Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

Measuring the surgical academic output of an institution: the "institutional" H-index.

INTRODUCTION: The Hirsch index is a novel index that combines the number of publications and citations in measuring the research output of researchers. We hypothesized that the h-index can be used to measure the academic success of an institution in a subject area (surgery) and compared this measure to previously published measures of ranking institutions. METHODS: We identified the top 10 research medical schools as designated by the United States News and World Report 2010. The h-index for an institution was obtained in 3-year periods for articles published in surgery. Independent rankings from the NIH and other web sites were then used to compare with our newly generated rankings. RESULTS: The median h-index for institutions was 52.5 (46-54) for 2000-2002, 50 (44-52) for 2003-2005, 35.5 (33-40) for 2006-2008, and 15.5 (13-16) for 2009-2011. The percentage of self citations was the highest in publications from Harvard University (22.2%) and the lowest from Columbia University (10%) in the years 2009-11. Our ranking closely mirrored the United States News and World Report, and Harvard Medical School remains the top ranking in the field of surgery, although NIH funding-based ranking may suggest otherwise. CONCLUSIONS: The institutional h-index appears to be a viable indicator for the measure of academic success of institutions in a subject area. Despite limitations, it yields objective data regarding the citations and number of articles published by an institution in a subject area and could be used to measure performance.

What's in a name? US academic radiology departments: investigation of the frequency of and associated factors in nontraditional department titles.

PURPOSE: The aim of this project was to survey the department titles of US academic radiology programs and to assess the frequency of nontraditional titles. A secondary aim was to evaluate whether there were any similarities among departments that were not traditionally titled Department of Radiology with respect to factors such as department size, affiliation, research emphasis, and geography. METHODS: Departments were identified on the basis of the Fellowship and Residency Electronic Interactive Database Access System, the Association of American Medical Colleges list of US medical schools, and the Society of Chairs of Academic Radiology Departments member roster. A total of 212 departments were evaluated, and the title of each department was obtained. Additionally, the size of the faculty, the number of diagnostic radiology residents (if applicable), whether the department offered fellowship positions, the number of nuclear medicine residents (if applicable), geographic region, and National Institutes of Health funding ranking for fiscal year 2009 (if applicable) were obtained for each program. RESULTS: Two hundred twelve programs were evaluated, from which 196 departments were ultimately included in the analysis. Of these, 159 (81%) had the title Department of Radiology. Twenty-two other titles were identified among the remaining 37 departments. Common words included in these titles were imaging, science or sciences, and services. There were no significant differences between the departments titled Department of Radiology and the departments with other names with respect to size, research affiliation, residency and fellowship size, or geography. CONCLUSIONS: Although only 19% of the departments analyzed had titles other than Department of Radiology, several trends were noted. With the expanding scope of radiology to include modalities not associated with ionizing radiation, such as ultrasound, MR, and molecular imaging, along with the growing importance of defining radiologists' role in the health care system and increasing patient concerns over the potential dangers of radiation, it remains to be seen whether additional departments elect to modify their names or whether Department of Radiology continues as the most common title.

A national analysis of the relationship between hospital volume, academic center status, and surgical outcomes for abdominal hysterectomy done for leiomyoma.

BACKGROUND: Volume-to-outcomes relationships have been established for high-risk surgical procedures. To determine whether hospital volume and academic center status affect surgical outcomes in a lower-risk procedure, morbidity and mortality in patients undergoing abdominal hysterectomy for leiomyoma were evaluated. STUDY DESIGN: Administrative data from the National Inpatient Sample were used to conduct a retrospective analysis of 172,344 individuals who had primary diagnoses of leiomyomata (ICD-9 diagnosis codes of 218.x in the first 2 positions) and who underwent abdominal hysterectomy (ICD-9 procedure codes 68.4 in the first 2 positions) from 1999 to 2003. Comparison was made between teaching hospitals versus nonteaching hospitals and annual case volume in quintiles. Morbidity was considered to be any postoperative condition that is not an expected outcome of hysterectomy and defined as instances in which a patient suffered hemorrhage, ureteral injury, bladder injury, intestinal injury, wound dehiscence, wound infection, deep vein thrombosis, pulmonary embolism, or required blood transfusion. RESULTS: A total of 37 deaths were observed. Mortality was not significantly related to hospital volume or academic medical center status. In contrast, morbidity was found to have a positive association with academic medical center status (odds ratio = 1.34; 95% CI, 1.23 to 1.45), although an inverse relationship between volume and morbidity was observed for extended length of stay (> 3 days) and blood transfusion outcomes in the first 3 (lowest) volume quintiles and for pulmonary embolism in the highest-volume quintile. No important association with volume was found for hemorrhage, ureteral injury, bladder injury, or intestinal injury. CONCLUSIONS: Unlike high-risk procedures, such as esophagectomy, pediatric cardiac surgery, and pancreaticoduodenectomy, mortality for abdominal hysterectomy done for benign indication does not improve with hospital volume or academic center status. The statistically significant positive association between academic medical center status and morbidity merits additional characterization to target areas for improvement.

