Thoroughly updated for its Second Edition, Hospital Medicine offers practical, evidence-based guidelines for the care of hospitalized patients. The only book geared directly and exclusively to inpatient management - and edited by the national leaders of the hospitalist field - Hospital Medicine includes indications for admission, guidelines for consultation, procedures for hospital discharge, diagnostic algorithms, and critical paths detailing effective, outcomes-oriented treatment plans for a range of diseases and disorders. New chapters in this edition focus on the hospitalist's increasing role in providing critical care, managing surgical patients with medical co-morbidities, ensuring patient safety and preventing adverse events, and directing hospital systems areas such as informatics, quality improvement, and practice management.

How successful are HIV prevention programs? Which HIV prevention programs are most cost effective? Which programs are worth expanding and which should be abandoned altogether? This book addresses the quantitative evaluation of HIV prevention programs, assessing for the first time several different quantitative methods of evaluation.

The authors of the book include behavioral scientists, biologists, economists, epidemiologists, health service researchers, operations researchers, policy makers, and statisticians. They present a wide variety of perspectives on the subject, including an overview of HIV prevention programs in developing countries, economic analyses that address questions of cost effectiveness and resource allocation, case studies such as Israel's ban on Ethiopian blood donors, and descriptions of new methodologies and problems.

Prevention is an important role for all health care providers. Providers can help individuals stay healthy by preventing disease, and they can prevent complications of existing disease by helping patients live with their illnesses. To fulfill this role, however, providers need data on the impact of their services and the opportunity to compare these data over time or across communities. Local, State, and Federal policymakers also need these tools and data to identify potential access or quality-of-care problems related to prevention, to plan specific interventions, and to evaluate how well these interventions meet the goals of preventing illness and disability.

The Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQIs) represent one such tool. Local, State, or national data collected using the PQIs can flag potential problems resulting from a breakdown of health care services by tracking hospitalizations for conditions that should be treatable on an outpatient basis, or that could be less severe if treated early and appropriately. The PQIs represent the current state of the art in measuring the outcomes of preventive and outpatient care through analysis of inpatient discharge data.

Many health plans apply evidence-based approaches to coverage decisions. The foundation of such approaches is the systematic review of information about the effectiveness of medical interventions. This paper discusses the principles underlying evidence-based coverage policy and how they are applied by two major programs: the Technology Evaluation Center of the Blue Cross Blue Shield Association and the Medicare Coverage Advisory Committee. Although such policies likely have limited effects on spending, they can help to direct medical resources toward effective care.

In response to a mail survey, 225 leading general internists provided their opinions of the relative importance to patients of thirty medical innovations. They also provided information about themselves and their practices. Their responses yielded a mean score and a variability score for each innovation. Mean scores were significantly higher for innovations in procedures than in medications and for innovations to treat cardiovascular disease than for those to treat other diseases. The rankings were similar across subgroups of respondents, but the evaluations of a few innovations were significantly related to physicians' age. The greatest variability in response was usually related to the physician's patient mix.

The specter of multidrug-resistant tuberculosis (MDR-TB) threatens the gains achieved by tuberculosis control through international recommendations currently accepted by 127 countries. The high cost of second-line drugs is a clear example of a market failure serving as a barrier to treatment of MDR-TB cases. Gupta et al. describe an approach based on policy development, consolidating and increasing demand, and increasing supply to decrease the cost of second-line drugs. As a result, prices decreased from 48-97% for a treatment regimen and competition was increased in monopoly markets. An independent scientific committee fosters access to the drugs under tightly monitored pilot projects to prevent the creation of resistance to second-line drugs. This strategy may be applicable to other infectious-disease treatment efforts.