Recommendations for preventive Pediatric Health Care (Bright Futures/AAP)

美國閃耀的未來(Bright Futures)對於從出生 學齡前 小學 中學 到21歲的預防醫學服務的建議

Recommendations for preventive Pediatric Health Care (Bright Futures/AAP)

Community Programs to Promote Youth Development

Community Programs to Promote Youth Development

Shared via AddThis

國民健康調查

美國版的國民健康調查

• The National Center for Health Statistics (NCHS)
• 
  
• The National Health Interview Survey (NHIS)
• 
  
• CDC WONDER DATA 2010(The Health People Database 2010)
• 
  
• The Child and Adolescent Health Measurement Initiative (CAHMI)
• 
  
• The Young Adult Health Care Survey (YAHCS)
• 
  
• The Youth Risk Behavior Surveillance System (YRBSS)

Adolescent Health Guide for States and Communities

美國版的2010年青少年健康目標 CDC, USA

Improving the Health of Adolescents & Young Adults: A Guide for States and Communities

21 Critical Health Objectives for Adolescents and Young Adults

Health Care Spending in the United States and OECD Countries, 2007

Kaiser Family Foundation Report

This paper uses information from the Organisation for Economic Co-operation and Development (OECD)¹ to compare the level and growth rate of health care spending in the United States with other OECD countries. In an increasingly competitive international economy, policymakers in the United States will need to be aware of how the health spending and spending growth in the United States compares to that of other nations.

How about Taiwan??

Will Check it out!

Mid-Michigan Coalition for Health Care Reform

(MidMcHCR)

Society for Adolescent Medicine (SAM) Position Papers for Adolescent Health

美國青少年醫學會的立場宣言文章網頁

These papers and statements have been approved by SAM’s Board of Directors and are published in the Journal of Adolescent Health. Position Papers and Statements that appear on the SAM web site are available for non-commercial use by the public and permission is hereby granted to download, reproduce, reprint, and distribute these position papers and statements provided that in each instance the SAM policy is clearly and correctly identified as a Society for Adolescent Medicine document with its full title and, if applicable, the citation to its publication in the Journal of Adolescent Health.

參加KCMS/MSU Pediatrics RETREAT有感

臺大醫院家庭醫學部對住院醫師的訓練評估真的非常多樣化!!

1.一般教學門診指導

2.住院病人照護的臨床指導

3.OSCE

4.門診錄影帶教學討論

5.針對ACGME 6項指標的定期書面評估

The ACGME identified six general competencies for residency education:

1. Medical Knowledge
2. Patient Care
3. Practice Based Learning and Improvement
4. Systems Based Practice
5. Professionalism
6. Interpersonal and Communication Skills

6.同儕評估

References:

1. ACGME outcome project(http://www.acgme.org/outcome/about/aboutHome.asp)

2. Epstein RM. Assessment in medical education. N Engl J Med. 2007;356(4):387-96.

3. Stern DT, Papadakis M. The developing physician--becoming a professional. N Engl J Med. 2006;355(17):1794-9.

4. Shaneyfelt T, Baum KD, Bell D, Feldstein D, Houston TK, Kaatz S, Whelan C, Green M.

Instruments for evaluating education in evidence-based practice: a systematic review. JAMA. 2006;296(9):1116-27.

5.Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002;287(2):226-35.

OBAMA的醫療保險改革

THE ECONOMIC CASE FOR HEALTH CARE REFORM

The findings in the report point to large economic impacts of genuine health care reform:

1. We estimate that slowing the annual growth rate of health care costs by 1.5 percentage points would increase real gross domestic product (GDP), relative to the no-reform baseline, by over 2 percent in 2020 and nearly 8 percent in 2030.
2. For a typical family of four, this implies that income in 2020 would be approximately $2,600 higher than it would have been without reform (in 2009 dollars), and that in 2030 it would be almost $10,000 higher. Under more conservative estimates of the reduction in the growth rate of health care costs, the income gains are smaller, but still substantial.
3. Slowing the growth rate of health care costs will prevent disastrous increases in the Federal budget deficit.
4. Slowing cost growth would lower the unemployment rate consistent with steady inflation by approximately one-quarter of a percentage point for a number of years. The beneficial impact on employment in the short and medium run (relative to the no-reform baseline) is estimated to be approximately 500,000 each year that the effect is felt.
5. Expanding health insurance coverage to the uninsured would increase net economic well-being by roughly $100 billion a year, which is roughly two-thirds of a percent of GDP.
6. Reform would likely increase labor supply, remove unnecessary barriers to job mobility, and help to “level the playing field” between large and small businesses.

