{"id":"https://openalex.org/W1999835489","doi":"https://doi.org/10.1056/nejme038149","title":"Medical Care \u2014 Is More Always Better?","display_name":"Medical Care \u2014 Is More Always Better?","publication_year":2003,"publication_date":"2003-10-22","ids":{"openalex":"https://openalex.org/W1999835489","doi":"https://doi.org/10.1056/nejme038149","mag":"1999835489","pmid":"https://pubmed.ncbi.nlm.nih.gov/14573739"},"language":"en","primary_location":{"id":"doi:10.1056/nejme038149","doi":"https://doi.org/10.1056/nejme038149","is_oa":false,"landing_page_url":"https://doi.org/10.1056/nejme038149","pdf_url":null,"source":{"id":"https://openalex.org/S62468778","display_name":"New England Journal of Medicine","issn_l":"0028-4793","issn":["0028-4793","0096-6762","1533-4406","2331-4710"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320239","host_organization_name":"Massachusetts Medical Society","host_organization_lineage":["https://openalex.org/P4310320239"],"host_organization_lineage_names":["Massachusetts Medical Society"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"New England Journal of Medicine","raw_type":"journal-article"},"volume":null,"type":"editorial","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5112042687","display_name":"Elliott S. Fisher","orcid":"https://orcid.org/0000-0002-9571-4879","observed_orcids":["https://orcid.org/0000-0002-9571-4879","https://orcid.org/0000-0001-9558-7665"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Elliott S. Fisher","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5112042687"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":107,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"349","issue":"17","first_page":"1665","last_page":"1667"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.6371999979019165,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.6371999979019165,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.15539999306201935,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.14920000731945038,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/veterans-health-care","display_name":"veterans' health care","score":0.6240000128746033},{"id":"https://openalex.org/keywords/department-of-veterans-affairs","display_name":"Department of Veterans Affairs","score":0.8180000185966492},{"id":"https://openalex.org/keywords/health-care-reform","display_name":"health care reform","score":0.9100000262260437},{"id":"https://openalex.org/keywords/integrated-health-care-delivery","display_name":"integrated care delivery","score":0.5569999814033508},{"id":"https://openalex.org/keywords/primary-care-access","display_name":"primary care access","score":0.7680000066757202},{"id":"https://openalex.org/keywords/healthcare-spending","display_name":"health care spending","score":0.7110000252723694},{"id":"https://openalex.org/keywords/quality-of-care","display_name":"quality of care","score":0.847000002861023},{"id":"https://openalex.org/keywords/hospital-bed-closures","display_name":"hospital bed closures","score":0.6620000004768372},{"id":"https://openalex.org/keywords/veterans","display_name":"veterans","score":0.46299999952316284}],"concepts":[{"id":"https://openalex.org/C2775969662","wikidata":"https://www.wikidata.org/wiki/Q7923600","display_name":"Veterans Affairs","level":2,"score":0.8135923147201538},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7668547630310059},{"id":"https://openalex.org/C3018280585","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care delivery","level":3,"score":0.5899288654327393},{"id":"https://openalex.org/C2778584109","wikidata":"https://www.wikidata.org/wiki/Q60603744","display_name":"Health care reform","level":4,"score":0.5485497713088989},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5119937062263489},{"id":"https://openalex.org/C68595000","wikidata":"https://www.wikidata.org/wiki/Q2274177","display_name":"Service delivery framework","level":3,"score":0.49733904004096985},{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.4462048411369324},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3605095148086548},{"id":"https://openalex.org/C2780378061","wikidata":"https://www.wikidata.org/wiki/Q25351891","display_name":"Service (business)","level":2,"score":0.34029698371887207},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3350565433502197},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.3297337293624878},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.3200274109840393},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.2838866710662842},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.22229266166687012},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.13103163242340088},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.0},{"id":"https://openalex.org/C162853370","wikidata":"https://www.wikidata.org/wiki/Q39809","display_name":"Marketing","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D002908","descriptor_name":"Chronic