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THE MEDICAL HOME The Patient Centered Medical Home (PCMH) is an approach to providing comprehensive primary care for children, youth, and adults.1 PCMH facilitates partnerships with individual patients, their personal physicians, and family. In pediatrics, PCMH is usually referred to as the Patient and Family Centered Medical Home, or just the Medical Home (MH). The MH was named over 40 years a...

Publicly asserting the necessity of slow, careful attention to immeasurable pleasure and immeasurable cares can be a form of political activism in our speeded-up society. If 'caring' has to be defended actively, people need a public, political language for defending it. How do Americans publicly defend attention to immeasurable pleasures and immeasurable suffering? How do they speak in everyday...

Matters of hospital management do not figure prominently on the medical ethics agenda. However, management decisions that have to be taken in the area of hospital care are in fact riddled with ethical questions and do have significant impact on patients, staff members, and the community being served. In this decision making process evidence based medicine (EBM) plays an increasingly important r...

PROBLEM Despite the Government's effort to expand services to district level, it is still hard for people living with HIV to access antiretroviral treatment (ART) in rural Zambia. Strong demands for expanding ART services at the rural health centre level face challenges of resource shortages. APPROACH The Mumbwa district health management team introduced mobile ART services using human resour...

Medicare expenditures of hospital outpatient department (HOPD) services are growing rapidly, prompting congressional interest in a prospective payment system. In this article, the authors identify frequently provided services and examine service volume and charges in the HOPD. Relatively few services drive Medicare HOPD spending, and volume is dominated by visits, imaging and laboratory tests, ...

and regions within the U.S., and specific systems of care has shown that health systems built on a solid foundation of primary care deliver more effective, efficient, and equitable care than systems that fail to invest adequately in primary care.i, ii However, some policy analysts have questioned whether these largely cross-sectional, observational studies are adequate for making inferences abo...