Organization of Healthcare Delivery

Streamlining how health care is delivered in the U.S.’s fragmented system.

Do Cardiac Centers of Excellence Really Excel?

May. 20, 2019

If I needed a cardiac procedure, I might look for a hospital designated as a cardiac “center of excellence” (COE) by my insurer. I might assume that the hospital delivers higher quality care and achieves better outcomes than other hospitals. But that assumption might be wrong, according to a new study by LDI Associate Fellow Sameed Khatana and colleagues in JAMA Internal Medicine.

Five-Year Cost of Dementia: Medicare

Research Brief
Apr. 29, 2019

[dropcap]A[/dropcap]bout 5.5 million older adults are living with dementia, a chronic, progressive disease characterized by severe cognitive decline. This number will likely grow significantly as the U.S. population ages, which has cost implications for the Medicare program. A full accounting of these additional expenses will help policymakers plan for them in their Medicare budgets. In this study, Norma Coe and colleagues examined survival and Medicare expenditures in older adults with and without dementia to estimate dementia’s incremental costs to Medicare in the five years after diagnosis.

Tracking a Trend: Nursing Home Specialists

Apr. 12, 2019

The world of health care is divided into many areas of specialization. At one point or another, we may have seen a podiatrist for a foot problem or a dermatologist for skin issues. Not all of us realize that – in addition to specializing in, say, the lungs – clinicians can devote their practice to providing general care to patients in a specific setting. For example, some physicians, called ‘hospitalists,’ see all or most of their patients in a hospital environment.

Patient-Centered Preference Assessment to Improve Satisfaction With Care Among Patients With Localized Prostate Cancer: A Randomized Controlled Trial

Mar. 20, 2019

Ravishankar Jayadevappa, Sumedha Chhatre, Joseph J. Gallo, Marsha Wittink, Knashawn H. Morales, David I. Lee, Thomas J. Guzzo, Neha Vapiwala, Yu-Ning Wong, Diane K. Newman, Keith Van Arsdalen, S. Bruce...

Abstract [from journal]

Purpose: To study the effectiveness of the Patient Preferences for Prostate Cancer Care (PreProCare) intervention in improving the primary outcome of satisfaction with care and secondary outcomes of satisfaction with decision, decision regret, and treatment choice among patients with localized prostate cancer.
 
Methods: In this multicenter randomized controlled study, we randomly assigned patients with localized prostate cancer to the PreProCare intervention or
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