Relationship Between Institutional Investment in High Value Care (HVC) Performance Improvement and Internal Medicine Residents’ Perceptions of HVC Training

Purpose: To measure the association between institutional investment in high value care (HVC) performance improvement and resident HVC experiences. Method: The authors analyzed data from two 2014 surveys assessing institutions’ investments in HVC performance improvement as reported by program directors (PDs) and residents’ perceptions of the frequency of HVC teaching, participation in HVC-focused quality improvement (QI), and [...] Lees meer

High-Value, Cost-Conscious Health Care – Concepts for Clinicians

Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions Health care costs in the United States are increasing unsustainably, and further efforts to control costs are inevitable and essential. Efforts to control expenditures should focus on the value, in addition to the costs, of health care interventions. Whether an intervention provides [...] Lees meer

What Is Value in Health Care?

In any field, improving performance and account- ability depends on having a shared goal that unites the interests and activities of all stakeholders. In health care, however, stakeholders have myriad, often conflicting goals, including access to services, profitability, high quality, cost containment, safety, convenience, patient-centeredness, and satis- faction. Lack of clarity about goals has led to [...] Lees meer

Views of US Physicians About Controlling Health Care Costs

The increasing cost of US health care strains the economy. Because physicians’ decisions play a key role in overall health care spending and quality, several recent initiatives have called on physicians to reduce waste and exercise wise stewardship of resources. Given their roles, physicians’ perspectives on policies and strategies related to cost containment and their perceived [...] Lees meer

‘Zorg zit niet te wachten op stelselwijziging’ (

Bestuursvoorzitter van het Radboudumc Leon van Halder roept het kabinet op om niet weer een stelselwijziging door te voeren. Van Halder: ‘Laten we met elkaar het huidige stelsel optimaliseren. Een nieuwe stelselwijziging helpt de patiënt niet en houdt professionals af van waar het om gaat.’ Van Halder ziet het aankomen: weer vier jaar bezig met de [...] Lees meer

Implementation and de-implementation: two sides of the same coin? (bmj)

Avoiding low value care received increasing attention in many countries, as with the Choosing Wisely campaign and other initiatives to abandon care that wastes resources or delivers no benefit to patients. While an extensive literature characterises approaches to implementing evidence-based care, we have limited understanding of the process of de-implementation, such as abandoning existing low [...] Lees meer

Waste vs. Value in American Health Care

Give economists a drink – or not – and with a straight face they will tell you that the American health-care systems is one of the highest value-added sectors in the economy (see, for example, the book “Measuring the Gains From Medical Research,” edited by Kevin M. Murphy and Robert H. Topel.) Uwe E. Reinhardt, […]

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