Comparison of Site of Death, Health Care Utilization, and Hospital Expenditures for Patients Dying With Cancer in 7 Developed Countries
In The Journal of the American Medical Association, Justin Bekelman and colleagues, including Scott Halpern, Connie Ulrich and Ezekiel Emanuel compare site of death, health care utilization and hospital expenditures in 7 countries: Belgium, Canada, England, Germany, the Netherlands, Norway and the United States. Using administrative and registry data, the researchers measured deaths in acute care hospital, along with inpatient and outpatient measures, and hospital expenditures paid by insurers. They find that a smaller proportion of decedents, older than 65, died in acute...
Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals
In BMJ Open, Hayley Germack and colleagues, including Linda Aiken, examine the association between patient satisfaction with nursing care in National Health Service (NHS) hospitals in England and the proportion of non-UK educated nurses providing care. The authors used data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. They found a significant association between the percentage of non-UK educated nurses providing bedside care and patient satisfaction; hospitals with higher percentages of non-UK educated nurses had lower...
“How do we close the gap between the care we actually provide and what ought to be provided?” This was the question posed by Dr. Martin Roland to open a recent seminar at Penn. Roland’s research focuses on the implementation of pay-for-performance schemes in the United Kingdom’s National Health System (NHS). He has found that the evidence of impact on quality of care is modest and mixed.
“Science has delivered solutions. The question for the world is: When will we put it into practice?”
In the mid-eighties, I coordinated a medical genetics clinic at Johns Hopkins Hospital. We shared our outpatient unit, the Moore Clinic, with the AIDS Care Program, which began in 1984. Every week, I would see the devastating and shockingly rapid decline of robust young men—men my age—in the waiting room outside my office. I came to recognize the pattern: two men would walk in, one weaker, one stronger.
Although the supply of nurses is likely to meet overall demand, the nature of a nurse’s job is changing dramatically as nurses assum expanded roles in redesigned health care systems for a broad range of patients in ambulatory settings and communitybased care.
The existence of a primary care physician shortage, even prior to the ACA, is not universally accepted. A new report by the Institute on Medicine found “no credible evidence” that the nation faces a looming physician shortage in primary care specialties. There is greater consensus about a maldistribution of physicians, in terms of specialty, geography, and practice settings.