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04/30/2012 Cardiac Care - A Case Study in Practice Variation

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Viewing entries tagged with 'quality'

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Cardiac Care - A Case Study in Practice Variation

Marianne Udow-Phillips

Posted by Marianne Udow-Phillips on April 30, 2012

In 2010, when we published our study on healthcare variation in Michigan, we were able to show considerable geographic variation around the state of Michigan on a variety of procedures and services. We intentionally chose services where the research indicated either a tendency toward over-utilization (relative to evidence-based guidelines) or where the guidelines were unclear.

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Is a national health service really such a bad idea? The VA Example

Marianne Udow-Phillips

Posted by Marianne Udow-Phillips on November 7, 2011

Many Americans have an almost visceral reaction against what is sometimes called "socialized medicine." Socialized medicine is often discussed in the context of the British Health Service – where the government is both the payer and the employer of those delivering care. But the irony is, we have a superb example of a very similar approach here in America: the U.S. Department of Veterans Affairs.

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Health Care Quality and Cost Improvement: State-based approaches can’t go it alone

Posted by Kevin L. Seitz on September 26, 2011

It is difficult to find an issue that is more politically contentious than health care; particularly the policy changes and programs that are needed to assure that Americans have access to needed care.  The liberal position tends to see health care as a right, and seeks a strong centralized public role in assuring that all Americans have access to the same kinds of benefits and care.  The conservative position sees fiscal and personal responsibility as the top priorities; tending to favor decentralized, private market solutions.

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A Better Approach to Quality Improvement

Marianne Udow-Phillips

Posted by Marianne Udow-Phillips on April 17, 2011

In the April issue of the journal Health Affairs, my colleagues and I descibe the success of a broad collaborative effort that has been in place in Michigan to improve quality of health care. The focus of the April Health Affairs is what has happened since the seminal work by the Institute of Medicine – Crossing the Quality Chasm – was published.

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IMRT and Patient Safety: The Way Forward

Posted by Heather Kofke-Egger on February 14, 2011

One year ago, the New York Times reported on a series of serious medical errors that had occurred during the administration of Intensity Modulated Radiation Therapy, or IMRT. IMRT is a relatively new technology that uses sophisticated equipment to deliver high doses of radiation to very specific areas of the body, while sparing normal tissue. When administered correctly, IMRT can reduce the toxic effects of radiation therapy and allow higher doses than traditional radiation therapy. However, when this highly targeted beam misses its target due to a medical error, the results can be catastrophic.

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A Michigan Look at Variation in Medical Care: Where you live often determines what you get

Marianne Udow-Phillips

Posted by Marianne Udow-Phillips on October 4, 2010

This week our Center is releasing a report on geographic variation in health care use in Michigan. Geographic variation in the use of health care services has been well described in the literature for more than 20 years now. Jack Wennberg pioneered this kind of systematic analysis at Dartmouth and has been reporting this data on an ongoing basis looking at the Medicare population. In 1997, Jack partnered with Blue Cross and Blue Shield of Michigan to do the same kind of analysis looking at a commercial, under 65 year old population. The report in Michigan got a lot of attention when it was released in 2000 – and sparked some interesting community dialogs including one in Grosse Pointe, Michigan about why their rates of use for ADHD drugs was so high (highest in the state).

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To scan or not to scan

Marianne Udow-Phillips

Posted by Marianne Udow-Phillips on August 30, 2010

There is an increasing consensus that many high tech radiology procedures are overused but no agreement on what to do about it.

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The Health Care Industry in Michigan: Staying on the Open Road

Posted by Ora Hirsch Pescovitz, M.D. on May 24, 2010

When I first came to Michigan from Indiana a year ago, I knew I was coming to a special state for health care.

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