In 1991, a violent military coup unseated Haiti’s first democratically elected government. An estimated 5000 people died, and hundreds of thousands more were displaced during the three years when military and paramilitary groups ruled the country. It was my privilege and responsibility to help provide basic medical services in central Haiti during those years. After constitutional rule was rest...

background vertically oriented global health initiatives (ghis) addressing the hiv/aids epidemic, including the president’s emergency plan for aids relief (pepfar), have successfully contributed to reducing hiv/aids related morbidity and mortality. however, there is still debate about whether these disease-specific programs have improved or harmed health systems overall, especially with respect...

Epidemiological issues in ‘special groups’ are dependent on both the source and age of the population. Cohort effects, due to year of birth, are important in defining prevalence in both learning disability1 and epilepsy2. Table 137 shows epidemiological surveys of the prevalence of epilepsy in people with mental and physical handicap. A survey in an institution for people with learning disabil...

Tucson Medical Center, a community hospital in Tucson, Ariz., is one of the provider groups participating in the Brookings–Dartmouth ACO Pilot Program to implement accountable care organizations (ACOs), which assume responsibility for improving patient care and lowering total costs and, in turn, share in the savings achieved. This case study explores the characteristics of Tucson Medical Center...