Publications from the National Academies of Sciences, Engineering, and Medicine provide objective and straightforward advice to decision makers and the public. This site includes Health and Medicine Division (HMD) publications released after 1998. A complete list of HMD’s publications from its establishment in 1970 to the present is available as a PDF.
Financing and Payment Strategies to Support High-Quality ...
Released: May 16, 2018
Those facing serious illness have a range of interconnected medical and non-medical needs, and the way their care is financed has a large impact on the care they receive. Medicare is the predominant payer, but both Medicaid and private payers also play significant roles in financing care for serious illness. In an effort to address the complex needs of people with serious illness, public and private health care payers are testing innovative financing strategies and alternative payment models.
Advancing Therapeutic Development for Pain and Opioid Use ...
Released: March 23, 2018
Chronic pain is one of the most prevalent, costly, and disabling health conditions in the United States. In parallel with increasing recognition of the need to treat chronic pain, the opioid epidemic has emerged as a growing public health emergency. In 2017, the National Institutes of Health began exploring public-private partnerships to develop solutions to the opioid crisis and cut in half the time it takes to develop non-addictive analgesics. To help inform this effort, the National Academies’ Forum on Neuroscience and Nervous Systems Disorders hosted a public workshop that brought together experts and stakeholders from academia, federal agencies, advocacy organizations, and companies developing therapeutics for pain and opioid use disorders.
Aging and Disability: Beyond Stereotypes to Inclusion ...
Released: March 13, 2018
How do stereotypes affect the health and independence of aging adults and those with disabilities? How do they impact the industries that interact with these populations? And what are some opportunities to disrupt the narrative and change perceptions of what it means to be older or have a disability?
Enabling Novel Treatments for Nervous System Disorders by ...
Released: March 08, 2018
The blood-brain barrier (BBB) presents a special challenge to the development of therapeutics for many central nervous system (CNS) disorders. Far from acting simply as a physical barrier, the BBB is a complex dynamic system involving several cell types, passive and active transport mechanisms, and adaptive function to control the exchange of substances between the blood and the CNS. Few therapeutic agents readily traverse the BBB to reach the brain or spinal cord, including most small molecule drugs and the vast majority of large molecules such as proteins.
Models and Strategies to Integrate Palliative Care Principles ...
Released: October 24, 2017
The Roundtable on Quality Care for People with Serious Illness hosted a full-day workshop on April 27, 2017 to explore Models and Strategies to Integrate Palliative Care Principles into Care for People with Serious Illness. The workshop aimed to highlight innovative models of community-based care for people of all ages facing serious illness.
Biomarkers of Neuroinflammation: Proceedings of a Workshop ...
Released: September 15, 2017
Innate and adaptive immunity have become very important areas of investigation for psychiatric, neurologic, and neurodevelopmental disorders, and neurodegeneration resulting from traumatic brain injury. To address these gaps in understanding mechanisms and how to translate that understanding into therapeutics, the Forum on Neuroscience and Nervous System Disorders of the National Academies of Sciences, Engineering, and Medicine convened a workshop on March 20–21, 2017, bringing together key leaders in the field from industry, academia, and governmental agencies to explore the role and mechanisms of neuroinflammation in a variety of central nervous system diseases.
Integrating the Patient and Caregiver Voice into Serious ...
Released: July 14, 2017
Millions of people—infants, children, adults, and their families—are currently coping with serious illness in the United States. Efforts are intensifying to improve overall care quality through the delivery of person-centered and family-oriented services, for patients of all ages and across disease stages, care settings, and specialties. While aging Baby Boomers are increasing the proportion of patients in the Medicare population over time, the sickest and most vulnerable patients needing health system support and other services to meet their complex needs can be found across the age spectrum and in a broad range of care settings, from perinatal care to geriatric care.
Preventing Cognitive Decline and Dementia: A Way Forward ...
Released: June 22, 2017
Individuals, families, and societies around the world are concerned about dementia and the other forms of cognitive impairment that affect many older adults. It is now known that brain changes typically begin years—if not decades—before people show symptoms, which suggests that a window of opportunity exists to prevent, slow, or delay the onset of these conditions. Further, emerging evidence that the incidence and prevalence of dementia are declining in some high-income countries offers hope that public health interventions can be effective in preventing cognitive decline and dementia.
Developing Affordable and Accessible Community-Based ...
Released: May 17, 2017
Accessible and affordable housing can enable community living, maximize independence, and promote health for vulnerable populations. However, the United States faces a shortage of affordable and accessible housing for vulnerable low-income older adults and individuals living with disabilities. This shortage is expected to grow over the coming years given the population shifts leading to greater numbers of older adults and of individuals living with disabilities.
Therapeutic Development in the Absence of Predictive Animal ...
Released: March 10, 2017
Despite the high prevalence and burden of nervous system disorders, development of new therapeutics lags behind other disease areas. Gaps in understanding the underlying pathophysiology, a dearth of biomarkers, and limitations in the capacity of animal models to predict drug efficacy for human brain disorders have contributed to a high rate of late stage failures in drug development and decreased investment in neuroscience research programs at pharmaceutical companies. On September 12-13, 2016, the National Academies of Sciences, Engineering, and Medicine’s Forum on Neuroscience and Nervous System Disorders hosted a public workshop to explore opportunities to accelerate drug development absent predictive animal models.