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...

Ours is, at its heart, a profession of service predicated on mutual trust. All too often policies aimed at resolving a particular problem in health care are inadequate not because they fail at what they were intended to do, but rather because of the unintended consequences, both direct and indirect, that are inevitable in complex systems where competing interests preclude unity of purpose. Ulti...

BACKGROUND Incidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often leads to resistance. Also, there is a lack of high quality evidence supporting lean premises. In this paper, we present an overview of lean thinking and its application to health care. DEVELOPMENT, THEORY A...

BACKGROUND Forty-one million Americans have no health insurance and, despite the growth of managed care, medical costs are again increasing rapidly. One proposed solution is a single-payer health care financing system with universal coverage. Yet, physicians' views of such a system have not been well studied. METHODS We surveyed a random sample of physicians (from the American Medical Associa...

introduction: health care is one of the most important sectors in the development of each country and disparities in their distribution will reduce the level of development. the aim of this study was to examine the access to healthcare and degree of development in health care resources in the west of iran in 2011. method: this was a cross-sectional and retrospective study. the study setting was...