Health policy

428 Herrin Labs
Department of Biological Sciences
Stanford University
Stanford, CA 94305-5020

(650) 725-7727 (650) 725-7745
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Burnet C. and Mildred Finley Wohlford Professor of Biological Sciences
Director of the Morrison Institute for Population and Resource Studies
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Marcus Feldman is the Burnet C. and Mildred Finley Wohlford Professor of Biological Sciences and director of the Morrison Institute for Population and Resource Studies at Stanford University. He uses applied mathematics and computer modeling to simulate and analyze the process of evolution. His specific areas of research include the evolution of complex genetic systems that can undergo both natural selection and recombination, and the evolution of learning as one interface between modern methods in artificial intelligence and models of biological processes, including communication. He also studies the evolution of modern humans using models for the dynamics of molecular polymorphisms, especially DNA variants. He helped develop the quantitative theory of cultural evolution, which he applies to issues in human behavior, and also the theory of niche construction, which has wide applications in ecology and evolutionary analysis. He also has a large research program on demographic issues related to the gender ratio in China.

Feldman is a trustee and member of the science steering committee of the Santa Fe Institute. He is managing editor of Theoretical Population Biology and associate editor of the journals Genetics; Human Genomics; Complexity; the Annals of Human Genetics; and the Annals of Human Biology. He is a former editor of The American Naturalist. He is a fellow of the American Academy of Arts and Sciences and of the California Academy of Science. His work received the "Paper of the Year 2003" award in all of biomedical science from The Lancet. He has written more than 335 scientific papers and four books on evolution, ecology, and mathematical biology. He received a BSc in mathematics and statistics from the University of Western Australia, an MSc in mathematics from Monash University (Australia), and a PhD in mathematical biology from Stanford. He has been a member of the Stanford faculty since 1971.

Stanford Health Policy Associate
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Richard E. Behrman Professor of Child Health and Society
Senior Fellow, Freeman Spogli Institute for International Studies
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Dr. Paul Wise is dedicated to bridging the fields of child health equity, public policy, and international security studies. He is the Richard E. Behrman Professor of Child Health and Society and Professor of Pediatrics, Division of Neonatology and Developmental Medicine, and Health Policy at Stanford University. He is also co-Director, Stanford Center for Prematurity Research and a Senior Fellow in the Center on Democracy, Development, and the Rule of Law, and the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Wise is a fellow of the American Academy of Arts and Sciences and has been working as the Juvenile Care Monitor for the U.S. Federal Court overseeing the treatment of migrant children in U.S. border detention facilities.

Wise received his A.B. degree summa cum laude in Latin American Studies and his M.D. degree from Cornell University, a Master of Public Health degree from the Harvard School of Public Health and did his pediatric training at the Children’s Hospital in Boston. His former positions include Director of Emergency and Primary Care Services at Boston Children’s Hospital, Director of the Harvard Institute for Reproductive and Child Health, Vice-Chief of the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital and Harvard Medical School and was the founding Director or the Center for Policy, Outcomes and Prevention, Stanford University School of Medicine. He has served in a variety of professional and consultative roles, including Special Assistant to the U.S. Surgeon General, Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health Research, Chair of the Strategic Planning Task Force of the Secretary’s Committee on Genetics, Health and Society, a member of the Advisory Council of the National Institute of Child Health and Human Development, NIH, and the Health and Human Secretary’s Advisory Committee on Infant and Maternal Mortality.

Wise’s most recent U.S.-focused work has addressed disparities in birth outcomes, regionalized specialty care for children, and Medicaid. His international work has focused on women’s and child health in violent and politically complex environments, including Ukraine, Gaza, Central America, Venezuela, and children in detention on the U.S.-Mexico border.  

Core Faculty, Center on Democracy, Development and the Rule of Law
Affiliated faculty at the Center for International Security and Cooperation
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This issue of CHP/PCOR's quarterly newsletter covers news and developments from the spring 2004 quarter.

It features articles about: our new core faculty member Paul Wise, a children's health policy researcher who joins us from Boston University; a survey of patient safety culture now getting underway at hospitals nationwide; CHP/PCOR acting director Doug Owens' research findings on the cost-effectiveness of potential HIV vaccines; a wrap-up of the second annual Health Care Quality and Outcomes Research Conference, where CHP/PCOR faculty and trainees attended and presented research; and new CHP/PCOR assistant director Vandana Sundaram.

