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Describes how the interests of doctors, patients, and the government have shaped the current health care system, and discusses the key issues of the future.
Most of the policy discussion about stimulating innovation has focused on the federal level. This study focuses on the significant activity at the state level, with the goal of improving the public's understanding of key policy strategies and exemplary practices. Based on a series of workshops and conferences that brought together policymakers along with leaders of industry and academia in a select number of states, the study highlights a rich variety of policy initiatives underway at the state and regional level to foster knowledge based growth and employment. Perhaps what distinguishes this effort at the state level is most of all the high degree of pragmatism. Operating out of necessity, innovation policies at the state level often involve taking advantage of existing resources and recombining them in new ways, forging innovative partnerships among universities, industry and government organizations, growing the skill base, and investing in the infrastructure to develop new technologies and new industries. Many of these initiatives are being guided by leaders from the private sector and universities. The objective of Best Practices in State and Regional Innovation Initiatives: Competing in the 21st Century is not to do an empirical review of the inputs and outputs of various state programs. Nor is it to evaluate which programs are superior. Indeed, some of the notable successes, such as the Albany nanotechnology cluster, represent a leap of leadership, investment, and sustained commitment that has had remarkable results in an industry that is actively pursued by many countries. The study's goal is to illustrate the approaches taken by a variety of highly diverse states as they confront the increasing challenges of global competition for the industries and jobs of today and tomorrow.
Dr. Kissick was an active participant in the drafting of Medicare legislation in the 1960s and for the past twenty-five years has held joint positions in a medical school and a business school where he has specialized in healthcare management. Drawing on his long experience in the field, he discusses the dimensions of the current crisis, the financial and medical implications of alternative proposals-- including the program put forth by the Clinton administration--and the requirements for long-term strategies.
Esther Gottesfeld is the last living survivor of the notorious 1911 Triangle Shirtwaist fire and has told her story countless times in the span of her lifetime. Even so, her death at the age of 106 leaves unanswered many questions about what happened that fateful day. How did she manage to survive the fire when at least 146 workers, most of them women, her sister and fiancé among them, burned or jumped to their deaths from the sweatshop inferno? Are the discrepancies in her various accounts over the years just ordinary human fallacy, or is there a hidden story in Esther's recollections of that terrible day? Esther's granddaughter Rebecca Gottesfeld, with her partner George Botkin, an ingenious composer, seek to unravel the facts of the matter while Ruth Zion, a zealous feminist historian of the fire, bores in on them with her own mole-like agenda. A brilliant, haunting novel about one of the most terrible tragedies in early-twentieth-century America, Triangle forces us to consider how we tell our stories, how we hear them, and how history is forged from unverifiable truths.
Describes the 1911 fire that destroyed the Triangle Shirtwaist factory in New York's Greenwich Village, the deaths of 146 workers in the fire, and the implications of the catastrophe for twentieth-century politics and labor relations.
Patient-reported outcomes (PROs) are measures of how patients feel or what they are able to do in the context of their health status; PROs are reports, usually on questionnaires, about a patient's health conditions, health behaviors, or experiences with health care that individuals report directly, without modification of responses by clinicians or others; thus, they directly reflect the voice of the patient. PROs cover domains such as physical health, mental and emotional health, functioning, symptoms and symptom burden, and health behaviors. They are relevant for many activities: helping patients and their clinicians make informed decisions about health care, monitoring the progress of care, setting policies for coverage and reimbursement of health services, improving the quality of health care services, and tracking or reporting on the performance of health care delivery organizations. We address the major methodological issues related to choosing, administering, and using PROs for these purposes, particularly in clinical practice settings. We include a framework for best practices in selecting PROs, focusing on choosing appropriate methods and modes for administering PRO measures to accommodate patients with diverse linguistic, cultural, educational, and functional skills, understanding measures developed through both classic and modern test theory, and addressing complex issues relating to scoring and analyzing PRO data.