IMPORTANCE Health care costs in the United States are rising rapidly, and consensus exists that we are not achieving sufficient value for this investment. Historically, US physicians have been paid more for performing costly procedures that drive up spending and less for cognitive services that may conserve costs and promote population health. OBJECTIVE To quantify the Medicare payment gap be...

BACKGROUND Complementary and Alternative Medicine use and how it impacts health care utilization in the United States Military is not well documented. Using data from the Millennium Cohort Study we describe the characteristics of CAM users in a large military population and document their health care needs over a 12-month period. The aim of this study was to determine if CAM users are requiring...

BACKGROUND Information about health care utilization and costs among patients with chronic obstructive pulmonary disease (COPD) is needed to improve care and for appropriate allocation of resources for patients with COPD (COPD patients or cases) in managed care organizations. METHODS Analysis of all inpatient, outpatient, and pharmacy utilization of 1522 COPD patients continuously enrolled du...

BACKGROUND There are few reports on the effects of extensive decentralization of mental health services. We investigated the total patterns of utilization in a local-bed model and a central-bed model. METHODS In a time-trend case-registry design, 7635 single treatment episodes, from the specialist and municipality services in 2003-2006, were linked to 2975 individual patients over all adminis...

Background Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach refl...