, Peter Salzman, Matthew C. Miller, Laura M. Calvi, Ekaterina Manuylova, Ismat Shafiq, G. Edward Vates. (2016) Geographic variation in cost of care for pituitary tumor surgery. Pituitary
CrossRef7
Philip J Turner, Ann Van den Bruel, Caroline H D Jones, Annette Plüddemann, Carl Heneghan, Matthew J Thompson, Christopher P Price, Jeremy Howick. (2016) Point-of-care testing in UK primary care: a survey to establish clinical needs. Family Practice 33:4, 388-394
CrossRef8
Eric C. Makhni, Erica K. Crump, Michael E. Steinhaus, Nikhil N. Verma, Christopher S. Ahmad, Brian J. Cole, Bernard R. Bach. (2016) Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Anterior Cruciate Ligament Reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery 32:8, 1612-1621
CrossRef9
Nathalie Scherz, Fabio Valeri, Thomas Rosemann, Sima Djalali. (2016) Quality of secondary prevention of coronary heart disease in Swiss primary care: Lessons learned from a 6-year observational study. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
CrossRef10
Adriana G. Ramirez, Margaret C. Tracci, George J. Stukenborg, Florence E. Turrentine, Benjamin D. Kozower, R Scott Jones. (2016) Physician-Owned Surgical Hospitals Outperform other Hospitals in the Medicare Value-Based Purchasing Program. Journal of the American College of Surgeons
CrossRef11
Carole Decker, Linda Garavalia, Brian Garavalia, Elizabeth Gialde, Robert W. Yeh, John Spertus, Adnan K. Chhatriwalla. (2016) Understanding physician-level barriers to the use of individualized risk estimates in percutaneous coronary intervention. American Heart Journal 178, 190-197
CrossRef12
Zain Sayeed, Mouhanad El-Othmani, Afshin A. Anoushiravani, Monique C. Chambers, Khaled J. Saleh. (2016) Planning, Building, and Maintaining a Successful Musculoskeletal Service Line. Orthopedic Clinics of North America
CrossRef13
Robin N. Kamal. (2016) Quality and Value in an Evolving Health Care Landscape. The Journal of Hand Surgery 41:7, 794-799
CrossRef14
Maame Yaa A. B. Yiadom, James Scheulen, Conor M. McWade, James J. Augustine, John H. Burton. (2016) Implementing Data Definition Consistency for Emergency Department Operations Benchmarking and Research. Academic Emergency Medicine 23:7, 796-802
CrossRef15
Andrew Thomas, Jeremiah Alt, Craig Gale, Sathya Vijayakumar, Reema Padia, Matthew Peters, Trevor Champagne, Jeremy D. Meier. (2016) Surgeon and hospital cost variability for septoplasty and inferior turbinate reduction. International Forum of Allergy & Rhinology
CrossRef16
Alex T. Sia. (2016) Improving quality and reducing cost – In search of value for the pregnant woman. Trends in Anaesthesia and Critical Care
CrossRef17
Sara R.C. Driessen, Erik W. Van Zwet, Pascal Haazebroek, Evelien M. Sandberg, Mathijs D. Blikkendaal, Andries R.H. Twijnstra, Frank Willem Jansen. (2016) A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes. American Journal of Obstetrics and Gynecology
CrossRef18
Silvia Riva, Gabriella Pravettoni. (2016) Value-Based Model: A New Perspective in Medical Decision-making. Frontiers in Public Health 4
CrossRef19
Kofi Osei-Frimpong. (2016) Examining the effects of patient characteristics and prior value needs on the patient-doctor encounter process in healthcare service delivery. International Journal of Pharmaceutical and Healthcare Marketing 10:2, 192-213
CrossRef20
Charles Scott Hultman. (2016) Procedural Portfolio Planning in Plastic Surgery, Part 2. Annals of Plastic Surgery 76, S347-S351
CrossRef21
Stephen B. Williams, Cameron K. Ghaffary, Tamer J. Dafashy, Eduardo Orihuela. (2016) Re: Jim C. Hu, Bilal Chughtai, Padraic O’Malley, et al. Perioperative Outcomes, Health Care Costs, and Survival After Robotic-assisted Versus Open Radical Cystectomy: A National Comparative Effectiveness Study. Eur Urol 2016;70:195–202. European Urology
CrossRef22
Christopher J.D. Wallis, Alyson L. Mahar, Patrick Cheung, Sender Herschorn, Raj Satkunasivam, Ashraf Al-Matar, Girish S. Kulkarni, Yuna Lee, Ronald T. Kodama, Steven A. Narod, Robert K. Nam. (2016) Hospitalizations to Manage Complications of Modern Prostate Cancer Treatment in Older Men. Urology
CrossRef23
Shintaro Okazaki, José Alberto Castañeda, Silvia Sanz, Prokriti Mukherji. (2016) Physicians’ motivations to use mobile health monitoring: a cross-country comparison. Behaviour & Information Technology, 1-12
CrossRef24
Lilian H.D. van Tuyl, Kaleb Michaud. (2016) Patient-Reported Outcomes in Rheumatoid Arthritis. Rheumatic Disease Clinics of North America 42:2, 219-237
CrossRef25
Nikhil G. Thaker, Thomas J. Pugh, Usama Mahmood, Seungtaek Choi, Tracy E. Spinks, Neil E. Martin, Terence T. Sio, Rajat J. Kudchadker, Robert S. Kaplan, Deborah A. Kuban, David A. Swanson, Peter F. Orio, Michael J. Zelefsky, Brett W. Cox, Louis Potters, Thomas A. Buchholz, Thomas W. Feeley, Steven J. Frank. (2016) Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven activity-based costing. Brachytherapy 15:3, 274-282
