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Improving the US Health Care System: Action Plan to Enhance Efficiency, Reduce Errors, and Improve Quality
  1. Hugh Tilson*,
  2. David Helms,
  3. David Dowdy
  1. From the School of Publication Health (H. T.), University of North Carolina, Chapel Hill, NC; Academy for Health Services Research and Health Policy (D.H.), Washington, DC; and School of Medicine (D.D.), Johns Hopkins University, Balti more, MD.
  1. *Member, Institute of Medicine's Clinical Research Round-table.
  2. Address correspondence to: Hugh Tilson, School of Public Health, University of North Carolina, Roseman Hall, Room 260, Chapel Hill, NC 27599-7400. Tel: 919-966-9275; fax: 919-966-0981; e-mail: hugh_tilson{at}


The decisions made by stakeholders in the nation's health care system that affect the quality of care experienced by patients are too often made without the benefit of scientific evidence. A multidisci-plinary set of investigators conducting health services research have traditionally filled this gap between research findings and clinical decision making, but several barriers are hindering this work. This article offers several recommendations—restructuring organizations, ensuring funding, developing infrastructure, strengthening the community of researchers, and forging new links among stakeholders—to promote high-quality information for health decision makers.

Key Words
  • health services research
  • training
  • workforce
  • clinical research

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