TY - BOOK AU - Institute of Medicine TI - Coverage Matters: Insurance and Health Care SN - DO - 10.17226/10188 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10188/coverage-matters-insurance-and-health-care PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers. ER - TY - BOOK AU - Institute of Medicine AU - National Research Council A2 - Maria Hewitt A2 - Joseph V. Simone TI - Enhancing Data Systems to Improve the Quality of Cancer Care SN - DO - 10.17226/9970 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9970/enhancing-data-systems-to-improve-the-quality-of-cancer-care PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - One of the barriers to improving the quality of cancer care in the United States is the inadequacy of data systems. Out-of-date or incomplete information about the performance of doctors, hospitals, health plans, and public agencies makes it hard to gauge the quality of care. Augmenting today's data systems could start to fill the gap. This report examines the strengths and weaknesses of current systems and makes recommendations for enhancing data systems to improve the quality of cancer care. The board's recommendations fall into three key areas: Enhance key elements of the data system infrastructure (i.e., quality-of-care measures, cancer registries and databases, data collection technologies, and analytic capacity). Expand support for analyses of quality of cancer care using existing data systems. Monitor the effectiveness of data systems to promote quality improvement within health systems. ER - TY - BOOK AU - Institute of Medicine TI - Care Without Coverage: Too Little, Too Late SN - DO - 10.17226/10367 PY - 2002 UR - https://nap.nationalacademies.org/catalog/10367/care-without-coverage-too-little-too-late PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital--based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million -- one in seven--working--age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash. ER - TY - BOOK AU - Institute of Medicine A2 - Molla S. Donaldson A2 - Karl D. Yordy A2 - Kathleen N. Lohr A2 - Neal A. Vanselow TI - Primary Care: America's Health in a New Era SN - DO - 10.17226/5152 PY - 1996 UR - https://nap.nationalacademies.org/catalog/5152/primary-care-americas-health-in-a-new-era PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge base—as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systems—important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals. ER - TY - BOOK AU - Institute of Medicine TI - Medical Technology Assessment Directory: A Pilot Reference to Organizations, Assessments, and Information Resources SN - DO - 10.17226/1090 PY - 1988 UR - https://nap.nationalacademies.org/catalog/1090/medical-technology-assessment-directory-a-pilot-reference-to-organizations-assessments PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - For the first time, a single reference identifies medical technology assessment programs. A valuable guide to the field, this directory contains more than 60 profiles of programs that conduct and report on medical technology assessments. Each profile includes a listing of report citations for that program, and all the reports are indexed under major subject headings. Also included is a cross-listing of technology assessment report citations arranged by type of technology headings, brief descriptions of approximately 70 information sources of potential interest to technology assessors, and addresses and descriptions of 70 organizations with memberships, activities, publications, and other functions relevant to the medical technology assessment community. ER - TY - BOOK AU - Institute of Medicine A2 - Rose Marie Martinez A2 - Erin Rusch TI - Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary SN - DO - 10.17226/18552 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18552/understanding-the-connections-between-coastal-waters-and-ocean-ecosystem-services-and-human-health PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health discusses the connection of ecosystem services and human health. This report looks at the state of the science of the role of oceans in ensuring human health and identifies gaps and opportunities for future research. The report summarizes a workshop convened by the Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine. Participants discussed coastal waters and ocean ecosystem services in the United States in an effort to understand impacts on human health. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health focuses on key linkages by discussing the ecosystem services provided by coastal waterways and oceans that are essential for human health and well-being; examining the major stressors that affect the ability of coastal waterways and ocean systems to provide essential services; and considering key factors that can enhance the resiliency of these systems. ER - TY - BOOK AU - Institute of Medicine TI - Using Performance Monitoring to Improve Community Health: Exploring the Issues DO - 10.17226/9137 PY - 1996 UR - https://nap.nationalacademies.org/catalog/9137/using-performance-monitoring-to-improve-community-health-exploring-the-issues PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - Institute of Medicine AU - National Research Council AU - National Research Council TI - Improving Palliative Care: We Can Take Better Care of People With Cancer SN - DO - 10.17226/10790 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10790/improving-palliative-care-we-can-take-better-care-of-people PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - As a society, we have made amazing gains in being able to detect and treat cancer. Even so, about half the people who are told by their doctors that they have cancer will die within a few years. This means that every year about one million people find out that