CrossRef26
Mia Mahmudur Rahim. (2016) Improving Social Responsibility in RMG Industries Through a New Governance Approach in Laws. Journal of Business Ethics
CrossRef27
Alan Dal Pra, Luis Souhami. (2016) Prostate cancer radiation therapy: A physician’s perspective. Physica Medica 32:3, 438-445
CrossRef28
Amit Kumar Bardhan, Samrat Pattnaik. (2016) Effect of cross-functional integration between operations and marketing on negative critical incidents. Total Quality Management & Business Excellence, 1-21
CrossRef29
Dipti Gupta, Ingolf Karst, Ellen B. Mendelson. (2016) Value-Based Reimbursement: Impact of Curtailing Physician Autonomy in Medical Decision Making. American Journal of Roentgenology 206, 276-279
CrossRef30
Monzer Chehab, Joshua A. Friedlander, Jeremy Handel, Stephen Vartanian, Anant Krishnan, Ching-yee Oliver Wong, Howard Korman, Brian Seifman, Joseph Ciacci. (2016) Percutaneous Cryoablation vs Partial Nephrectomy: Cost Comparison of T1a Tumors. Journal of Endourology 30, 170-176
CrossRef31
(2016) A proposed set of metrics for standardized outcome reporting in the management of low back pain. Acta Orthopaedica 87, 88-90
CrossRef32
Diane E. Holland, Joel E. Pacyna, Kristine L. Gillard, Lisa C. Carter. (2016) Tracking Discharge Delays. Journal of Nursing Care Quality 31, 17-23
CrossRef33
Deborah Korenstein, Kevin Duan, Manuel J. Diaz, Rosa Ahn, Salomeh Keyhani. (2016) Do Health Care Delivery System Reforms Improve Value? The Jury Is Still Out. Medical Care 54, 55-66
CrossRef34
Akash P. Kansagra, John-Paul J. Yu, Arindam R. Chatterjee, Leon Lenchik, Daniel S. Chow, Adam B. Prater, Jean Yeh, Ankur M. Doshi, C. Matthew Hawkins, Marta E. Heilbrun, Stacy E. Smith, Martin Oselkin, Pushpender Gupta, Sayed Ali. (2016) Big Data and the Future of Radiology Informatics. Academic Radiology 23, 30-42
CrossRef35
David C. Markel, Mark W. Allen, Nicole M. Zappa. (2016) Can an Arthroplasty Registry Help Decrease Transfusions in Primary Total Joint Replacement? A Quality Initiative. Clinical Orthopaedics and Related Research® 474, 126-131
CrossRef36
Johannes A. Govaert, Wouter A. van Dijk, Marta Fiocco, Alexander C. Scheffer, Lieke Gietelink, Michel W.J.M. Wouters, Rob A.E.M. Tollenaar. (2016) Nationwide Outcomes Measurement in Colorectal Cancer Surgery: Improving Quality and Reducing Costs. Journal of the American College of Surgeons 222, 19-29.e2
CrossRef37
Javier A.-Cienfuegos, Fernando Rotellar. (2016) Cholecystectomy in mild acute biliary pancreatitis: The sooner; the better. Revista Española de Enfermedades Digestivas 108
CrossRef38
Jesse D. Schold. (2016) Editorial Comment. Urology 87, 92-93
CrossRef39
Aaron L. Thatcher, Margot L. Beckerman, Steven A. Telian, William Michael King. (2016) Monothermal Caloric Screening to Improve Healthcare Value. Ear and Hearing 37:3, e188-e193
CrossRef40
Natasha Kareem Brusco, Jennifer J Watts, Nora Shields, Nicholas F Taylor. (2015) Is cost effectiveness sustained after weekend inpatient rehabilitation? 12 month follow up from a randomized controlled trial. BMC Health Services Research 15
CrossRef41
Sholom M. Weiss, Casimir A. Kulikowski, Robert S. Galen, Peder A. Olsen, Ramesh Natarajan. (2015) Managing healthcare costs by peer-group modeling. Applied Intelligence 43, 752-759
CrossRef42
Renée A. Scheepers, Benjamin C. M. Boerebach, Onyebuchi A. Arah, Maas Jan Heineman, Kiki M. J. M. H. Lombarts. (2015) A Systematic Review of the Impact of Physicians’ Occupational Well-Being on the Quality of Patient Care. International Journal of Behavioral Medicine 22, 683-698
CrossRef43
Jeffrey Bruckel, Neil Wagle, Cashel O’Brien, Josephine Elias, Sharon McKenna, Peter Meyers, Michael A. Fifer, Eugene Pomerantsev, Robert W. Yeh. (2015) Feasibility of a Tablet Computer System to Collect Patient-reported Symptom Severity in Patients Undergoing Diagnostic Coronary Angiography. Critical Pathways in Cardiology 14, 139-145
CrossRef44
Lee A. Fleisher. (2015) Value—The Current Cure for Health Care's Ailments?. Anesthesiology Clinics 33, xv-xvi
CrossRef45
Gregory A. Coté, Sheryl Lynch, Jeffery J. Easler, Alyson Keen, Patricia A. Vassell, Stuart Sherman, Siu Hui, Huiping Xu. (2015) Development and Validation of a Prediction Model for Admission After Endoscopic Retrograde Cholangiopancreatography. Clinical Gastroenterology and Hepatology 13, 2323-2332.e9
CrossRef46
Michael J. Rossi, Jefferson C. Brand, Matthew T. Provencher, James H. Lubowitz. (2015) The Expectation Game: Patient Comprehension Is a Determinant of Outcome. Arthroscopy: The Journal of Arthroscopic & Related Surgery 31, 2283-2284
CrossRef47
Thembayena Mgozi, Richard Weeks. . (2015) The impact of cloud computing on the transformation of healthcare system in South Africa. , 1-7
CrossRef48
Christian Wernz, Inga Gehrke, Daniel R. Ball. (2015) Managerial decision-making in hospitals with real options analysis. Information Systems and e-Business Management 13, 673-691
