Robert Wood Johnson Health Policy Research Articles

Data, Patient Narratives Must Be Integrated to Address Racial Inequities

Data, Patient Narratives Must Be Integrated to Address Racial Inequities

Projected prevalence and mortality associated with alcohol-related liver disease in the USA, 2019–40: a modelling study

Alcohol-related liver disease is the leading indication for liver transplantation in the USA. After remaining stable for over three decades, the number of deaths due to alcohol-related liver disease has been increasing as a result of increased high-risk drinking. We aimed to project trends in alcohol-related cirrhosis and deaths in the USA up to 2040 and assess the effect of potential changes in alcohol consumption on those trends. In this modelling study, we developed a multicohort state-transition (Markov) model of high-risk alcohol drinking patterns and alcohol-related liver disease in high-risk drinking populations born in 1900-2016 in the USA projected up to 2040. We used data from the National Epidemiologic Survey on Alcohol and Related Conditions, National Institute of Alcohol Abuse and Alcoholism, US National Death Index, National Vital Statistics System, and published studies. We modelled trends in alcohol-related liver disease under three projected scenarios: the status quo scenario, in which current trends continued; a moderate intervention scenario, in which trends in high-risk drinking reduced to 2001 levels under some hypothetical moderate intervention; and a strong intervention, in which trends in high-risk drinking decreased by 3·5% per year under some hypothetical strong intervention. The primary outcome was to project deaths associated with alcohol-related liver disease from 2019 to 2040 for each pattern of alcohol consumption under the different scenarios. Our model closely reproduced the observed trends in deaths due to alcohol-related liver disease from 2005 to 2018. Under the status quo scenario, age-standardised deaths due to alcohol-related liver disease are expected to increase from 8·23 (95% uncertainty interval [UI] 7·92-9·29) per 100 000 person-years in 2019 to 15·20 (13·93-16·19) per 100 000 person-years in 2040, and from 2019 to 2040, 1 003 400 (95% CI 896 800-1 036 200) people are projected to die from alcohol-related liver disease, resulting in 1 128 400 (1 113 200-1 308 400) DALYs by 2040. Under the moderate intervention scenario, age-standardised deaths due to alcohol-related liver disease would increase to 14·49 (95% UI 12·55-14·57) per 100 000 person-years by 2040, with 968 100 (95% UI 845 600-975 900) individuals projected to die between 2019 and 2040-35 300 fewer deaths than under the status quo scenario (a 3·5% decrease). Whereas, under the strong intervention scenario, age-standardised deaths due to alcohol-related liver disease would peak at 8·65 (95% UI 8·12-9·51) per 100 000 person-years in 2024 and decrease to 7·60 (6·96-8·10) per 100 000 person-years in 2040, with 704 300 (95% CI 632 700-731 500) individuals projected to die from alcohol-related liver disease in the USA between 2019 and 2040-299 100 fewer deaths than under the status quo scenario (a 29·8% decrease). Without substantial changes in drinking culture or interventions to address high-risk drinking, the disease burden and deaths due to alcohol-related liver disease will worsen in the USA. Additional interventions are urgently needed to reduce mortality and morbidity associated with alcohol-related liver disease. American Cancer Society and the Robert Wood Johnson Health Policy Research Fellowship.

Letters: Andrew Seidman, Clifford Hudis, and Eric Winer on the Point-Counterpoint on Dosing for Paclitaxel for Ovarian Cancer (11/25/09 issue); Letters: Simone's OncOpinion: 'Professional Professional Careers for ‘Old’ Guys (12/10/09 issue), by Leonard Zwelling MD; Letters: “Advances in Bone Biology Research Setting Stage for New Cancer Therapies” (11/25/09 issue), by W. Reid Pitts, Jr., MD

Letters: Andrew Seidman, Clifford Hudis, and Eric Winer on the Point-Counterpoint on Dosing for Paclitaxel for Ovarian Cancer (11/25/09 issue); Letters: Simone's OncOpinion: 'Professional Professional Careers for ‘Old’ Guys (12/10/09 issue), by Leonard Zwelling MD; Letters: “Advances in Bone Biology Research Setting Stage for New Cancer Therapies” (11/25/09 issue), by W. Reid Pitts, Jr., MD