they have cancer and are treated, and about one-half million people die of cancer nationwide. So far, most cancer research and treatment has focused on trying to cure cancer. There hasn't been much attention paid to other important issues, such as pain control and taking care of other troubling symptoms. Now more and more people are aware that there are cancer care needs beyond just trying to cure it. Attention is now being paid to helping people with cancer cope better with the problems that may arise when people are being treated or as they approach death. ER - TY - BOOK AU - Institute of Medicine A2 - Emily Ann Meyer A2 - Kathi Hanna A2 - Kristine Gebbie TI - Cord Blood: Establishing a National Hematopoietic Stem Cell Bank Program SN - DO - 10.17226/11269 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11269/cord-blood-establishing-a-national-hematopoietic-stem-cell-bank-program PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - With the potential for self-renewal and differentiation, the possibilities for stem cells are enormous. One specific type of stem cell, the hematopoietic progenitor cell (HPC), which is derived from umbilical cord blood (as well as adult bone marrow and mobilized peripheral blood), holds particular promise. To make the most of these HPCs, the Institute of Medicine was asked to consider the optimal structure for a national cord blood program and to address pertinent issues related to maximizing the potential of stem cell technology. Cord Blood: Establishing a National Hematopoietic Stem Cell Bank Program examines: The role of cord blood in stem cell transplantation The current status of blood banks already in existence The optimal structure for the cord blood program The current use and utility of cord blood for stem cell transplants The best way to advance the use of cord blood units and make them available for research Expert advice from leaders in the fields of economics, public health, medicine, and biostatistics combine to make this very timely and topical book useful to a number of stakeholders. ER - TY - BOOK AU - Institute of Medicine A2 - Michael A. Stoto A2 - Cynthia Abel A2 - Anne Dievler TI - Healthy Communities: New Partnerships for the Future of Public Health SN - DO - 10.17226/5475 PY - 1996 UR - https://nap.nationalacademies.org/catalog/5475/healthy-communities-new-partnerships-for-the-future-of-public-health PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Future of Public Health, issued in 1988, set forth a vision of public health and a specific role for the governmental public health agency within that vision, including the mission and content of public health, and an organizational framework. In the eight years since the report was released, there has been a significant strengthening of practice in governmental public health agencies and other settings. Substantial social, demographic, and technological changes in recent years, however, have made it necessary to reexamine governmental public health agencies' efforts to improve the public's health. Drawing on the activities and discussions initiated by the Institute of Medicine (IOM) Committee on Public Health, the current report addresses two critical public health issues that can greatly influence the opportunity for our public to be healthy as the United States enters a new century-(1) the relationship between public health agencies and managed care organizations, and (2) the role of the public health agency in the community-and their implications for the broader issues raised in The Future of Public Health. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Crystal J. Bell A2 - Anne Frances Johnson TI - The Use of Telehealth for Disability Evaluations in Medicine and Allied Health: Proceedings of a Workshop SN - DO - 10.17226/26650 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26650/the-use-of-telehealth-for-disability-evaluations-in-medicine-and-allied-health PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Over the past few years the common use of telehealth technology has been rapidly expanding. While remote models of care have been successfully used in rural communities for decades, the adoption of telehealth rapidly expanded during the COVID-19 pandemic, narrowing some gaps in care access and equity while exacerbating health care inequities in other ways. At the request of the Social Security Administration, the National Academies hosted a workshop on March 9 and 10, 2022 to examine the use of telehealth for patient evaluation. The workshop explored the evolution of telehealth and commonly used terminology, the impact of inequities in digital access, privacy and cybersecurity concerns, its use in a variety of allied health and medical specialties for patient evaluation, and interstate licensure related to providing telehealth care. This publication provides a high-level summary of the presentations and discussions from the workshop. ER - TY - BOOK AU - Institute of Medicine A2 - Jonathan R. Davis TI - Managed Care Systems and Emerging Infections: Challenges and Opportunities for Strengthening Surveillance, Research, and Prevention: Workshop Summary SN - DO - 10.17226/9760 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9760/managed-care-systems-and-emerging-infections-challenges-and-opportunities-for PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - This workshop summary report examines how the managed care revolution has created both problems and opportunities in the fight against infectious diseases. It highlights ways in which managed care systems can aid research, develop clinical guidelines, manage the use of antibiotics, support public education efforts, and monitor the spread of emerging infections and microbial resistance. ER - TY - BOOK AU - Institute of Medicine TI - Seafood Safety SN - DO - 10.17226/1612 PY - 