Resident’s values and the hidden training program

What Kind of Physician Will You Be? | The Dartmouth Atlas of Health Care | "We look to you as med stud nearing grad" http://t.co/OFqonpPjxo
— Rafael Manzanera (@rafaelmanzanera) September 6, 2013

Dr. Rafael Manzanera, the author of this week’s selected tweet, is a doctor with a career related to the planning and management of public health. Now he is responsible for quality and "knowledge management" at MC Mutual.

The informed medical decision making

In this post, I’ll discuss some initiatives that began in the U.S. long before the emergence of the internet, but now, with the explosion of communication channels and social networks, these have taken on an impressive dimension that I’d like to bring to your knowledge and appreciation because, as we stand today in our environment, we are very far from these advances.

Healthwise is a U.S. company offering all kinds of solutions helping healthy people to better preserve their health and patients to better understand their disease. Many assurances, such as Kaiser Permanente, are offering Healthwise products and solutions to their members, with the aim of supporting policies of empowerment.

End of Life Overtreatment: Hospital Care Intensity (HCI) Index

Hospital Care Intensity (HCI) Index is a summary measure of the intensity of hospital resource consumption that is constructed, starting from the number of hospital stays and the number of visits to a specialist. Through this index, created by The Dartmouth Atlas, John Wennberg discusses the use of hospital services series by chronic patients for the last two years of their life, and notices a change in HCI up to 4 times between regions with more extreme data: New Jersey (NJ) and Salt Lake City (SLC).

HCI last two years of life in patients with chronic

The healthcare systems are all clear that if an 80 year old lady’s femur breaks she should be operated. After the intervention, she’ll have more or less successful results and this will determine the functional recovery of the patient, the permanent disability, or the death. But instead, when a patient with one or more chronic diseases grows older and his chronic diseases multiply or aggravate, then the response of almost all the systems is to provide disproportionate and costly hospital services, but all very uneven, as seen in the table above.