Health care providers, hospital administrators, and politicians face competing challenges to reduce clinical errors, control expenditure, increase access and throughput, and improve quality of care. The safe management of the acutely ill inpatient presents particular difficulties. In the first of five Lancet articles on this topic we discuss patients' safety in the acute hospital. We also prese...

As reforms to China's health care system have raised costs to users in recent decades, studies suggest that ill health has become intimately tied to social stratification as both a precipitant and a consequence of poverty. The problem may be particularly pronounced in China’s poorest rural populations. Focusing on Gansu Province, one of China’s poorest, this paper investigates the possibility t...

Thirty of the first 45 individuals to receive guilty but mentally ill (GBMI) verdicts in South Carolina were interviewed using a structured interview schedule for diagnosis. The relationship of diagnosis to pretrial evaluation and posttrial conviction treatment are discussed. No person received GBMI in a jury trial. Suggestions to improve the operation of the GBMI verdict are made, as well as a...

The concepts are synergistic in that population management capabilities help to identify high-risk patients, whose costliest episodes can be managed through integrated specialty services, including cardiac and orthopedics that makes better use of post-acute and community-based follow-up. Even in a chronically-ill population, what drive high costs are acute episodes. Bajner believes integrating ...

Civil commitment involves abridgment of civil rights of the mentally ill person. The involuntarily hospitalized patient is deprived of many elementary rights" which the average citizen takes for granted, such as visitation, written communication and compensation for work." , Furthermore, the committed patients often have been deprived of various rights dealing with their functioning in the soci...

Social networks of 35 mentally ill persons were studied in Lao villages. Mental illness was associated with a decrease in size of social networks, disproportionate reliance on family, and asymmetric instrumental exchange. Nonkin "sponsors" provided assistance to those alienated from or abandoned by relatives. For those with late onset or episodic course, past accumulation of "social reserve" or...

A pilot of item-of-service payments (85 Pounds per annum per patient) to general practitioners for monitoring long-term mentally ill individuals was successful in recruiting practices and ensuring assessments. It did not, however, demonstrate an improvement in health care.