weblinks 2011-4-2

Three health ideas from Harvard. (video)

中国经济研究所和经济学家排名

OECD:  the European Union will see an increase in health expenditure of 350% by 2050. The economy is only set to expand by 180%.

Why Is There A Problem With Health Care Quality?  总之，简单的扩大医保覆盖范围和改进医疗服务的质量和数量是完全不同的。

什么是QIO质量改进组织？US在医疗照护质量上面做了大量的功夫，他们的同行评审、质量改进组织是情况呢？

According to the CMS website, Quality Improvement Organizations (QIOs) are private, mostly not-for-profit organizations, which are staffed by professionals, mostly doctors and other health care professionals, who are trained to review medical care and help beneficiaries with complaints about the quality of care and to implement improvements in the quality of care available throughout the spectrum of care.

According to Zeitler (2004), Peer Review Organizations (PROs)) were established through the Peer Review Improvement Act of 1982 (a part of the Tax Equity and Fiscal Responsibility Act of 1982), replacing Professional Standards Review Organizations (PSROs) that had been established in  1972. In FY2002, they were renamed Quality Improvement Organizations (QIOs).

宗教信仰更易肥胖？

西北大学一个四年级的医学生Feinstein在北美一个presentation上展示了一个模型，认为在控制了age, race, sex, education, income, and baseline body mass index等因素的条件下，年轻人（20-32岁）频繁（至少每周一次）参加宗教活动与50%的肥胖风险因素增加有关。这当然是一个很有意思的研究，至少在西方宗教生活是一个所有人都逃不开的话题（天朝例外）。但是这始终还只是一个会议研究，没有经过peer-review和publication。
Steve Pizer认为宗教更可能是一个肥胖模型中的一个代理变量，而不是肥胖的驱动因素(a variable that doesn't drive the result itself but stands in for something the researcher doesn't have，比如人均GDP常常用作生活水平/质量的一个代理变量)。

Source：
http://theincidentaleconomist.com/wordpress/big-hits-of-epidemiology-church-makes-you-fat/

美国医院-临床质量信息报告--州和州以上层面

全美各个州都有针对医院层面的质量报告项目，经过识别后有25个州存在这种报告，但是其信息质量在州际间、报告的健康条件、过程、健康产出测评上出入很大。各州的报告特点见这里。

而AHRQ为了协调这些口径和标准，作出了不少努力，其中MONAHRQ软件(a software product that enables organizations – such as state and local data organizations, Chartered Value Exchanges, hospital systems, and health plans – to input their own hospital administrative data and generate a data-driven Web site. )就是其中之一，这个软件可以产出交互性非常好的网站（前提是只要你输入数据就行），而软件整理出的就是关于医院和地区医护质量的报告和map。如：

• quality of care at the hospital level,
• health care utilization at the hospital level,
• preventable hospitalizations at the county level, and
• rates of conditions and procedures at the county level.

但是呢，现在还只看到三个州(Maine, Hawaii, Nevada)使用了这种软件。

Tips：
关于The Agency for Healthcare Research and Quality's (AHRQ), part of the U.S. Department of Health and Human Services, is the lead agency charged with supporting research designed to improve the quality of health care, reduce its cost, and broaden access to essential services. It's mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.
AHRQ was established in 1989 and formerly known as the Agency for Health Care Policy and Research. Reauthorizing legislation passed in November 1999 establishes AHRQ as the lead Federal agency on quality research. The website includes clinical practice guidelines, evidence reports and technical reviews.

Source：
State-Sponsored Public Reporting Of Hospital Quality: Results Are Hard To Find And Lack Uniformity  * Joseph S. Ross,  Health Aff December 2010 29:122317-2322; doi:10.1377/hlthaff.2010.0564
A Tool For Reporting Hospital Data On Care   * Anne Elixhauser, Health Aff March 2011 30:3538; doi:10.1377/hlthaff.2011.0205