0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Access to Care in Regionalized Health Care Systems

Paul James, MD; Jere A. Wysong, PhD; Thomas Rosenthal, MD; Mary Bliss; Jason Osborne, MA; Ge Lin, MA
JAMA. 1996;275(10):758-759. doi:10.1001/jama.1996.03530340022020.
Text Size: A A A
Published online

To the Editor.  —Dr Grumbach and colleagues1 are to be commended for their creative study of coronary artery bypass surgery (CABS) outcomes, geographic access, and regionalization of health care in the United States and Canada. We found the study particularly thought-provoking with respect to the issues of access and regionalization of services for rural patients. The results clearly demonstrate a reduced mortality rate for CABS patients in hospitals of high procedural volume across different health care environments. However, the study raises significant questions regarding the indicators of quality that are most appropriate to measure in regionalized health care systems.Research suggests that the prevalence of coronary artery disease is as high in rural areas as it is in urban locales.2 If the rate of CABS is lower in rural locales, the issue of equitable access becomes an important health policy concern. This issue becomes even more important as

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
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.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();