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Health Care Policy: A Clinical Approach |

The Organization of Health Care

Kevin Grumbach, MD; Thomas Bodenheimer, MD, MPH
JAMA. 1995;273(2):160-167. doi:10.1001/jama.1995.03520260082038.
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Frank Hope has walked with a limp since his attack of polio in the 1940s. When he watches his daughter run after her young toddler, he experiences a sense of gratitude that the era of vaccinations has protected his child and grandchild from such a disabling infection. He recalls the sense of excitement that gripped the nation as the Salk polio vaccine was first tested and then adopted into widespread use. In Frank's mind, these types of scientific breakthroughs attest to the wonders of the US health care system.

Frank's grandson attends a day-care program. Ruby, a 2-year-old girl in his program, was recently hospitalized for a severe case of measles complicated by pneumonia. She spent 2 weeks in a pediatric intensive care unit, including several days on a respirator. She had not received her measles immunization, normally scheduled for 15 months of age. Ruby's mother works full-time as a

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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