Comilla Sasson, M.D., David J facts about drugs . Magid, M.D., Paul Chan, M.D., Elisabeth D. Root, Ph.D., Bryan F. McNally, M.D., M.P.H., Arthur L. Kellermann, M.D., M.P.H., and Jason S. Haukoos, M.D. For the CARES Surveillance Group: Association of Neighborhood Features with Bystander-Initiated CPR More than 300,000 cases of out-of-hospital cardiac arrest occur in the United States each full year.1 Outcomes of out-of-medical center cardiac arrest vary markedly,2 with survival prices ranging from 0.2 percent in Detroit3 to 16.0 percent in Seattle.2 This variation in survival rates can be explained, in part, by different rates of bystander-initiated cardiopulmonary resuscitation .4,5 Typically, bystanders administer CPR during fewer than one third of most out-of-hospital cardiac arrests.6 Prior studies have shown racial or ethnic-group and socioeconomic disparities in the provision of bystander-initiated CPR.7-11 However, it is unclear to what extent such disparities are due to neighborhood effects, which were shown to exert a substantial influence in explaining variations and disparities in care for other conditions.12-15 Although a few studies have examined the result of neighborhood on the receipt of bystander-initiated CPR during out-of-hospital cardiac arrest,6,16,17 these studies were conducted within small geographic areas and for that reason might not be generalizable to other settings.
At the time, however, significantly less than 17 percent of physician practices were using EHRs, and their systems often lacked necessary data-capture capabilities. Given the high up-front costs and uncertainty regarding future returns, cultural and financial hurdles to adoption were formidable. Wachter interviewed three previous national coordinators for health it : the libertarian-inclined David Brailer, who offers such faith in market-driven technology that he believed in the organization he was leading barely; David Blumenthal, the consummate diplomat, whose $30 billion budget was 71,000 percent higher than Brailer’s and who, in precipitating widespread adoption, was the most successful innovator arguably; and Farzad Mostashari, the most controversial perhaps, whose hard-series insistence on the need for Meaningful Use 2 has been widely criticized.