CrossRef49
Sara J. T. Guilcher, Daria Parsons, B. Catharine Craven, Susan B. Jaglal, Molly Verrier. (2015) Developing quality of care indicators for patients with traumatic and non-traumatic spinal cord injury (SCI): A feasibility study using administrative health data. The Journal of Spinal Cord Medicine 38, 765-776
CrossRef50
Jagmeet P. Singh, David J. Wilber. (2015) Electrophysiology and Health Care Reform. JACC: Clinical Electrophysiology 1, 463-464
CrossRef51
Ali Kazemi, Petri J. Kajonius. (2015) User-oriented elderly care: a validation study in two different settings using observational data. Quality in Ageing and Older Adults 16, 140-152
CrossRef52
R Carter Clement, Adina Welander, Caleb Stowell, Thomas D Cha, John L Chen, Michelle Davies, Jeremy C Fairbank, Kevin T Foley, Martin Gehrchen, Olle Hagg, Wilco C Jacobs, Richard Kahler, Safdar N Khan, Isador H Lieberman, Beth Morisson, Donna D Ohnmeiss, Wilco C Peul, Neal H Shonnard, Matthew W Smuck, Tore K Solberg, Bjorn H Stromqvist, Miranda L Van Hooff, Ajay D Wasan, Paul C Willems, William Yeo, Peter FRitzell. (2015) A proposed set of metrics for standardized outcome reporting in the management of low back pain. Acta Orthopaedica 86, 523-533
CrossRef53
Neil E. Martin. (2015) Improving What Matters. European Urology 68, 384-385
CrossRef54
Maulik D. Majmudar, Lina Avancini Colucci, Adam B. Landman. (2015) The quantified patient of the future: Opportunities and challenges. Healthcare 3, 153-156
CrossRef55
Antonio del Puente, Vinicio Lombardi, Antonella Esposito. (2015) Personalized medicine is the evidence based medicine saved in the right horizon. Journal of Medicine and the Person 13, 91-95
CrossRef56
Paul A. Merguerian, Richard Grady, John Waldhausen, Arlene Libby, Whitney Murphy, Lilah Melzer, Jeffrey Avansino. (2015) Optimizing value utilizing Toyota Kata methodology in a multidisciplinary clinic. Journal of Pediatric Urology 11:4, 228.e1-228.e6
CrossRef57
Kjeld Harald Aij, René L.M.C. Aernoudts, Gepke Joosten. (2015) Manager traits and quality-of-care performance in hospitals. Leadership in Health Services 28, 200-215
CrossRef58
Suzanne V. Arnold, Jae-Sik Jang, Fengming Tang, Garth Graham, David J. Cohen, John A. Spertus. (2015) Prediction of residual angina after percutaneous coronary intervention. European Heart Journal - Quality of Care and Clinical Outcomes 1, 23-30
CrossRef59
L. M. Breakwell, A. A. Cole, N. Birch, C. Heywood. (2015) Should we all go to the PROM? The first two years of the British Spine Registry. The Bone & Joint Journal 97-B, 871-874
CrossRef60
Kristine A. Smith, Luke Rudmik. (2015) Update on the Costs of Chronic Rhinosinusitis. Current Otorhinolaryngology Reports 3, 87-93
CrossRef61
Sarah K. Abbett, Richard M. Kaufman, Michael Gustafson, Jeffrey O. Greenberg. (2015) Multifaceted approach to reducing unnecessary red blood cell utilization. Healthcare 3, 67-73
CrossRef62
John R. Kirkpatrick, Stanley Marks, Michele Slane, Donald Kim, Lance Cohen, Michael Cortelli, Juan Plate, Richard Perryman, John Zapas. (2015) Using Value-Based Analysis to Influence Outcomes in Complex Surgical Systems. Journal of the American College of Surgeons 220, 461-468
CrossRef63
Jeroen N. Struijs, Hanneke W. Drewes, Richard Heijink, Caroline A. Baan. (2015) How to evaluate population management? Transforming the Care Continuum Alliance population health guide toward a broadly applicable analytical framework. Health Policy 119, 522-529
CrossRef64
Richard V. Milani, Carl J. Lavie. (2015) Health Care 2020: Reengineering Health Care Delivery to Combat Chronic Disease. The American Journal of Medicine 128, 337-343
CrossRef65
Behfar Ehdaie, James A. Eastham. (2015) Standardization of Patient-centered Outcomes: Less Is More. European Urology 67, 468-469
CrossRef66
Alvar Agustí, Josep Maria Antó, Charles Auffray, Ferran Barbé, Esther Barreiro, Jordi Dorca, Joan Escarrabill, Rosa Faner, Laura I. Furlong, Judith Garcia-Aymerich, Joaquim Gea, Bertil Lindmark, Eduard Monsó, Vicente Plaza, Milo A. Puhan, Josep Roca, Juan Ruiz-Manzano, Laura Sampietro-Colom, Ferran Sanz, Luis Serrano, James Sharpe, Oriol Sibila, Edwin K. Silverman, Peter J. Sterk, Jacob I. Sznajder. (2015) Personalized Respiratory Medicine: Exploring the Horizon, Addressing the Issues. Summary of a BRN-AJRCCM Workshop Held in Barcelona on June 12, 2014. American Journal of Respiratory and Critical Care Medicine 191, 391-401
CrossRef67
Kirsten Strudwick, Mark Nelson, Melinda Martin-Khan, Michael Bourke, Anthony Bell, Trevor Russell, Shahriar Zehtabchi. (2015) Quality Indicators for Musculoskeletal Injury Management in the Emergency Department: a Systematic Review. Academic Emergency Medicine 22:10.1111/acem.2015.22.issue-2, 127-141
CrossRef68
Tridib Bandyopadhyay, Bahman Zadeh. . Economics: Concepts, Methodologies, Tools, and Applications. 2015:, 1664.
