Health care

About: Health care is a research topic. Over the lifetime, 342157 publications have been published within this topic receiving 7214284 citations. The topic is also known as: healthcare & medical care.

The Department of Health and Human Services.

Abstract: This letter is in response to your two Citizen Petitions dated November 17, 1994 and May 13, 2008, requesting that the Food and Drug Administration (FDA or the Agency) require a cancer warning on cosmetic talc products. Your 1994 Petition requests that all cosmetic talc bear labels with a warning such as \"Talcum powder causes cancer in laboratory animals. Frequent talc application in the female genital area increases the risk of ovarian cancer.\" Additionally, your 2008 Petition requests that cosmetic talcum powder products bear labels with a prominent warning such as: \"Frequent talc application in the female genital area is responsible for major risks of ovarian cancer.\" Further, both of your Petitions specifically request, pursuant to 21 CFR 1 0.30(h)(2), a hearing for you to present scientific evidence in support of this petition.

The need for a new medical model: a challenge for biomedicine

Abstract: The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.

Methods for the Economic Evaluation of Health Care Programmes

Abstract: The purpose of economic evaluation is to inform decisions intended to improve healthcare. The new edition of Methods for the Economic Evaluation of Health Care Programmes equips the reader with the necessary tools and understanding required to undertake evaluations by providing an outline of key principles and a 'tool kit' based on the authors' own experiences of undertaking economic evaluations. Building on the strength of the previous edition, the accessible writing style ensures the text is key reading for the non-expert reader, as no prior knowledge of economics is required. The book employs a critical appraisal framework, which is useful both to researchers conducting studies and to decision-makers assessing them. Practical examples are provided throughout to aid learning and understanding. The book discusses the analytical and policy challenges that face health systems in seeking to allocate resources efficiently and fairly. New chapters include 'Principles of economic evaluation' and 'Making decisions in healthcare' which introduces the reader to core issues and questions about resource allocation, and provides an understanding of the fundamental principles which guide decision making. A key part of evidence-based decision making is the analysis of all the relevant evidence to make informed decisions and policy. The new chapter 'Identifying, synthesising and analysing evidence' highlights the importance of systematic review, and how and why these methods are used. As methods of analysis continue to develop, the chapter on 'Characterising, reporting and interpreting uncertainty' introduces the reader to recent methods of analysis and why characterizing uncertainty matters for health care decisions. The fourth edition of Methods for the Economic Evaluation of Health Care Programmes has been thoroughly revised and updated, making it essential reading for anyone commissioning, undertaking, or using economic evaluations in health care, including health service professionals, health economists, and health care decision makers.

Validation and utility of a self-report version of PRIME-MD : The PHQ Primary Care Study

Abstract: ContextThe Primary Care Evaluation of Mental Disorders (PRIME-MD) was developed as a screening instrument but its administration time has limited its clinical usefulness.ObjectiveTo determine if the self-administered PRIME-MD Patient Health Questionnaire (PHQ) has validity and utility for diagnosing mental disorders in primary care comparable to the original clinician-administered PRIME-MD.DesignCriterion standard study undertaken between May 1997 and November 1998.SettingEight primary care clinics in the United States.ParticipantsOf a total of 3000 adult patients (selected by site-specific methods to avoid sampling bias) assessed by 62 primary care physicians (21 general internal medicine, 41 family practice), 585 patients had an interview with a mental health professional within 48 hours of completing the PHQ.Main Outcome MeasuresPatient Health Questionnaire diagnoses compared with independent diagnoses made by mental health professionals; functional status measures; disability days; health care use; and treatment/referral decisions.ResultsA total of 825 (28%) of the 3000 individuals and 170 (29%) of the 585 had a PHQ diagnosis. There was good agreement between PHQ diagnoses and those of independent mental health professionals (for the diagnosis of any 1 or more PHQ disorder, κ = 0.65; overall accuracy, 85%; sensitivity, 75%; specificity, 90%), similar to the original PRIME-MD. Patients with PHQ diagnoses had more functional impairment, disability days, and health care use than did patients without PHQ diagnoses (for all group main effects, P<.001). The average time required of the physician to review the PHQ was far less than to administer the original PRIME-MD (<3 minutes for 85% vs 16% of the cases). Although 80% of the physicians reported that routine use of the PHQ would be useful, new management actions were initiated or planned for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses not previously recognized.ConclusionOur study suggests that the PHQ has diagnostic validity comparable to the original clinician-administered PRIME-MD, and is more efficient to use.