Lansing 的大型醫院 Sparrow Hospital

Sparrow Hospital System是密西根州中部主要醫療發展中心。

The Official U.S. Government Site for People with Medicare

了解美國官方健保Medicare的網站

http://www.medicare.gov/default.asp

Role of International Medical Graduates Providing Office-based Medical Care: United States, 2005–2006

NCHS Data Brief ■ No. 13 ■ February 2009
Medical graduates from outside the U.S. now perform medical care at about a quarter of all office visits in the U.S. each year. (Source: National Health Care Survey, "Role of International Medical Graduates Providing Office-Based Medical Care: United States, 2005-2006")

1. In 2005–2006, about one-quarter (24.6%) of all visits to office-based physicians were to international medical graduates. Hispanic or Latino and Asian or Pacific Islander patients made more visits to international medical graduates (24.9%) than to U.S. medical graduates (12.4%). International medical graduates also saw a higher percentage of visits made by patients expecting to use Medicaid or State Children’s Health Insurance Program (SCHIP) as their primary payment source (17.6 %) compared with U.S. medical graduates(10.2 %).
2. In 2005–2006, international medical graduates comprised 24.5% of all office-based physicians. International medical graduates were more likely to be of Asian or Pacific Islander (31.6 % compared with 4.9 % of U.S. medical graduates) and Hispanic or Latino descent (6.7 % compared with 1.5 % of U.S. medical graduates).
3. International medical graduates were more likely to practice in primary care shortage areas outside of metropolitan statistical areas (67.8 %) than U.S. medical graduates (39.8%).

Reports Warn of Primary Care Shortages in the U.S.

Reports Warn of Primary Care Shortages
Bridget M. Kuehn
JAMA. 2008;300(16):1872-1875.

Reference:

1. Colwill JM et al. Health Aff [Millwood]. 2008;27[3]:232-241.
2. the National Association of Community Health Centers report http://www.nachc.com/client/documents/ACCESS%20Transformed%20full%20report.PDF

Why Americans pay more for health care ?

The United States spends more on health care than comparable countries do and more than its wealth would suggest. Here’s how—and why.
Diana M. Farrell, Eric S. Jensen, and Bob Kocher
The McKinsey Quarterly DECEMBER 2008

In This Article
Exhibit 1: Health care spending in the United States is far above the expected level, even after adjusting for relative wealth.
Exhibit 2: The United States spends nearly $650 billion more on health care than might be expected, with outpatient care accounting for over two-thirds of this extra spending.
Exhibit 3: Delivering care in an outpatient settings saves $100 billion to $120 billion in inpatient costs­ but reduces above-expected spending on outpatient costs by very little.
Exhibit 4: Same-day hospital care and visits to physicians’ offices contribute the most to the overall growth in spending for outpatient care.
Exhibit 5: Drug prices for comparable products are 50 percent higher in the United States than in other OECD member countries.
Exhibit 6: The US health system’s payment structure has a strong impact on the cost of health administration and insurance.

Overhauling the US health care payment system

During the next five years, rapid innovation may restructure the value chain of health care payments and change the sector’s balance of power.
JUNE 2007 • Nick A. LeCuyer and Shubham Singhal
The McKinsey Quarterly JUNE 2007

In This Article
Exhibit 1: Inefficiency in the health care system is concentrated in the payment flows to medical providers from consumers and insurance companies.
Exhibit 2: The health care payment system is more complicated and less efficient than payment systems in the retail sector.
Exhibit 3: Consumer bad debt is already a significant problem for providers and is growing fast.
Exhibit 4: Transactions between payers and providers are numerous and complex.

Three imperatives for improving US health care

Making health care more affordable is the key to making the US system sustainable. We can bring three of the largest sources of underlying costs and their growth under control.
Paul D. Mango and Vivian E. Riefberg
The McKinsey Quarterly DECEMBER 2008
In This Article
Exhibit 1: Premiums paid by commercial health insurance policies help subsidize the uninsured, as well as people in government-sponsored programs.
Exhibit 2: End-of-life health care costs are a small share of lifetime health care costs.
Exhibit 3: The average annual cost of health care claims associated with morbidly obese patients is more than $7,500 a year, nearly twice the average for adults who are not obese.
Exhibit 4: The medical outcomes of the providers often bear little relation to their reimbursements.
Exhibit 5: Nearly 60 percent of all US health care funding in 2007 came from insurance, while only 43 percent of health care payments covered infrequent, random, or catastrophic events.

1. The high incidence and cost of treating lifestyle- and behavior-induced diseases, such as obesity. These diseases are responsible not only for a majority of the deaths in the United States but also for the fastest-growing share of health care costs.
2. Public and private stakeholders should make health care more affordable and improve its quality by minimizing the economic distortions that now tend to prevent consumers and providers from making value-conscious decisions.
3. Simplify the system’s pervasive and unnecessary administrative complexity to remove the waste that drives up costs, to facilitate the real-time flow of critical information, and to promote the introduction of productivity-enhancing technologies.

Seven principles to guide health care reform

Seven principles to guide health care reform
A health care system's fundamental problems can be addressed if the decision makers recognize the interlocking nature of its elements.
Diana Farrell, Nicolaus P. Henke, and Paul D. Mango
The McKinsey Quarterly FEBRUARY 2007

In This Article
Exhibit 1: Seven common principles, applicable to a broad spectrum of health systems, provide a framework to guide decision making.
Exhibit 2: Health-care system leaders should deploy three main approaches to implementation.


1. Prevent illness and injury
2.Promote value-conscious consumption
3. Analyze under- and overcapacity
4. Safeguard the quality of suppliers
5. Promote cost competitiveness
6. Improve finance mechanisms
7. Ensure successful implementation