CrossRef69
Kofi Osei-Frimpong, Alan Wilson, Nana Owusu-Frimpong. (2015) Service experiences and dyadic value co-creation in healthcare service delivery: a CIT approach. Journal of Service Theory and Practice 25:4, 443
CrossRef70
Arthur Atchabahian, Michael Andreae. (2015) Long-term Functional Outcomes After Regional Anesthesia. ASA Refresher Courses in Anesthesiology 43, 15-26
CrossRef71
Sibel Vildan Altin, Stephanie Stock. (2015) Impact of health literacy, accessibility and coordination of care on patient’s satisfaction with primary care in Germany. BMC Family Practice 16:1
CrossRef72
Deborah R. Kaye, Jeffrey K. Mullins, H. Ballentine Carter, Trinity J. Bivalacqua. (2014) Robotic surgery in urological oncology: patient care or market share?. Nature Reviews Urology 12, 55-60
CrossRef73
Nancy McLaughlin, Michael A. Burke, Nisheeta P. Setlur, Douglas R. Niedzwiecki, Alan L. Kaplan, Christopher Saigal, Aman Mahajan, Neil A. Martin, Robert S. Kaplan. (2014) Time-driven activity-based costing: a driver for provider engagement in costing activities and redesign initiatives. Neurosurgical Focus 37, E3
CrossRef74
Nancy McLaughlin, Neil A. Martin, Pooja Upadhyaya, Ausaf A. Bari, Farzad Buxey, Marilene B. Wang, Anthony P. Heaney, Marvin Bergsneider. (2014) Assessing the cost of contemporary pituitary care. Neurosurgical Focus 37, E7
CrossRef75
Fevzi Akinci, Poonam M. Patel. (2014) Quality Improvement in Healthcare Delivery Utilizing the Patient-Centered Medical Home Model. Hospital Topics 92, 96-104
CrossRef76
Subrata Ghosh, Benjamin Pariente, Diane R. Mould, Stefan Schreiber, Joel Petersson, Daniel Hommes. (2014) New tools and approaches for improved management of inflammatory bowel diseases. Journal of Crohn's and Colitis 8, 1246-1253
CrossRef77
Neil E. Martin, Anthony V. D'Amico. (2014) Progress and controversies: Radiation therapy for prostate cancer. CA: A Cancer Journal for Clinicians, n/a-n/a
CrossRef78
Nancy McLaughlin, Pooja Upadhyaya, Farzad Buxey, Neil A. Martin. (2014) Value-based neurosurgery: measuring and reducing the cost of microvascular decompression surgery. Journal of Neurosurgery 121, 700-708
CrossRef79
Davide Ghinolfi, Hanan G. El Baz, Elio Borgonovi, Amr Radwan, Ola Laurence, Hanan A. Sayed, Paolo De Simone, Moaz Abdelwadoud, Alessandro Stefani, Sanaa S. Botros, Franco Filipponi. (2014) A model for southern mediterranean research institute self-assessment: A SWOT analysis-based approach to promote capacity building at Theodor Bilharz Research Institute in Cairo (Egypt). Arab Journal of Gastroenterology 15, 92-97
CrossRef80
B. C. M. Boerebach, R. A. Scheepers, R. M. van der Leeuw, M. J. Heineman, O. A. Arah, K. M. J. M. H. Lombarts. (2014) The impact of clinicians' personality and their interpersonal behaviors on the quality of patient care: a systematic review. International Journal for Quality in Health Care 26, 426-481
CrossRef81
Torquil Watt, Per Cramon, Daniel M. Frendl, John E. Ware. (2014) Assessing health-related quality of life in patients with benign non-toxic goitre. Best Practice & Research Clinical Endocrinology & Metabolism 28, 559-575
CrossRef82
Ahmed M. Raslan, Kim J. Burchiel. (2014) Letters to the Editor: Value-based neurosurgery and microvascular decompression. Journal of Neurosurgery 121, 495-497
CrossRef83
Joseph A. Hyder, Nathalie Roy, Elliot Wakeam, Roland Hernandez, Simon P. Kim, Angela M. Bader, Robert R. Cima, Louis L. Nguyen. (2014) Performance Measurement in Surgery Through the National Quality Forum. Journal of the American College of Surgeons
CrossRef84
Gregory A. Coté. (2014) Endoscopic Treatment of Acute Biliary Diseases: Have We Optimized the Value of Inpatient Endoscopic Retrograde Cholangiopancreatography?. Clinical Gastroenterology and Hepatology 12:7, 1160-1162
CrossRef85
Sarah Ruiz, Teresa J. Brady, Russell E. Glasgow, Richard Birkel, Michelle Spafford. (2014) Chronic Condition Self-Management Surveillance: What Is and What Should Be Measured?. Preventing Chronic Disease 11
CrossRef86
