Tracking Medicine: A Researcher's Quest to Understand Health Care [Kindle Edition]
Author: John E. Wennberg | Language: English | ISBN: B004GXAH3M | Format: PDF, EPUB
Tracking Medicine: A Researcher's Quest to Understand Health Care
Download Tracking Medicine: A Researcher's Quest to Understand Health Care [Kindle Edition] from 4shared, mediafire, hotfile, and mirror link Written by a groundbreaking figure of modern medical study, Tracking Medicine is an eye-opening introduction to the science of health care delivery, as well as a powerful argument for its relevance in shaping the future of our country. An indispensable resource for those involved in public health and health policy, this book uses Dr. Wennberg's pioneering research to provide a framework for understanding the health care crisis; and outlines a roadmap for real change in the future. It is also a useful tool for anyone interested in understanding and forming their own opinion on the current debate. Direct download links available for Tracking Medicine: A Researcher's Quest to Understand Health Care [Kindle Edition]
Download Tracking Medicine: A Researcher's Quest to Understand Health Care [Kindle Edition] from 4shared, mediafire, hotfile, and mirror link Written by a groundbreaking figure of modern medical study, Tracking Medicine is an eye-opening introduction to the science of health care delivery, as well as a powerful argument for its relevance in shaping the future of our country. An indispensable resource for those involved in public health and health policy, this book uses Dr. Wennberg's pioneering research to provide a framework for understanding the health care crisis; and outlines a roadmap for real change in the future. It is also a useful tool for anyone interested in understanding and forming their own opinion on the current debate. Direct download links available for Tracking Medicine: A Researcher's Quest to Understand Health Care [Kindle Edition]
- File Size: 1421 KB
- Print Length: 344 pages
- Publisher: Oxford University Press, USA; 1 edition (July 29, 2010)
- Sold by: Amazon Digital Services, Inc.
- Language: English
- ASIN: B004GXAH3M
- Text-to-Speech: Enabled
- Lending: Enabled
- Amazon Best Sellers Rank: #447,225 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
- #87 in Kindle Store > Kindle eBooks > Nonfiction > Professional & Technical > Medical eBooks > Internal Medicine > Infectious Disease > Epidemiology
- #89 in Kindle Store > Kindle eBooks > Nonfiction > Professional & Technical > Medical eBooks > Administration & Policy > Health Policy
Read this book too (along with Overtreated) if you want to understand what has gone wrong with American Medicine.
It always a pleasure to hear a brilliant scientist explain his work. But it is also a revelation to hear such a figure explain how he worked his way through the data with a good deal of self observation, willingness to acknowledge mis-steps and point-by-point response to those who try to provide alternative explanations to his results. Wennberg explains the studies done by the Dartmouth Health Atlas Project, how they altered his original beliefs and gradually caused him to recognize the omnipresence of self-delusion in much of the
medical-industrial complex.
Wennberg's original mission was to examine practices across the state of Vermont to make sure that rural areas were receiving the same "excellent" care as those living near academic medical centers. Looking for underserved populations, he developed a map of regions served by various medical centers and began looking at the frequency of various procedures corrected for population size. In one town, 60% of the children had had their tonsils removed by age 15, while in the next town over only 20% of the kids were tonsils free. The odds that a women had had a hysterectomy varied fourfold from region to region. Hospitalization for digestive diseases varied two fold, and for respiratory ailments, threefold. Given the relative homogeneity of the population, these differences in practice patterns made no sense. And death rates, and average age at death, were indistinquishable across regions. Rather than justifying his original concern over undertreatment, Wennberg's data made a strong case for overutilization of dubiously effective procedures favored in the local community.
Book Review
John Wennberg's book, Tracking Medicine, a researcher's quest to understand health care, challenges anyone interested in health information technology or the Affordable Health Care Act to a `must read.` Wenneberg spent 40 years applying statistical analysis to the care given in various U.S. locations. Wennberg discovered an extreme variation in the manner and quantity of medical services rendered. He applied the science of epidemiology and statistics to understand these differences. What he found was a fundamental contradiction in the patterns of medical practice. These contradictions surprise and shock the medical establishment and others who believed that for healthcare more is better.
Patient satisfaction, outcome and longevity -- even in some teaching centers - proved inversely related to the intensity of medical, surgical and hospital services. Furthermore, Wennberg found that the greater the capacity of the facility and number of specialists per capita, the greater the intensity of care. Intriguingly, he found that providers were completely unaware of this variation. Present day Certificates of Need, required for expanding the number of hospital beds -- and in large measure many other provisions in the Affordable Health Care Act - indeed reflect much of Wennberg's research.
Wennberg together with the Dartmouth Institute of Health Policy and Clinical Practice proposed four policies to improve clinical medicine and quality. They suggested:
1. Organized local systems
2. Decreasing overtreatment by shared decision making between patient and doctor
3. Strengthening the science of health care delivery
4.
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