The Affordable Care Act provides an opportunity to reinvent the health care delivery system to make it more accessible, patient-centered, and comprehensive, with an emphasis on prevention and primary care. This article explores how community health centers are well positioned to implement the Act's provisions, by expanding access to high-quality, affordable care to millions.

For national and local leaders to achieve universal health coverage, a new approach or technique to gathering evidence and understanding the contexts that influence the outcome of a study and goes beyond the quantitative results of clinical trials and pilot projects is important. The Doris Duke Charitable Foundation's African Health Initiative (AHI) was designed to produce this type of knowledg...

T here is growing recognition among investigators, funding agencies, and other constituencies that the clinical trial enterprise in the United States is not keeping pace with our health system's need for more and better information to guide clinical decision making. 1 The need for better information is largely driven by the rapid pace of discovery in biology, technology, and health services del...

As states' Medicaid programs continue to evolve from traditional fee-for-service to value-based health care delivery, there is growing recognition that systemwide multipayer approaches provide the market power needed to address the triple aim of improved patient care, improved health of populations, and reduced costs. Federal initiatives, such as the State Innovation Model grant program, make s...

BACKGROUND Tuberculosis (TB) notification in India by the Revised National TB Control Programme (RNTCP) provides information on TB patients registered for treatment from the programme. There is limited information about the proportion of patients treated for TB outside RNTCP and where these patients access their treatment. OBJECTIVES To estimate the proportion of patients accessing TB treatme...

Consumer satisfaction with healthcare is an important quality and outcome indicator. Satisfaction may be at the crux of survival for healthcare delivery systems because it creates the competitive edge in healthcare. To better understand patient satisfaction by examining consumer healthcare experiences and expectations, a study was conducted. An important concept identified in the data, MY CARE,...

This issue brief surveys health coverage expansion initiatives that are operating on the county or local level, often without the benefit of federal funding. The paper explores the circumstances that have made these initiatives possible and considers the ongoing barriers that local policymakers face in sustaining the programs. Descriptions of four initiatives illustrate the range and variety of...

The use and development of software in the medical field offers tremendous opportunities for making health care delivery more efficient, more effective, and less error-prone. We discuss and explore the use of clinical pathways analysis with Adaptive Bayesian Networks and Data Mining Techniques to perform such analyses. The computation of "lift" (a measure of completed pathways improvement poten...

Introduction In order to provide effective healthcare to the rural population, the National Rural Health Mission (NRHM) by government of India proposed introduction of female health workers village level. These workers are called Accredited Social Health Activists (ASHA) and their role is to act at an interface between the community and the government healthcare services. More specifically, she...

Providing primary care to rural patients requires creativity, resourcefulness, and sensitivity. The NP's education in and exposure to cultural sensitivity can support delivery of care that is both patient-centered and ethnically-focused. Clinicians' knowledge about the cultural heritage of their constituency must include recognition of norms, beliefs, and practices. Knowledge of culture and its...