Alik S. Widge, Jeffrey Hunt, Mark Servis. (2014) Systems-Based Practice and Practice-Based Learning for the General Psychiatrist: Old Competencies, New Emphasis. Academic Psychiatry 38, 288-293
CrossRef87
Alik S. Widge, Heather E. Schultz. (2014) Opportunities and Challenges: Residents’ Perspectives on the Next Accreditation System in Psychiatry. Academic Psychiatry 38, 303-304
CrossRef88
J. Kooiman, Y. W. J. Sijpkens, J.-P. P. M. de Vries, H. F. H. Brulez, J. F. Hamming, A. J. van der Molen, N. J. M. Aarts, S. C. Cannegieter, H. Putter, R. Swarts, W. B. van den Hout, T. J. Rabelink, M. V. Huisman. (2014) A randomized comparison of 1-h sodium bicarbonate hydration versus standard peri-procedural saline hydration in patients with chronic kidney disease undergoing intravenous contrast-enhanced computerized tomography. Nephrology Dialysis Transplantation 29, 1029-1036
CrossRef89
Rachel L. Medbery, Tatiana S. Chadid, John F. Sweeney, Stuart J. Knechtle, David A. Kooby, Shishir K. Maithel, Edward Lin, Juan M. Sarmiento. (2014) Laparoscopic vs Open Right Hepatectomy: A Value-Based Analysis. Journal of the American College of Surgeons 218, 929-939
CrossRef90
Rachel L. Medbery, Sebastian D. Perez, Seth D. Force, Theresa W. Gillespie, Allan Pickens, Daniel L. Miller, Felix G. Fernandez. (2014) Video-Assisted Thoracic Surgery Lobectomy Cost Variability: Implications for a Bundled Payment Era. The Annals of Thoracic Surgery 97, 1686-1693
CrossRef91
Vanessa Kerry, Agnes Binagwaho, Jonathan Weigel, Paul Farmer. . From Aid to Accompaniment: Rules of the Road for Development Assistance. 2014:, 483-504.
CrossRef92
Rachel L. Medbery, Amareshwar Chiruvella, Jahnavi Srinivasan, John F. Sweeney, Edward Lin, S. Scott Davis. (2014) The Value of Continuous Wound Infusion Systems for Postoperative Pain Control Following Laparoscopic Roux-en-Y Gastric Bypass: an Analysis of Outcomes and Cost. Obesity Surgery 24, 541-548
CrossRef93
Bruce G. Bender. (2014) Can Health Care Organizations Improve Health Behavior and Treatment Adherence?. Population Health Management 17, 71-78
CrossRef94
J. Case-Smith, S. J. Page, A. Darragh, M. Rybski, D. Cleary. (2014) The Professional Occupational Therapy Doctoral Degree: Why Do It?. American Journal of Occupational Therapy 68, e55-e60
CrossRef95
Nancy McLaughlin, Nasim Afsar-manesh, Victoria Ragland, Farzad Buxey, Neil A. Martin. (2014) Tracking and Sustaining Improvement Initiatives. Neurosurgery 74, 235-244
CrossRef96
Carin A. Uyl-de Groot, Elisabeth G.E. de Vries, Jaap Verweij, Richard Sullivan. (2014) Dispelling the myths around cancer care delivery: It's not all about costs. Journal of Cancer Policy 2, 22-29
CrossRef97
Tom Bartol. (2014) Patient-centered medical homes or data-centered medical homes?. The Nurse Practitioner 39, 8-9
CrossRef98
Nancy McLaughlin, Farzad Buxey, Karen Chaw, Neil A. Martin. (2014) Value-based neurosurgery: the example of microvascular decompression surgery. Journal of Neurosurgery 120, 462-472
CrossRef99
Emilio Quaia, Guido Grisi, Elisa Baratella, Roberto Cuttin, Gabriele Poillucci, Sara Kus, Maria Assunta Cova. (2014) Diagnostic imaging costs before and after digital tomosynthesis implementation in patient management after detection of suspected thoracic lesions on chest radiography. Insights into Imaging 5, 147-155
CrossRef100
Giles W. Boland, Richard Duszak, Geraldine McGinty, Bibb Allen. (2014) Delivery of Appropriateness, Quality, Safety, Efficiency and Patient Satisfaction. Journal of the American College of Radiology 11, 7-11
CrossRef101
Michael V. Beheshti, James Meek. (2014) Calculation of Operating Expenses for Conventional Transarterial Chemoembolization in an Academic Medical Center: A Step toward Defining the Value of Transarterial Chemoembolization. Journal of Vascular and Interventional Radiology
CrossRef102
Michele Mussap. (2014) An alternative perspective on how laboratory medicine can contribute to solve the health care crisis: A model to save costs by acquiring excellence in diagnostic systems. Clinica Chimica Acta 427, 202-204
CrossRef103
