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Pages 1-6

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From page 1...
... These include widespread emergency department crowding, frequent boarding of admitted patients in emergency department hallways, diversion of inbound ambulances due to lack of capacity, a serious and worsening shortage of on-call specialty coverage, and persistent financial challenges. All of these problems are exacerbated by a fragmented delivery system and lack of clear lines of responsibility for oversight and policymaking.
From page 2...
... While regionalization often centers on the important role of states, patient transports frequently involve crossing state lines and these can highlight deficiencies in areas such as communication, coordination, and performance measurement. Some argue that accountability at the regional system level may require leadership from the federal level, while others see this as a state responsibility.
From page 3...
... As is expected in an IOM workshop, the participants expressed a wide array of perspectives and opinions, sometimes differing sharply from each other. Various philosophical perspectives were expressed as well, ranging from strong support for market driven solutions to equally strong support for highly regulated systems with substantial government oversight.
From page 4...
... Chapter 3 examines three large integrated delivery systems -- the Veterans Administration health system, the military's Joint Theater Trauma System, and the Kaiser Permanente health system. These case studies illustrate how regionalization can be achieved within integrated health care delivery systems.
From page 5...
... within disaster response scenarios. Chapter 9 summarizes the responses of the workshop's federal partners -- officials from the Department of Transportation's National Highway Traffic Safety Administration (NHTSA)


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