JAMA : the journal of the American Medical Association
-
Randomized Controlled Trial Multicenter Study
Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials.
Medicare expenditures of patients with chronic illnesses might be reduced through improvements in care, patient adherence, and communication. ⋯ Viable care coordination programs without a strong transitional care component are unlikely to yield net Medicare savings. Programs with substantial in-person contact that target moderate to severe patients can be cost-neutral and improve some aspects of care.
-
Improving the function of prosthetic arms remains a challenge, because access to the neural-control information for the arm is lost during amputation. A surgical technique called targeted muscle reinnervation (TMR) transfers residual arm nerves to alternative muscle sites. After reinnervation, these target muscles produce electromyogram (EMG) signals on the surface of the skin that can be measured and used to control prosthetic arms. ⋯ These results suggest that reinnervated muscles can produce sufficient EMG information for real-time control of advanced artificial arms.
-
Editorial Comment
The elusive quest for quality and cost savings in the Medicare program.