Thembayena Mgozi, Richards Weeks. (2014) The Impact of Technological Innovation on Cloud Computing as an Emerging Phenomenon within the South African Healthcare Environment. INCOSE International Symposium 24:10.1002/iis2.2014.24.issue-s1, 223-235
CrossRef104
Thomas R. Vetter. (2013) Tighten Your Belts! Reduce Your Transfusion Costs with Preoperative Management of Anemic Patients. Anesthesia & Analgesia 117, 51-57
CrossRef105
Gregory A. Coté, Timothy D. Imler, Huiping Xu, Evgenia Teal, Dustin D. French, Thomas F. Imperiale, Marc B. Rosenman, Jeffery Wilson, Siu L. Hui, Stuart Sherman. (2013) Lower Provider Volume is Associated With Higher Failure Rates for Endoscopic Retrograde Cholangiopancreatography. Medical Care 51, 1040-1047
CrossRef106
Thomas R. Vetter, Nataliya V. Ivankova, Lee A. Goeddel, Gerald McGwin, Jean-Francois Pittet. (2013) An Analysis of Methodologies That Can Be Used to Validate if a Perioperative Surgical Home Improves the Patient-centeredness, Evidence-based Practice, Quality, Safety, and Value of Patient Care. Anesthesiology 119, 1261-1274
CrossRef107
Erika Davis Sears, Ryan Shin, Lisa A. Prosser, Kevin C. Chung. (2013) Economic Analysis of Revision Amputation and Replantation Treatment of Finger Amputation Injuries. Plastic and Reconstructive Surgery, 1
CrossRef108
Thomas R Vetter, Lee A Goeddel, Arthur M Boudreaux, Thomas R Hunt, Keith A Jones, Jean-Francois Pittet. (2013) The Perioperative Surgical Home: how can it make the case so everyone wins?. BMC Anesthesiology 13:1
CrossRef109
José A Sacristán. (2013) Patient-centered medicine and patient-oriented research: improving health outcomes for individual patients. BMC Medical Informatics and Decision Making 13:1
CrossRef110
Luiz Roberto Martins Rocha, Daniela Francescato Veiga, Paulo Rocha e Oliveira, Elaine Horibe Song, Lydia Masako Ferreira. (2013) Health service quality scale: Brazilian Portuguese translation, reliability and validity. BMC Health Services Research 13:1
CrossRef111
N. S. Berry. (2013) An Ethnographic Check-Up. Science 342, 561-561
CrossRef112
Donald R. Murphy, Marco Lopez. (2013) Neck and back pain specific outcome assessment questionnaires in the Spanish language: a systematic literature review. The Spine Journal 13, 1667-1674
CrossRef113
Deborah Kendall-Gallagher, Eileen Breslin. (2013) Developing DNP Students as Adaptive Leaders: A Key Strategy in Transforming Health Care. Journal of Professional Nursing 29, 259-263
CrossRef114
Jörgen Nordenström, Anna Kiessling, Jonas Nordquist. (2013) Building for change: university hospital design for future clinical learning. Journal of Interprofessional Care 27, 72-76
CrossRef115
Eric M. Black, Laurence D. Higgins, Jon J.P. Warner. (2013) Value-based shoulder surgery: practicing outcomes-driven, cost-conscious care. Journal of Shoulder and Elbow Surgery 22, 1000-1009
CrossRef116
Khoon-Kiat Tan, Katri Vehviläinen-Julkunen, Sally Wai-Chi Chan. (2013) Integrative review: salutogenesis and health in older people over 65 years old. Journal of Advanced Nursing, n/a-n/a
CrossRef117
Sara J. T. Guilcher, B. Cathy Craven, Louise Lemieux-Charles, Tiziana Casciaro, Mary Ann McColl, Susan B. Jaglal. (2013) Secondary health conditions and spinal cord injury: an uphill battle in the journey of care. Disability and Rehabilitation 35, 894-906
CrossRef118
Fu-Ren Lin, Rung-Wei Po, Min-Chen Lin, Wen-Ya Lin, Benjamin Chang. . (2013) Modeling an Agent-Based Healthcare Service System: An Exploration of the Capitation Payment Scheme of Zhishan-CHG in Taiwan. , 67-74
CrossRef119
Lodovico Balducci. (2013) Value, the new medical mantra: misunderstood, abused, and underused. Journal of Medicine and the Person 11, 3-4
CrossRef120
Jeffrey H. Barsuk, Elaine R. Cohen, Joe Feinglass, William C. McGaghie, Diane B. Wayne. (2013) Clinical Outcomes after Bedside and Interventional Radiology Paracentesis Procedures. The American Journal of Medicine 126, 349-356
CrossRef121
John R. Kirkpatrick, Bruce M. Smith, John L. Zapas, William L. Thomas. (2013) Clinical Impact of a Value-Based Decision: A Surgical Case Study. Journal of the American College of Surgeons 216, 800-811
CrossRef122
Bibliography. 2013:, 131-140.
