Daytime intensivist physician staffing has been consistently associated with improved outcomes among patients admitted to an intensive care unit (ICU).¹ This observation has led to policy initiatives calling for expansion of the intensivist staffing model ...

The Prescription Drug User Fee Act (PDUFA) of 1992 was enacted to augment the resources of the Food and Drug Administration (FDA) that are devoted to reviewing applications for drugs for humans and to ensuring drug efficacy and safety.¹ In exchange for ...

In this study, the Medicare Premier pay-for-performance demonstration project had no effect on 30-day mortality among patients hospitalized for acute MI, congestive heart failure, or pneumonia — sobering findings for those who hoped pay for performance would improve outcomes.

Unless we attend to the major sources of waste and impediments to performance in our health system, the United States will remain vulnerable to an excessively costly system that delivers incommensurate health benefit.

This analysis of 2008 Medicare data shows that regional variation in drug spending is driven primarily by the use of more expensive drugs (i.e., brand-name rather than generic drugs) in the highest-spending geographic areas.

Medicare Advantage plans receive capitated payments and may benefit from enrolling healthier people. This study showed that after plans introduced fitness benefits, new enrollees reported better health status than those who had enrolled before the benefit was added.

Hospital readmission rates are thought to reflect the quality of transitional care. In this study, readmission rates for congestive heart failure and pneumonia were associated with overall hospitalization rates. Interventions may best be focused on reducing incentives to use hospital services.

In this trial, eliminating copayments for medications after hospitalization for MI did not reduce the primary outcome (first major vascular event or revascularization) but did improve medication adherence and secondary outcomes, without significantly increasing total spending.

This national study estimated that nearly 100,000 elderly patients were hospitalized for adverse drug events annually from 2007 through 2009. Most resulted from use of common medications such as warfarin and insulin, and only 1% from medications designated as high-risk.

The Medicare Health Support Pilot Program was a study of eight commercial disease-management programs for patients with heart failure, diabetes, or both. The programs did not reduce ER visits or hospitalizations and achieved only small improvements in 14 of 40 measures.

In this study, women with children were enabled to move from poor neighborhoods to neighborhoods with lower poverty rates. The moves were associated with modest but potentially important reductions in the prevalence of extreme obesity and diabetes.

Among nursing home residents with cognitive impairment, burdensome transitions between the nursing home and the hospital or hospice during the last months of life were common, varied according to state, and were associated with a poor quality of care.

In 2009, Blue Cross Blue Shield of Massachusetts implemented a global payment system, the Alternative Quality Contract (AQC). In the first year, the AQC was associated with reduced growth in medical spending; estimated payments to AQC groups exceeded estimated savings.

This observational study showed that measures of quality of care for patients with diabetes are better in practices using electronic health records (EHRs) than in those using paper records. Although not definitive, the data suggest that EHRs may improve quality of care.

In this analysis of data from a national liability insurer, 7.4% of physicians faced a malpractice claim each year, although 78% of claims did not result in payments to claimants. The authors estimate that 75 to 99% of physicians will face a malpractice claim by the age of 65.

In this audit study, pediatric specialists were more likely to deny appointments to patients with Medicaid–CHIP insurance than to those with private insurance: appointments were denied to 66% of callers with public insurance but to only 11% of those with private insurance.

Operative mortality is lower at hospitals with a high volume of certain surgical procedures. In this analysis of Medicare data, operative mortality declined for eight surgical procedures studied over a decade. Higher hospital volumes explained much of the decline for three of the operations.

In this analysis of a large national sample of nursing homes, those rated as having more deficiencies in quality of care were more likely to have malpractice claims brought against them; however, the difference was modest.

In this analysis of data on nurse staffing and patient mortality for nearly 200,000 admissions to a large academic medical center, actual nurse staffing below target levels was associated with increased mortality.

This article reviews the history and current status of clinical trial registrations and results data posted on the National Library of Medicine's Web site ClinicalTrials.gov.