RESUMO
This paper examines National Institutes of Health (NIH) pediatric research spending in absolute terms and relative to the doubling of the NIH overall budget between fiscal years 1998 and 2003. Pediatric spending increased by an average annual rate of 12.8 percent during the doubling period (almost on par with the NIH average annual growth rate of 14.7 percent). However, the proportion of the total NIH budget devoted to the pediatric portfolio declined from 12.3 to 11.3 percent. We offer recommendations for implementing existing commitments to strengthen the pediatric research portfolio and to protect the gains of the doubling period.
Assuntos
Orçamentos , Financiamento Governamental/tendências , National Institutes of Health (U.S.)/economia , Pediatria , Apoio à Pesquisa como Assunto/tendências , Criança , Serviços de Saúde da Criança/legislação & jurisprudência , Pré-Escolar , Gastos em Saúde , Humanos , Estados UnidosRESUMO
The Beacon Community Program, authorized under the 2009 American Recovery and Reinvestment Act (ARRA), aims to demonstrate the potential for health information technology to enable local improvements in health care quality, cost efficiency, and population health. If successful, these communitywide efforts will yield important lessons that will assist other communities seeking to harness technology to achieve and sustain health care improvements. This paper highlights key programmatic details that reflect the meaningful use of technology in the fifteen Beacon communities. It describes the innovations they propose and provides insight into current and future challenges.
Assuntos
American Recovery and Reinvestment Act , Serviços de Saúde Comunitária/organização & administração , Atenção à Saúde/organização & administração , Informática Médica/organização & administração , Reembolso de Incentivo , Benchmarking , Serviços de Saúde Comunitária/economia , Serviços de Saúde Comunitária/normas , Atenção à Saúde/normas , Reforma dos Serviços de Saúde , Humanos , Modelos Organizacionais , Objetivos Organizacionais , Desenvolvimento de Programas , Estados UnidosRESUMO
The concept of accountable care organizations (ACOs) has been set forth in recently enacted national health reform legislation as a strategy to address current shortcomings in the U.S. health care system. This paper focuses on implementation issues related to these organizations, building on some initial examples. We seek to clarify definitions and key principles, provide an update on implementation in the context of other reforms, and address emerging issues that will affect the organizations' success. Finally, building on the initial experience of several organizations that are implementing accountable care and complementary reforms, we propose a national strategy to identify and expand successful approaches to accountable care implementation.