CrossRef123
Jennifer R. Piazza, Susan T. Charles, Martin J. Sliwinski, Jacqueline Mogle, David M. Almeida. (2013) Affective Reactivity to Daily Stressors and Long-Term Risk of Reporting a Chronic Physical Health Condition. Annals of Behavioral Medicine 45, 110-120
CrossRef124
Arthur M. Boudreaux, Thomas R. Vetter. (2013) The Creation and Impact of a Dedicated Section on Quality and Patient Safety in a Clinical Academic Department. Academic Medicine 88, 173-178
CrossRef125
Sharon H. Pappas. (2013) Value, a Nursing Outcome. Nursing Administration Quarterly 37, 122-128
CrossRef126
Colleen L Jay, Anton I Skaro. (2013) Comparative effectiveness research in liver transplantation: crossing the cost and quality chasm. Journal of Comparative Effectiveness Research 2, 7-9
CrossRef127
FERNANDO GOMOLLÓN, JAVIER P. GISBERT. (2012) Intravenous iron in digestive diseases. Transfusion Alternatives in Transfusion Medicine 12:10.1111/tatm.2012.12.issue-3-4, 122-129
CrossRef128
Ana Vieta, Xavier Badia, Enric Álvarez, José A. Sacristán. (2012) Which Nontraditional Outcomes Should Be Measured in Healthcare Decision-Making in Schizophrenia? A Systematic Review. Perspectives in Psychiatric Care 48:10.1111/ppc.2012.48.issue-4, 198-207
CrossRef129
José Antonio Sacristán, Tatiana Dilla, Fernando Antoñanzas. (2012) Priorización de intervenciones sanitarias en función de su efectividad: un paso intermedio en el camino hacia una medicina más eficiente. Medicina Clínica 139, 458-460
CrossRef130
Felicia Marie Knaul, Eduardo González-Pier, Octavio Gómez-Dantés, David García-Junco, Héctor Arreola-Ornelas, Mariana Barraza-Lloréns, Rosa Sandoval, Francisco Caballero, Mauricio Hernández-Avila, Mercedes Juan, David Kershenobich, Gustavo Nigenda, Enrique Ruelas, Jaime Sepúlveda, Roberto Tapia, Guillermo Soberón, Salomón Chertorivski, Julio Frenk. (2012) The quest for universal health coverage: achieving social protection for all in Mexico. The Lancet 380, 1259-1279
CrossRef131
Michele Mussap, Vassilios Fanos. (2012) Reducing neonatal mortality and expenditure in the era of health care crisis: is it possible?. The Journal of Maternal-Fetal & Neonatal Medicine 25, 1-3
CrossRef132
Joan Espaulella Panicot, Jordi Roca Casas. (2012) Geriatría del presente. Revista Española de Geriatría y Gerontología 47, 189-190
CrossRef133
Mitesh S. Patel, Matthew M. Davis, Monica L. Lypson. (2012) The VALUE Framework: Training Residents to Provide Value-Based Care for their Patients. Journal of General Internal Medicine 27, 1210-1214
CrossRef134
Arlene S. Ash, Randall P. Ellis. (2012) Risk-adjusted Payment and Performance Assessment for Primary Care. Medical Care 50, 643-653
CrossRef135
Janice N. Cormier, Kate D. Cromwell, Raphael E. Pollock. (2012) Value-Based Health Care. Surgical Oncology Clinics of North America 21, 497-506
CrossRef136
Angela Sauaia, Ernest E. Moore, Jennifer L. Crebs, Ronald V. Maier, David B. Hoyt, Steven R. Shackford. (2012) Evidence level of individual studies. Journal of Trauma and Acute Care Surgery 72, 1484-1490
CrossRef137
Mary Norine Walsh, Alfred A. Bove, Russell R. Cross, Keith C. Ferdinand, Daniel E. Forman, Andrew M. Freeman, Suzanne Hughes, Elizabeth Klodas, Michelle Koplan, William R. Lewis, Brian MacDonnell, David C. May, Joseph V. Messer, Susan J. Pressler, Mark L. Sanz, John A. Spertus, Sarah A. Spinler, Louis Evan Teichholz, John B. Wong, Katherine Doermann Byrd. (2012) ACCF 2012 Health Policy Statement on Patient-Centered Care in Cardiovascular Medicine. Journal of the American College of Cardiology 59:23, 2125-2143
CrossRef138
John Spertus, Paul Chan. (2012) The Need to Improve the Appropriate Use of Coronary Revascularization. Journal of the American College of Cardiology 59:21, 1877-1880
CrossRef139
Frank L. Douglas. (2012) Innovation and value-driven engineering. Nature Reviews Drug Discovery 11, 335-335
CrossRef140
David Lansky, Benedict U. Nwachukwu, Kevin J. Bozic. (2012) Using Financial Incentives to Improve Value in Orthopaedics. Clinical Orthopaedics and Related Research® 470, 1027-1037
CrossRef141
Ashley A. Fitzgerald, Larry A. Allen, Frederick A. Masoudi. (2012) The evolving landscape of quality measurement for heart failure. Annals of the New York Academy of Sciences 1254:10.1111/nyas.2012.1254.issue-1, 131-139
CrossRef142
Julie M. Fritz. (2012) Physical Therapy in a Value-Based Healthcare World. Journal of Orthopaedic & Sports Physical Therapy 42, 1-2
CrossRef143
Susan Albers Mohrman, Michael H. Kanter. . Chapter 3 Designing for Health: Learning from Kaiser Permanente. 2012:, 77-111.
CrossRef144
Susan Albers Mohrman, Abraham B. (Rami) Shani, Arienne McCracken. . Chapter 1 Organizing for Sustainable Health Care: The Emerging Global Challenge. 2012:, 1-39.
CrossRef145
John G. Byrne, Marzia Leacche, David X. Zhao. (2012) Surgical and interventional hybrid procedures: Lessons from China and beyond. The Journal of Thoracic and Cardiovascular Surgery 143:1, 246
CrossRef146
How Can We Improve the Quality of Care in the United States?. 2011:, 93-112.