1991 UR - https://nap.nationalacademies.org/catalog/1612/seafood-safety PB - The National Academies Press CY - Washington, DC LA - English KW - Food and Nutrition AB - Can Americans continue to add more seafood to their diets without fear of illness or even death? Seafood-caused health problems are not widespread, but consumers are at risk from seafood-borne microbes and toxins—with consequences that can range from mild enteritis to fatal illness. At a time when legislators and consumer groups are seeking a sound regulatory approach, Seafood Safety presents a comprehensive set of practical recommendations for ensuring the safety of the seafood supply. This volume presents the first-ever overview of the field, covering seafood consumption patterns, where and how seafood contamination occurs, and the effectiveness of regulation. A wealth of technical information is presented on the sources of contamination—microbes, natural toxins, and chemical pollutants—and their effects on human health. The volume evaluates methods used for risk assessment and inspection sampling. ER - TY - BOOK AU - Institute of Medicine A2 - Ellen M. Weissman TI - Using Performance Monitoring to Improve Community Health: Conceptual Framework and Community Experience SN - DO - 10.17226/5514 PY - 1996 UR - https://nap.nationalacademies.org/catalog/5514/using-performance-monitoring-to-improve-community-health-conceptual-framework-and PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - Institute of Medicine TI - State Programs Can Reduce Tobacco Use DO - 10.17226/9762 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9762/state-programs-can-reduce-tobacco-use PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - Institute of Medicine A2 - Henry J. Aaron A2 - Hellen Gelband TI - Extending Medicare Reimbursement in Clinical Trials SN - DO - 10.17226/9742 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9742/extending-medicare-reimbursement-in-clinical-trials PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Increasingly over the past five years, uncertainty about reimbursement for routine patient care has been suspected as contributing to problems enrolling people in clinical trials. Clinical trial investigators cannot guarantee that Medicare will pay for the care required, and they must disclose this uncertainty to potential participants during the informed consent process. Since Medicare does not routinely "preauthorize" care (as do many commercial insurers) the uncertainty cannot be dispelled in advance. Thus, patients considering whether to enter trials must assume that they may have to pay bills that Medicare rejects simply because they have enrolled in the trial. This report recommends an explicit policy for reimbursement of routine patient care costs in clinical trials. It further recommends that HCFA provide additional support for selected clinical trials, and that the government support the establishment of a national clinical trials registry. These policies (1) should assure that beneficiaries would not be denied coverage merely because they have volunteered to participate in a clinical trial; and (2) would not impose excessive administrative burdens on HCFA, its fiscal intermediaries and carriers, or investigators, providers, or participants in clinical trials. Explicit rules would have the added benefit of increasing the uniformity of reimbursement decisions made by Medicare fiscal intermediaries and carriers in different parts of the country. Greater uniformity would, in turn, decrease the uncertainty about reimbursement when providers and patients embark on a clinical trial. ER - TY - BOOK AU - Institute of Medicine TI - Preparing for a Changing Healthcare Marketplace: Lessons from the Field DO - 10.17226/9134 PY - 1993 UR - https://nap.nationalacademies.org/catalog/9134/preparing-for-a-changing-healthcare-marketplace-lessons-from-the-field PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - Institute of Medicine TI - Improving the Medicare Market: Adding Choice and Protections, Summary DO - 10.17226/9281 PY - 1996 UR - https://nap.nationalacademies.org/catalog/9281/improving-the-medicare-market-adding-choice-and-protections-summary PB - The National Academies Press CY - Washington, DC LA - English KW - ER - TY - BOOK AU - Institute of Medicine TI - The Richard and Hinda Rosenthal Lectures 2002: Fostering Rapid Advances in Health Care DO - 10.17226/10848 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10848/the-richard-and-hinda-rosenthal-lectures-2002-fostering-rapid-advances PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - Institute of Medicine A2 - Annetine C. Gelijns TI - Technology and Health Care in an Era of Limits SN - DO - 10.17226/2024 PY - 1992 UR - https://nap.nationalacademies.org/catalog/2024/technology-and-health-care-in-an-era-of-limits PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The U.S. health care system is in a state of flux, and changes currently under way seem capable of exerting sizable effects on medical innovation. This volume explores how the rapid transition to managed care might affect the rate and direction of medical innovation. The experience with technological change in medicine in other nations whose health care systems have "single-payer" characteristics is thoroughly examined. Technology and Health Care in an Era of Limits examines how financing and care delivery strategies affect the decisions made by hospital administrators and physicians to adopt medical technologies. It also considers the patient's stake in the changing health care economy and the need for a stronger independent contribution of patients to the choice of technology used in their care. Finally, the volume explores the impact of changes in the demand for medical technology in pharmaceutical, medical device, and surgical procedure innovation. ER -