...Southampton General Hospital, Southampton, UK 7. Ouderkerk aan den ijssel, The Netherlands 8. Boston Scientific Corporation, Maastricht, The Netherlands 9. Boston Scientific Corporation, Natick Massachusetts, USA 10. Herzzentrum, Leipzig, Germany Introduction Optimal revascularization strategy in patients with coronary artery disease remains a subject of debate between interventional cardiologists and surgeons. Numerous large scale randomized trials addressed this issue comparing coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) in patients with multivessel disease (MVD). Initially these trials compared multivessel balloon angioplasty with CABG1-6 and in a later period multivessel stenting with CABG7-11. These studies clearly demonstrated that there was no difference between the two therapeutic modalities regarding mortality and non fatal myocardial infarction but patients treated with balloon angioplasty or stenting required more often repeat revascularization procedures related to restenosis12,13. Clearly stenting reduced the gap in the event free survival rate between...
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...1 Introduction Governments facing scal pressure have increasingly turned to proposals to create or enhance consumer choice for public services (see, e.g., Besley and Ghatak 2003, Blochliger 2008, Hoxby 2003, Le Grand 2003). In health care, choice is a popular reform model adopted by administrations of di erent political orientations in many countries, including the US, the UK, Denmark, Italy (Lombardy), the Netherlands, Germany and Sweden. The belief is that by increasing choice for patients, providers of care or insurers will become more responsive to patient demand, which in turn will drive greater eciency in the delivery and funding of health care. However, whether enhanced patient choice will make hospital choice more responsive to quality is not well established, although the consequences of poor quality in health care can be dire. Patients' health can be severely compromised by poor quality care, including, as we show below, an increased risk of death. Thus there is a need to understand the responses of health care consumers when they are o ered more choice. This is exactly the issue we address here. To do this we exploit a reform which introduced patient choice and tie this to the estimation of a structural demand model that explicitly incorporates the institutional features of the reform. This enables us to identify the e ect of increasing choice on patient behavior. We use the model to quantify the gains from the reform in terms of patient welfare and...
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...Essentials Ruth E. McCall, BS, MT (ASCP) Retired Program Director and Instructor Central New Mexico Community College Albuquerque, New Mexico President, NuHealth Educators, LLC Faculty, Emeritus Phoenix College Phoenix, Arizona Fifth Edition Cathee M. Tankersley, BS, MT (ASCP) Acquisitions Editor: Peter Sabatini Product Manager: Meredith L. Brittain Marketing Manager: Shauna Kelley Designer: Holly McLaughlin Production Services: Aptara, Inc. Fifth Edition Copyright © 2012, 2008 by Lippincott Williams & Wilkins, a Wolters Kluwer business. Two Commerce Square 2001 Market Street Philadelphia, PA 19103 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com, or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress...
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