Case Managersʼ Voices Must Be Heard by State, National Policymakers

Barbara L. Kornblau, JD, OT/L, FAOTA, ABDA, DAAPM, CDMS, CCM, is Commissioner of the Commission for Case Manager Certification (CCMC), and an occupational therapist, and case manager. She is also Professor of Occupational Therapy, Public Health, and Law at Nova Southeastern University in Fort Lauderdale, Florida. She was recently named a Robert Wood Johnson Health Policy Fellow and is the first certified case manager to receive this fellowship. Address correspondence to Barbara L. Kornblau, JD, OT/L, FAOTA, ABDA, DAAPM, CDMS, CCM, 9040 SW 64th Court, Miami, FL 33156 ([email protected]).

On the Stigma of Mental Illness: Practical Strategies for Research and Social Change

On the Stigma of Mental Illness: Practical Strategies for Research and Social Change

Fascinating Sessions in Exciting City Promise Not-to-Be-Missed Meeting

Fascinating Sessions in Exciting City Promise Not-to-Be-Missed Meeting

Congressional Fellowship Program celebrates 50 years with 2002-2003 Class of Fellows

As the APSA Congressional Fellowship Program enters its fiftieth year, it welcomes the 2002-2003 class of fellows, who will join more than 1900 alumni since 1953 in gaining a “hands-on” understanding of Congress. While the fellowship was first founded so that political scientists and journalists could transmit their legislative experiences to the classroom and to the public, it has since expanded to share the benefits of such study to other professional fields. These are represented by the Federal Executive and Foreign Affairs fellows, Robert Wood Johnson health policy fellows, Native American Hatfield fellows, Carl Albert fellows, American Sociological Association fellows, and by the international scholars sponsored by the Senior Fulbright Scholars program, the Asia Foundation, and the German Marshall Fund of the United States. Now half a century old, the Congressional Fellowship Program continues to benefit from the generosity of Congressional Quarterly, Inc., the John S. and James L. Knight Foundation, and MCI.

FDA adverse events medwatch program

Combat Casualties and Civilian Injuries. Committee on Fluid Resuscitation for Combat Casualties, Institute of Medicine. 6 x 9, 208 pages, 1999. [7] Measuring the Quality of Health Care. Molla S. Donaldson (Ed.); The National Roundtable on Health Care Quality, Institute of Medicine. 6 x 9, 42 pages, 1999. [8] Non-Heart-Beating Organ Transplantation: Medical and Ethical Issues in Procurement. John T. Potts, Principal Investigator; Roger Herdman, Project Director; Institute of Medicine. 6 x 9, 104 pages, 1997. [9] The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Richard S. Dick, Elaine B. Steen, Don E. Detmer (Eds.); Committee on Improving the Patient Record, Institute of Medicine. 6 x 9, 256 pages, 1997. [10] Information Trading: How Information Influences the Health Policy Process. Marion Ein Lewin, Elise Lipoff (Eds.); A Project of the Robert Wood Johnson Health Policy Fellowships Program at the Institute of Medicine. 6 x 9, 152 pages, 1997. [11] For the Record: Protecting Electronic Health Information. Committee on Maintaining Privacy and Security in Health Care Applications of the National Information Infrastructure, National Research Council. 6 x 9, 288 pages, 1997. [12] Blood and Blood Products: Safety and Risk . Henrik Bendixen, Frederick Manning, Linette Sparacino (Eds.); Forum on Blood Safety and Blood Availability, Institute of Medicine. 6 x 9, 208 pages, 1996.

Dr. David E. Rogers and his legacy: the Robert Wood Johnson Health Policy Fellowship.

Dr. David E. Rogers and his legacy: the Robert Wood Johnson Health Policy Fellowship.

Experience of the Robert Wood Johnson Health Policy Fellowship.

Experience of the Robert Wood Johnson Health Policy Fellowship.

Family practice and the health care system. Implications of health reform for family practice.