Embryonic cardiac morphometry in Carnegie stages 15-23, from the Complutense University of Madrid Institute of Embryology Human Embryo Collection.

AIMS: We performed a morphometric study of cardiac development on human embryos to complement the scarce data on human embryonic cardiac morphometry and to attempt to establish, from these, algorithms describing cardiac growth during the second month of gestation. METHODS: Thirty human embryos from Carnegie stages 15-23 were included in the study. Shrinkage and compression effects from fixation and inclusion in paraffin were considered in our calculations. RESULTS: Growth of the cardiac (whole heart) volume and volume of ventricular myocardium through the Carnegie stages were analysed by ANOVA. Linear correlation was used to describe the relationship between the ventricular myocardium and cardiac volumes. Comparisons of models were carried out through the R2 statistic. The relationship volume of ventricular myocardium versus cardiac volume is expressed by the equation: cardiac volume = 0.6266 + 2.4778 volume of ventricular myocardium. The relationship cardiac volume versus crown-rump length is expressed by the equation: cardiac volume = 1.3 e(0.126 CR length), where e is the base of natural logarithms. CONCLUSION: At a clinical level, these results can contribute towards the establishment of a normogram for cardiac development, useful for the design of strategies for early diagnosis of congenital heart disease. They can also help in the study of embryogenesis, for example in the discussion of ventricular trabeculation.

Sustaining the edge: factors influencing strategy selection in academic health centers.

Competition within the acute care sector as well as increased penetration by managed care organizations has influenced the structure and role of academic health centers during the past decade. The market factors confronting academic health centers are not dissimilar from conditions that confront other organizations competing in mature industries characterized by declining profitability and intense rivalry for market share. When confronted with intense competition or adverse external events, organizations in other industries have responded to potential threats by forming alliances, developing joint ventures, or merging with another firm to maintain their competitive advantage. Although mergers and acquisitions dominated the strategic landscape in the healthcare industry during the past decade, recent evidence suggests that other types of strategic ventures may offer similar economic and contracting benefits to member organizations. Academic health centers have traditionally been involved in network relationships with multiple partners via their shared technology, collaborative research, and joint educational endeavors. These quasi-organizational relationships appear to have provided a framework for strategic decisions and allowed executives of academic health centers to select strategies that were competitive yet closely aligned with their organizational mission. The analysis of factors that influenced strategy selection by executives of academic health centers suggests a deliberate and methodical approach to achieving market share objectives, expanding managed care contracts, and developing physician networks.

Physicians lead the way at America's top hospitals.

The 100 Top hospitals are selected annually based on seven critical parameters for each of the 6,200-plus U.S. hospitals with 25 or more beds. They include the previous year's risk-adjusted patient mortality and complication rates, severity-adjusted average patient lengths of stay, expenses, profitability, proportional outpatient revenue, and asset turnover ratio (a measure of facility and technological pace-keeping ability). The winners are selected from five comparable size groupings--small, medium, large community, teaching, and large academic hospitals. Conspicuous among the winners at every level are physician-led organizations. Even in the majority of hospitals headed by non-physician administrators, however, the managerial capabilities of medical directors are the key to success. The most common characteristic of these award-winning hospitals is that the leadership is working together and communicating the institution's goals effectively to all levels of the organization.

Fundación del Centro de Estudiantes de Medicina 8 de mayo de 1906 / Fundation of the Center of Medical Student May 8, 1906

Al atardecer del 8 de mayo de 1906, un grupo de estudiantes de la entonces primera "Facultad de Ciencias Médicas de Bolivia" bajo el lema "La unión hace la fuerza" se congregaron y fundaron el "Centro de estudios Médicos" con gran entuciasmo y de vocación. los tiempos eran difíciles, en la Universidad y la sociedad reinaba un espíritu de rechazo a este tipo de organizaciones, ya que existía la suceptibilidad académica de destruir los pensamientos del "Magister Dei". A un contra las advesidades en Julio del mismo año ya se ven los primeros frutos importantes de este Centro, es asi que el 15 de julio de 1906 circula la "Revista del Centro de Estudios Médicos" en cuyo contenido se ven plasmadas los altos intereses académicos y de servicio para se "un instrumento científico.

Top hospital designation rates ad series. South Carolina University Medical Center highlights its centers of excellence.

Medical University of South Carolina Medical Center last December was rated among the nation's 100 Top Hospitals. The designation prompted hospital officials to develop a newspaper ad campaign featuring 12 centers of excellence which boosted calls to its Health Connection line by 10%.

Medical research centres : A world directory of organizations and programmes / Medical research centres : A world directory of organizations and programmes

This publication is a most comprehensive sources providing profiles of industrial centres, official laboratories and major university or technical college laboratories which carry out, or fund research into the medical specialities such as anatomy, clinical medicine, dental sciences, neoplasia, surgery and anaesthesia, into biomedical topics such as immunology, transplantation, pharmacology and therapeutics, and into medically oriented elements of biochemestry such as molecular biology, microbiology, genetics and biophysics