Health care delivery systems that are designed to understand and meet patient preferences for care have the potential to improve health outcomes and reduce disparities. Studies that rigorously assess patient care preferences in minority and underserved populations, stakeholder engagement, and policies that promote a diverse health care workforce that can address patient preferences are importan...

The world’s first degree programme in health care delivery science is offered by Dartmouth College in New Hampshire. Health care managers are trained in how to reverse the continuous rise in health service costs. As a leader in Norwegian hospitals over many years, I have been amazed at everything that fails to function, despite committed professionals who make every possible effort. In this art...

WORKFORCE AND WORKPLACE Health System Reconstruction and Nation-Building How important is the role of health in nation-building? To answer this question, a RAND team of political scientists, physicians, and economists examined past attempts to rebuild public health and health care delivery systems during nationbuilding eff orts after U.S. military deployments intended to underpin the transition...

Complexity science suggests that our current health care delivery system acts as a complex adaptive system (CAS). Such systems represent a dynamic and flexible network of individuals who can coevolve with their ever changing environment. The CAS performance fluctuates and its members' interactions continuously change over time in response to the stress generated by its surrounding environment. ...

THECENTERSFORMEDICARE&MEDICAIDSERVICES(CMS) is the largest US payer of fee-for-service health care claims.However,healthcareprovidershavehad,atbest, limitedaccess toMedicare fee-for-servicedatabecause CMS has not made the information broadly accessible. Access to Medicare fee-for-service data could help increase efficiency in health care delivery, reduce costs, and improve the quality ofcare.Re...

The National Programme for IT (NPfIT) promises to revolutionize the delivery of health care by enabling seamless and secure electronic exchange of clinical information within the NHS. Challenges to NPfIT highlighted in the media and academic commentary are common to such initiatives worldwide. This paper offers key messages and recommendations derived from a comparable electronic clinical commu...

In this article we critically examine the principle of equivalence of care in prison medicine. First, we provide an overview of how the principle of equivalence is utilized in various national and international guidelines on health care provision to prisoners. Second, we outline some of the problems associated with its applications, and argue that the principle of equivalence should go beyond e...

The health care delivery system aims to improve the functioning of Americans, but little information exists to judge progress toward meeting this goal. Administrative data generated through running and overseeing health care delivery offer considerable information about diagnoses and procedures in coded formats comparable across settings of care. This article explores the issues raised when con...