CrossRef147
Richard Sullivan, Jeffrey Peppercorn, Karol Sikora, John Zalcberg, Neal J Meropol, Eitan Amir, David Khayat, Peter Boyle, Philippe Autier, Ian F Tannock, Tito Fojo, Jim Siderov, Steve Williamson, Silvia Camporesi, J Gordon McVie, Arnie D Purushotham, Peter Naredi, Alexander Eggermont, Murray F Brennan, Michael L Steinberg, Mark De Ridder, Susan A McCloskey, Dirk Verellen, Terence Roberts, Guy Storme, Rodney J Hicks, Peter J Ell, Bradford R Hirsch, David P Carbone, Kevin A Schulman, Paul Catchpole, David Taylor, Jan Geissler, Nancy G Brinker, David Meltzer, David Kerr, Matti Aapro. (2011) Delivering affordable cancer care in high-income countries. The Lancet Oncology 12, 933-980
CrossRef148
S. Jalal. (2011) The lady health worker program in Pakistan--a commentary. The European Journal of Public Health 21, 143-144
CrossRef149
Vincenzo Mazzaferro, Pietro Majno. (2011) Principles for the best multidisciplinary meetings. The Lancet Oncology 12, 323-325
CrossRef150
M. Lungen, M. Siegel, K. W. Lauterbach. (2011) Could inequality in health be cured by universal coverage for all citizens?. International Journal of Clinical Practice 65:10.1111/ijcp.2011.65.issue-3, 249-252
CrossRef151
Corey Scurlock, Jayashree Raikhelkar, Jeffrey I Mechanick. (2011) The economics of glycemic control in the ICU in the United States. Current Opinion in Clinical Nutrition and Metabolic Care 14, 209-212
CrossRef152
Jason E. Owen, Eric R. Hanson, Doug A. Preddy, Erin O’Carroll Bantum. (2011) Linguistically-tailored video feedback increases total and positive emotional expression in a structured writing task. Computers in Human Behavior 27, 874-882
CrossRef153
Lawrence S. Kim. (2011) How Will Accreditation of Your Ambulatory Endoscopy Center Be an Essential Component of Showing Value-Based Health Care?. Clinical Gastroenterology and Hepatology 9, 21-23
CrossRef154
Murphy R Donald, Brian D Justice, Ian C Paskowski, Stephen M Perle, Michael J Schneider. (2011) The establishment of a primary spine care practitioner and its benefits to health care reform in the United States. Chiropractic & Manual Therapies 19, 17
CrossRef155
Robert A Lancey. (2010) How Valid is the Quantity and Quality Relationship in CABG Surgery? A Review of the Literature. Journal of Cardiac Surgery 25:10.1111/jcs.2010.25.issue-6, 713-718
CrossRef156
David G Hewett, Douglas K Rex. (2010) Improving Colonoscopy Quality Through Health-Care Payment Reform. The American Journal of Gastroenterology 105, 1925-1933
CrossRef157
Sabina De Geest, Eileen M. Sullivan Marx, Victoria Rich, Elisabeth Spichiger, Rene Schwendimann, Rebecca Spirig, Greet Van Malderen. (2010) Developing a Financial Framework for Academic Service Partnerships: Models of the United States and Europe. Journal of Nursing Scholarship 42, 295-304
CrossRef158
Mario Plebani, Giuseppe Lippi. (2010) Is laboratory medicine a dying profession? Blessed are those who have not seen and yet have believed. Clinical Biochemistry 43, 939-941
CrossRef159
William H. Gruber, David J. Hunter. (2010) Transforming Osteoarthritis Care in an Era of Health Care Reform. Clinics in Geriatric Medicine 26:3, 433-444
CrossRef160
Matthew D. Tipping, Victoria E. Forth, David B. Magill, Kate Englert, Mark V. Williams. (2010) Systematic review of time studies evaluating physicians in the hospital setting. Journal of Hospital Medicine 5, 353-359
CrossRef161
Philip J. Clapham, Allison G. Pushman, Kevin C. Chung. (2010) A Systematic Review of Applying Patient Satisfaction Outcomes in Plastic Surgery. Plastic and Reconstructive Surgery 125, 1826-1833
CrossRef162
Maureen Hemingway, Marion Freehan, Lisa Morrissey. (2010) Expanding the Role of Nonclinical Personnel in the OR. AORN Journal 91, 753-761
CrossRef163
Douglas K. Rex. (2010) Reply. Gastroenterology 138, 2022-2024
CrossRef164
(2010) Value-Based Design: A New Powerful Perspective for Worksite Health Promotion. American Journal of Health Promotion 24, TAHP-1-TAHP-12
CrossRef165
Jie Lian, K. DiStefano, S.D. Shields, C. Heinichen, M. Giampietri, Lian Wang. (2010) Clinical Appointment Process: Improvement Through Schedule Defragmentation. IEEE Engineering in Medicine and Biology Magazine 29, 127-134
CrossRef166
Norbert Blanckaert. (2010) Clinical pathology services: remapping our strategic itinerary. Clinical Chemistry and Laboratory Medicine 48
CrossRef167
Lynn Hadaway. (2010) Development of an Infusion Alliance. Journal of Infusion Nursing 33, 278-290
CrossRef168
Richard C. Wender, Marc Altshuler. (2009) Can the Medical Home Reduce Cancer Morbidity and Mortality?. Primary Care: Clinics in Office Practice 36, 845-858
CrossRef169
Mark Hauswald, Lowell W. Gerson, Nancy L. Kerr. (2009) Public Health and Emergency Medicine. Academic Emergency Medicine 16:10.1111/acem.2009.16.issue-11, 1040-1043
CrossRef170
Fredrick K. Orkin, Peter G. Duncan. (2009) Substrate for Healthcare Reform. Anesthesiology 111, 697-698
CrossRef171
Jo-anne E Brien. (2009) Healthcare Reform 2009. Journal of Pharmacy Practice and Research 39:10.1002/jppr.2009.39.issue-3, 175-175
CrossRef172
Tridib Bandyopadhyay, Bahman Zadeh. . Mobile Health Technology in the US:. :, 304-321.
CrossRef173
Yue Dong, Huitian Lu, Ognjen Gajic, Brian Pickering. . Intensive Care Unit Operational Modeling and Analysis. :, 132-147.
CrossRef
