An illuminating and timely synthesis of methodological and clinical studies showing how medical costs can be established, how the value of clinical outcomes can be assessed, and how difficult choices can be rationally made. The methodological chapters review the conceptual and practical issues involved in estimating and interpreting health care costs, making health status and utility assessments, and statistically analyzing cost-effectiveness and clinical trials. The clinical chapters apply these methods to the major clinical areas of cardiology-primary prevention of coronary artery disease, acute coronary syndromes, angioplasty vs coronary bypass surgery, CABG vs medicine, congestive heart failure, arrhythmias, and cardiac surgery. Additional chapters consider the use of economic studies for policy purposes and the future of Medicare under a balanced budget in an aging America.

This study analyzes the entire health scene, providing valuable insights into the working of the health care practices, and offering policy recommendations for more effective distribution. Although the study focuses mainly on cost containment, it also explores the relationship between health and medical care, the expansion of the demand for medical care and the over-regulated supply, and the economic differences between emergency and nonemergency care. Originally published in 1985. A UNC Press Enduring Edition -- UNC Press Enduring Editions use the latest in digital technology to make available again books from our distinguished backlist that were previously out of print. These editions are published unaltered from the original, and are presented in affordable paperback formats, bringing readers both historical and cultural value.

Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.

This report examines how countries perform in their ability to prevent, manage and treat cardiovascular disease (CVD) and diabetes.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

One of the main purposes of medical cost-benefit analyses is to define the rational priorities in health care. This book ambitiously undertakes to compare the cost-benefit analyses of three countries: the United States, Germany and Israel. Cardiovascular disease is focused on to provide a model case study, but other areas also provide examples. The contribu- tions consider in particular two recent developments. These are the increase in comprehensive epidemiological data, es- pecially with regards to risk factors, and improved methodo- logy for measuring the quality of life. The contributions stem from clinicians, epidemiologists and health economists who give an overall picture of these complex issues and the prospects for the future.