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Center for Health Care Evaluation
VA Palo Alto Health Care System
Menlo Park Division (152)
795 Willow Road
Menlo Park, CA 94025

(650) 593-5000 x 22811
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Consulting Professor of Sociology
Research Health Science Specialist at Center for Health Care Evaluation (VA)
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Ruth Cronkite is a consulting professor in the Department of Sociology at Stanford University, a research health science specialist at the VA Palo Alto Health Care System, and an associate at the Center for Health Policy/Center for Primary Care and Outcomes Research. Her research focuses on the evaluation of mental health services, cohort studies of the long-term course of psychiatric disorders, and the influence of life context factors on the course of psychiatric disorders. Her current research projects include: (1) a 23-year cohort study of individuals treated for depression and a matched community control group, (2) the effect of Hepatitis C-positive status and comorbid psychiatric disorders on quality of life, and (3) the assessment of continuity-of-care practices in substance abuse programs and their effect on engagement in continuing care and treatment outcomes. She is director of the VA Postdoctoral Training Program in Health Services Research and is associate director of the VA Postdoctoral Training Program in Medical Informatics. Her book Alcoholism Treatment: Context, Process, and Outcome was deemed the Most Distinguished Book Reviewed in 1993 by the journal Addiction. She received a BA, MA and PhD in sociology from Stanford University and an MS in statistics, also from Stanford.

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Toward a 21st Century Health System is a collection of essays that explore a key element of the health care delivery system -- large multispecialty physician group practices. Edited by policy experts Alain Enthoven and Laura Tollen, and written by a panel of health policy scholars and leaders including Stephen Shortell, Hal Luft, Donald Berwick, James Robinson, and Helen Darling, this resource addresses a variety of topics, including:

  • organized delivery systems
  • quality of care in prepaid group practice versus other types of managed care
  • the role of physician leadership and culture in group practice
  • prepaid group practice and the formation of national health policy

The book also covers such topics as pharmacy benefit management, technology assessment, health services research, and employer purchasing of benefits, all as they relate to prepaid group practice.

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Jossey-Bass, San Francisco
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Alain C. Enthoven
Number
0787973092
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This issue of CHP/PCOR's quarterly newsletter covers news and developments at the centers for the fall quarter 2003.

The issue features articles about a handful of health policy talks sponsored by the centers in the fall quarter; a novel "interactive textbook" on clinical symptom research; the recent arrival from China of the second fellow for CHP/PCOR's China-U.S. Health and Aging Research Training Program; a roundup of the 25th annual conference of the Society for Medical Decision Making; and a summary of last quarter's media coverage highlighting the centers' research work.

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In a random assignment study, substance-abusing patients with HIV/AIDS in a public general hospital received a brief contact condition or received 12 months of case management delivered by paraprofessionals. Patient outcomes included substance use, HIV transmission risk, physical health, psychological status, and quality of living situation. In both conditions, a significant decrease occurred in a range of problems from Intake to the 6-month interview, followed by no significant pattern of change at 12- and 18-month interviews. On major outcome variables, there were no significant differences between the brief contact and case management conditions. Sixteen percent had died by the 18-month interview. Process data indicated wide variation in the amount of case management received by participants, and the amount of case management was not related to improvement in the outcome measures. The study has limitations yet does not support the hypothesis that case management improves outcomes better than brief contact for this population.

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American Journal of Drug and Alcohol Abuse
Authors
Ciaran S. Phibbs
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Automated quality assessment of clinician actions and patient outcomes is a central problem in guideline- or standards-based medical care. In this paper we describe a model representation and algorithm for deriving structured quality indicators and auditing protocols from formalized specifications of guidelines used in decision support systems. We apply the model and algorithm to the assessment of physician concordance with a guideline knowledge model for hypertension used in a decision-support system. The properties of our solution include the ability to derive automatically context-specific and case-mix-adjusted quality indicators that can model global or local levels of detail about the guideline parameterized by defining the reliability of each indicator or element of the guideline.

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Working Papers
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Proceedings of the American Medical Informatics Association's fall 2003 symposium
Authors
Mary K. Goldstein
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