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Frank Davidoff

Publications and source records attributed to Frank Davidoff.

17 recordsLinked to original sources
PubMed2006

Homeless.

Explore the source record for details and available documents.

Aged, 80 and over↗
PubMed2006

A physicians' agenda for partnering with employers and insurers: fresh ideas.

We report the results of the second phase of a multiphase qualitative investigation of the ways physicians, employers, and insurers can work together more effectively to provide better ambulatory care to employees and their dependents. This article focuses on ways physicians can develop more useful relationships among these groups. We used a grounded theory approach to conduct 71 interviews from August 12, 2004, to December 27, 2005, with 25 practicing physicians in large and small groups, urban and rural areas, private and academic settings, and primary care and specialty practices; 33 hospital administrators, medical association executives, health insurance medical officers, and health policy analysts; and 13 senior executives of large and small companies. The study identifies 2 approaches to the structuring of ambulatory care that can lead to improved health care outcomes and value. In the first approach, direct contracting between physicians and employers transfers tasks previously performed by insurers to employers or other intermediaries who may be able to provide better service or lower cost. In the second approach, insurer-mediated relationships between physicians and employers are restructured, particularly in ways that improve information flow. Such relationships may strengthen physicians' ability to provide quality services while enabling patients to make more informed decisions about physician selection, treatments, and spending. We believe that broader use of these approaches may improve the quality and efficiency of ambulatory care for the large proportion of the population that has work-related health insurance. Although the findings are promising, our intent is not to claim broad external validity but rather to encourage greater experience with these approaches and more formal studies of their effectiveness.

Attitude of Health Personnel↗
PubMed2005

Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety.

BACKGROUND: Increases in adverse clinical outcomes have been documented when hospital nurse staffing is inadequate. Since most hospitals limit nurse staffing to levels for average rather than peak patient census, substantial census increases create serious potential stresses for both patients and nurses. By reducing unnecessary variability, hospitals can reduce many of these stresses and thereby improve patient safety and quality of care. THE SOURCE AND NATURE OF VARIABILITY IN DEMAND: The variability in the daily patient census is a combination of the natural (uncontrollable) variability contributed by the emergency department and the artificial (potentially controllable) peaks and valleys of patient flow into the hospital fromelective admissions. Once artificial variability in demand is significantly reduced, a substantial portion of the peaks and valleys in census disappears; the remaining censsus variability is largely patient and disease driven. When artificial variability has been minimized, a hospital must have sufficient resources for the remaining patient-driven peaks in demand, over which it has no control, if it is to deliver an optimal level of care. DISCUSSION: Study of operational issues in health care delivery, and acting on what is learned, is critical. Al forms of artificial variation in the demand and supply of health care services should be identified, and pilot programs to test operational changes should be conducted.

Efficiency, Organizational↗
PubMed2002

Effects of editorial peer review: a systematic review.

CONTEXT: Editorial peer review is widely used to select submissions to journals for publication and is presumed to improve their usefulness. Sufficient research on peer review has been published to consider a synthesis of its effects. METHODS: To examine the evidence of the effects of editorial peer-review processes in biomedical journals, we conducted electronic and full-text searches of private and public databases to June 2000 and corresponded with the World Association of Medical Editors, European Association of Science Editors, Council of Science Editors, and researchers in the field to locate comparative studies assessing the effects of any stage of the peer-review process that made some attempt to control for confounding. Nineteen of 135 identified studies fulfilled our criteria. Because of the diversity of study questions, methods, and outcomes, we did not pool results. RESULTS: Nine studies considered the effects of concealing reviewer/author identity. Four studies suggested that concealing reviewer or author identity affected review quality (mostly positively); however, methodological limitations make their findings ambiguous, and other studies' results were either negative or inconclusive. One study suggested that a statistical checklist can improve report quality, but another failed to find an effect of publishing another checklist. One study found no evidence that training referees improves performance and another showed increased interrater reliability; both used open designs, making interpretation difficult. Two studies of how journals communicate with reviewers did not demonstrate any effect on review quality. One study failed to show reviewer bias, but the findings may not be generalizable. One nonrandomized study compared the quality of articles published in peer-reviewed vs other journals. Two studies showed that editorial processes make articles more readable and improve the quality of reporting, but the findings may have limited generalizability to other journals. CONCLUSIONS: Editorial peer review, although widely used, is largely untested and its effects are uncertain.

Peer Review, Research↗
PubMed2002

Measuring the quality of editorial peer review.

CONTEXT: The quality of a process can only be tested against its agreed objectives. Editorial peer-review is widely used, yet there appears to be little agreement about how to measure its effects or processes. METHODS: To identify outcome measures used to assess editorial peer review as performed by biomedical journals, we analyzed studies identified from 2 systematic reviews that measured the effects of editorial peer review on the quality of the output (ie, published articles) or of the process itself (eg, reviewers' comments). RESULTS: Ten studies used a variety of instruments to assess the quality of articles that had undergone peer review. Only 1, nonrandomized study compared the quality of articles published in peer-reviewed and non-peer-reviewed journals. The others measured the effects of variations in the peer-review process or used a before-and-after design to measure the effects of standard peer review on accepted articles. Eighteen studies measured the quality of reviewers' reports under different conditions such as blinding or after training. One study compared the time and cost of different review processes. CONCLUSIONS: Until we have properly defined the objectives of peer-review, it will remain almost impossible to assess or improve its effectiveness. The research needed to understand the broader effects of peer review poses many methodologic problems and would require the cooperation of many parts of the scientific community.

Evaluation Studies as Topic↗
PubMedDate not supplied

The business case for quality: case studies and an analysis.

The financial implications of implementing quality improvements are often poorly understood. Simply put, does improving quality yield a return on investment? We examine four cases--management of high-cost pharmaceuticals, diabetes management, smoking cessation, and wellness programs in the workplace--to understand the financial and clinical implications of improving care. We explore costs and benefits, in both the short and the long term, to four stakeholders with different and sometimes conflicting interests: providers, purchasers and employers, individual patients, and society. Finally, we recommend policy changes to better align financial incentives for superior quality of care.

Anticholesteremic Agents↗