Context: In the United States, more than a third of patients are referred to a specialist each
year, and specialist visits constitute more than half of outpatient visits. Despite the frequency …

An estimated 99 million Americans live with a chronic illness. Meeting the needs of this
population is one of the major challenges facing the US health care system today and in the …

Despite rising costs, health care often is of poor quality. 1-4 Current solutions to improving
quality may do more harm than good if they focus more on diseases than on people. 2, 5-9 …

Context.—The effectiveness of recruiting local medical opinion leaders to improve quality of
care is poorly understood. Objective.—To evaluate a guideline-implementation intervention …

Background The outcome after myocardial infarction may be influenced by the type of
physician providing ambulatory care. Methods We studied 35,520 patients 65 years of age …

Cirrhosis is a common chronic condition with high rates of morbidity and mortality. Optimal
medical management involves a multidisciplinary approach, but coordination between …

Patients usually cannot assess the technical quality of their care; however, examining a
hospitalization through the patients' eyes can reveal important information about the quality …

High use of specialist physicians and specialized procedures coupled with low expo-sure to
primary care are distinguishing traits of the US health care system. Although the tasks of the …

Background: Previous studies suggest that specialty care is more costly but may produce
improved outcomes for patients with acute cardiac illnesses. Objective: To determine …

This article enables the reader to understand the newest scientific concepts and advances in
the field of self-management in chronic obstructive pulmonary disease, recognize the …