Medicare and private plans encourage individuals to use hospitals that are designated as centers of excellence. Evidence shows that the costs of knee and hip replacements in centers of excellence do not differ from other hospitals, but patients who had hip replacements in such centers had lower complication rates.
Medicare's National Pilot Program on Payment Bundling should use hip fracture and joint replacement as the conditions to include and use longer episodes, capturing a higher percentage of costs and hospital readmissions but adding little financial risk.
Estimates the minimally important difference for a fatigue visual analog scale (VAS) using patient-reported anchors (fatigue, pain, and overall health). This information can aid in interpreting fatigue VAS in day-to-day care in clinical practice.
The authors conducted a prospective cohort study of rates of change in disease-modifying antirheumatic drug (DMARD) and/or systemic corticosteroid drug or dose for 568 patients with rheumatoid arthritis (RA) across 6,159 clinical encounters within 12 months to examine how changes in clinical specifications change adherence.
Prediction rules have yet to be published for the interventions listed as brief pain-management programmes, but there is evidence that some tools are useful in detecting psychosocial aspects of low back pain and are predictive of poor outcomes.
The evidence for effects of omega-3 fatty acids on outcomes in the conditions assessed varies greatly. Omega-3 fatty acids appear to reduce serum triglycerides among type II diabetics, but have no effect on total cholesterol, HDL cholesterol, and LDL cholesterol.
RAND/Samueli Chair for Integrative Medicine and Senior Health Policy Researcher
Ian Coulter is a senior health policy analyst at the RAND Corporation, where he holds the Samueli Institute Chair in Policy for Integrative Medicine. He is a professor in the School of Dentistry, UCLA, in the Division of Public Health and Community Dentistry; a health consultant at RAND; a…