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Effectiveness Initiative: Setting Priorities for Clinical Conditions.


Institute of Medicine (US) Division of Health Care Services.


Washington (DC): National Academies Press (US); 1989.


In 1988 the Health Care Financing Administration (HCFA) of the U.S. Department of Health and Human Services proposed an Effectiveness Initiative to bring the resources of Medicare to bear on the question of what works in the practice of medicine. During this time, HCFA consulted widely with many individuals and organizations in medicine, health care financing, and health services and policy research for guidance on this new program initiative. In August 1988 HCFA requested the Institute of Medicine, National Academy of Sciences, to recommend clinical conditions that should receive priority attention initially. This emphasis on the clinical condition reflected a decision to focus on this unit of analysis rather than specific procedures or technologies. To accomplish this task, the Institute appointed a committee according to National Academy of Sciences procedures (following a collaborative consultation between the Institute and HCFA) and convened a one-day workshop on October 27, 1988, preceded by an opening session on the evening of October 26. The committee, chaired by Kenneth I. Shine, M.D., Dean of the UCLA School of Medicine, included the physicians named in the accompanying roster. This report conveys the committee's findings and recommendations pursuant to workshop deliberations.

Copyright © National Academy of Sciences.

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