Disease","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006296","descriptor_name":"Health Services","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":false},{"descriptor_ui":"D006296","descriptor_name":"Health Services","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D006297","descriptor_name":"Health Services Accessibility","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006787","descriptor_name":"Hospitals, Veterans","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014493","descriptor_name":"United States Department of Veterans Affairs","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014728","descriptor_name":"Veterans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015331","descriptor_name":"Cohort Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.1056/nejme038149","doi":"https://doi.org/10.1056/nejme038149","is_oa":false,"landing_page_url":"https://doi.org/10.1056/nejme038149","pdf_url":null,"source":{"id":"https://openalex.org/S62468778","display_name":"New England Journal of Medicine","issn_l":"0028-4793","issn":["0028-4793","0096-6762","1533-4406","2331-4710"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320239","host_organization_name":"Massachusetts Medical Society","host_organization_lineage":["https://openalex.org/P4310320239"],"host_organization_lineage_names":["Massachusetts Medical Society"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"New England Journal of Medicine","raw_type":"journal-article"},{"id":"pmid:14573739","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/14573739","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The New England journal of medicine","raw_type":"Editorial"},{"id":"pmh:oai:repository.library.georgetown.edu:10822/997188","doi":null,"is_oa":false,"landing_page_url":"http://hdl.handle.net/10822/997188","pdf_url":null,"source":{"id":"https://openalex.org/S4306402467","display_name":"DigitalGeorgetown (Georgetown University Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210145449","host_organization_name":"Center for Security and Emerging Technology","host_organization_lineage":["https://openalex.org/I4210145449"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"eweb:264150","raw_type":null}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.8048999905586243,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"sustainable_development_goals_aurora":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":14,"referenced_works":["https://openalex.org/W1976821590","https://openalex.org/W1998179632","https://openalex.org/W2030044538","https://openalex.org/W2032018352","https://openalex.org/W2064436685","https://openalex.org/W2068657668","https://openalex.org/W2072129658","https://openalex.org/W2088738070","https://openalex.org/W2101857176","https://openalex.org/W2129327240","https://openalex.org/W2151443489","https://openalex.org/W2160200574","https://openalex.org/W2244547113","https://openalex.org/W4238759981"],"related_works":["https://openalex.org/W2124748616","https://openalex.org/W2134697154","https://openalex.org/W58657379","https://openalex.org/W2335093665","https://openalex.org/W2768469537","https://openalex.org/W7097828295","https://openalex.org/W2068657668","https://openalex.org/W1974626514","https://openalex.org/W2027007256","https://openalex.org/W2982657987"],"abstract_inverted_index":{"During":[0],"the":[1,4,25,38,43,46,60,88,96],"past":[2],"decade,":[3],"Department":[5],"of":[6,14,40,45,73,98],"Veterans":[7],"Affairs":[8],"(VA)":[9],"undertook":[10],"a":[11,70],"major":[12],"reform":[13,62],"its":[15,74],"health":[16,31],"care":[17,32],"system,":[18],"one":[19],"that":[20],"is":[21],"increasingly":[22],"relevant":[23],"as":[24],"United":[26],"States":[27],"confronts":[28],"rapidly":[29],"rising":[30],"spending":[33],"and":[34,55,77,94],"persistent":[35],"gaps":[36],"in":[37],"quality":[39],"care.":[41],"While":[42],"rest":[44],"country":[47],"moved":[48],"toward":[49],"less":[50],"tightly":[51],"structured":[52],"delivery":[53],"systems":[54],"unfettered":[56],"access":[57,81],"to":[58,82,87],"specialists,":[59],"VA":[61,89],"established":[63],"22":[64],"regional,":[65],"integrated":[66],"service-delivery":[67],"networks,":[68],"closed":[69],"substantial":[71],"fraction":[72],"hospital":[75],"beds,":[76],"focused":[78],"on":[79],"ensuring":[80],"high-quality":[83],"primary":[84],"care.1":[85],"According":[86],"Central":[90],"Office,":[91],"between":[92],"1994":[93],"1998":[95],"number":[97],"veterans":[99],".":[100,101,102]},"counts_by_year":[{"year":2024,"cited_by_count":1},{"year":2023,"cited_by_count":3},{"year":2022,"cited_by_count":3},{"year":2021,"cited_by_count":6},{"year":2020,"cited_by_count":3},{"year":2019,"cited_by_count":2},{"year":2018,"cited_by_count":1},{"year":2017,"cited_by_count":1},{"year":2016,"cited_by_count":3},{"year":2015,"cited_by_count":4},{"year":2014,"cited_by_count":1},{"year":2013,"cited_by_count":6},{"year":2012,"cited_by_count":11}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}