The United States presidential and congressional elections have triggered much speculation and cautious optimism about the likelihood and substance of health care reform during the Clinton administration. The reflections in this article are drawn from conversations with many health policy analysts and those representing special interests in Washington, DC, who were interviewed from September to November 1992 as part of the orientation of the 1992-93 Robert Wood Johnson Health Policy Fellowship Program. My comments are also in larger part personal reflections of an academic family physician on sabbatical exposed to a wholly political view of health care. Impressions of the current position of family practice at the federal level and the repercussions of health care reform on clinical family practice, family practice education, and research are discussed together with suggestions for actions that family practice can take to achieve a leadership position in primary care. It may be a surprise to some that few in Washington have the slightest idea what family practice is. Many are confounded by the meaning of "primary care" or "generalist physician." There are many reasons for this confusion. Organized family medicine has only relatively recendy been established as a political presence within Washington. Few at this time would say that this presence is weighty. Second, the organizational home of family practice is located quite far from the nation's capital. Sporadic or even regular visits to

Washington Odyssey: An anesthesiologist's view of the politics of health care

In the fall of 1987, as a Robert Wood Johnson Health Policy Fellow, I began a year working for Senator Robert Dole as his health aide. This fellowship program gives academic health professionals a hands-on education in legislation and policy development in Washington, DC, and an insight into the function of government that cannot be obtained simply from written materials or observation. My purpose in this article is to encourage anesthesiologists to learn more about the political process that creates the rules, regulations, and policies shaping and governing their practice and professional lives. Moreover, if upon reading, a few become inclined to spend a year in Washington to learn health policy on the job, I would consider this article successful. Most physicians are uninterested in or uncomfortable with the affairs of government. We tend to hold politics and politicians in low esteem and shun involvement in political activity. At one time, this attitude might have been commendable. Today, however, our

The Robert Wood Johnson Health Policy Fellowship

IN JANUARY, as the federal legislative process reawakens with renewed vigor on Capitol Hill with the full attention of the national media, another process is concluding quietly in northwest Washington, DC. A board that consists of nationally recognized experts in the health sciences, political science, and public policy completes its annual charge of selecting six Robert Wood Johnson (RWJ) Health Policy Fellows. These RWJ fellows, faculty members from health-related professional schools, will be granted leave from their academic institutions to come to Washington, DC, for a year of intensive study. They will receive a special invitation to what Woodrow Wilson originally described and Eric Redman popularized as "the dance of legislation." <h3>THE RWJ HEALTH POLICY FELLOWSHIP PROGRAM</h3> The RWJ Health Policy Fellowship Program was initiated in 1973. Funded by the Robert Wood Johnson Foundation, Princeton, NJ, and administered by the Institute of Medicine, Washington, DC, the fellowships provide midcareer academic

The Robert Wood Johnson Health Policy Fellowship. The experience and perspectives on its academic applications

The Robert Wood Johnson Health Policy Fellowship. The experience and perspectives on its academic applications

Today??s Legislation

Dr. Griffith is a Consultant in Health Policy and Nursing Economics; an Assistant Professor at the University of Texas-Austin School of Nursing; a Robert Wood Johnson Health Policy Fellow for 1986–87; and Editor and Cofounder of Legislative Network for Nurses in Washington, DC.

Evaluation of the Robert Wood Johnson Health Policy Fellowship program: a synopsis.

Evaluation of the Robert Wood Johnson Health Policy Fellowship program: a synopsis.

The Physician and the Civic Self

How does a physician serve? How should he serve? Peter Dans, MD, has written a quietly provocative article on physicians and health policy that makes a number of apt observations about physicians and the big picture (p 1451). He presents these views in the context of a brief description of the Institute of Medicine's Robert Wood Johnson Health Policy Fellows Program (not to be confused with the Robert Wood Johnson Clinical Scholars Program)—a program that has been a success by all indications. Since its inception, competition for the fellowships has been keen. But what happened to the fellows themselves after leaving the program? What of their reentry? Have the physicians among them remained clinically active? If not, should they have? How should these physicians serve? How should any physician serve? For centuries the socialization process in medicine has overwhelmingly emphasized the values of philanthropy and technophilia. Historically, physicians have held

Blueprint for Health: A Multinational Portrait of the Costs and Administration of Medical Care in the Public Interest

Associate Professor Department of Community Medicine Mount Sinai School of Medicine of C.U.N.Y. New York, N.Y. Robert Wood Johnson Health Policy Fellow Institute of Medicine National Academy of Sciences Washington, D.C.