Needs-based planning for generalist physicians.

Abstract:

OBJECTIVES:The Manitoba Centre for Health Policy and Evaluation (MCHPE) collaborated with a provincially-appointed Physician Resource Committee in an assessment of provincial physician resources. RESEARCH DESIGN:Beginning with map-based analyses of physician supply and contacts across the province, compared with the health and socioeconomic characteristics of local populations, the study moved to a needs-based, regression-based approach to physician resource planning. RESULTS:The results challenged the popular belief that Manitoba suffers from an increasing shortage of physicians. A handful of high-need, low-supply and low-use areas are identified, as is the expensive surplus of generalist physicians in Winnipeg. (Generalist physicians include general and family practitioners as well as general internists and pediatricians.) No relationship between physician supply and health characteristics of populations, or between high physician supply and low hospital use patterns were found. Given the Committee's interest in what drives high physician contact rates, analyses of visit patterns of hypertensive patients were undertaken. We found that patients who had more complex medical conditions made more contacts, but that after controlling for this and other key patient characteristics, the patient's primary care physician's patient recall rate was a strong influence on how frequently visits were made.

journal_name

Med Care

journal_title

Medical care

authors

Roos NP,Fransoo R,Bogdanovic B,Carriere KC,Frohlich N,Friesen D,Patton D,Wall R

doi

10.1097/00005650-199906001-00017

keywords:

subject

Has Abstract

pub_date

1999-06-01 00:00:00

pages

JS206-28

issue

6 Suppl

eissn

0025-7079

issn

1537-1948

journal_volume

37

pub_type

杂志文章
  • Self-reported health status of the general adult U.S. population as assessed by the EQ-5D and Health Utilities Index.

    abstract:OBJECTIVE:This study aimed to describe the self-reported health status of the general adult U.S. population using 3 multi-attribute preference-based measures: the EQ-5D, Health Utilities Index Mark 2 (HUI2), and Mark 3 (HUI3). METHODS:We surveyed the general adult U.S. population using a probability sample with oversa...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000182493.57090.c1

    authors: Luo N,Johnson JA,Shaw JW,Feeny D,Coons SJ

    更新日期:2005-11-01 00:00:00

  • The effect of improving primary care depression management on employee absenteeism and productivity. A randomized trial.

    abstract:OBJECTIVE:To test whether an intervention to improve primary care depression management significantly improves productivity at work and absenteeism over 2 years. SETTING AND SUBJECTS:Twelve community primary care practices recruiting depressed primary care patients identified in a previsit screening. RESEARCH DESIGN:...

    journal_title:Medical care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005650-200412000-00007

    authors: Rost K,Smith JL,Dickinson M

    更新日期:2004-12-01 00:00:00

  • A comparison of the patients and practices of recent graduates of family practice and general internal medicine residency programs.

    abstract::This study compares the characteristics of the practices and patients of recent graduates of family practice and general internal medicine residency programs. National samples of 104 family physicians and 134 general internists completed questionnaires and provided log-diary data for more than 7,500 office visits and ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198612000-00006

    authors: Cherkin DC,Rosenblatt RA,Hart LG,Schleiter MK

    更新日期:1986-12-01 00:00:00

  • Collaborative chronic care models for mental health conditions: cumulative meta-analysis and metaregression to guide future research and implementation.

    abstract:OBJECTIVE:Prior meta-analysis indicates that collaborative chronic care models (CCMs) improve mental and physical health outcomes for individuals with mental disorders. This study aimed to investigate the stability of evidence over time and identify patient and intervention factors associated with CCM effects to facili...

    journal_title:Medical care

    pub_type: 杂志文章,meta分析

    doi:10.1097/MLR.0b013e3182a3e4c4

    authors: Miller CJ,Grogan-Kaylor A,Perron BE,Kilbourne AM,Woltmann E,Bauer MS

    更新日期:2013-10-01 00:00:00

  • Access to and utilization of health care by subgroups of Latino children.

    abstract:BACKGROUND:Latinos make up the largest group of minority children in the United States. Despite great diversity among Latino children, studies have traditionally treated them as a monolithic group. Few studies have examined patterns and determinants of access to and use of health care for different subgroups of Latino ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318190d9e4

    authors: Perez VH,Fang H,Inkelas M,Kuo AA,Ortega AN

    更新日期:2009-06-01 00:00:00

  • Predicting inpatient costs with admitting clinical data.

    abstract::Hospital cost-containment programs should themselves be cost-effective, targeting high-cost physicians (which requires adjusting for case mix) and patients (which requires early identification). In this study, clinical data available within 24 hours of admission from an electronic medical record system were used to de...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199501000-00001

    authors: Tierney WM,Fitzgerald JF,Miller ME,James MK,McDonald CJ

    更新日期:1995-01-01 00:00:00

  • Identification of hospital-acquired catheter-associated urinary tract infections from Medicare claims: sensitivity and positive predictive value.

    abstract:BACKGROUND AND OBJECTIVE:Hospital-acquired catheter-associated urinary tract infection (CAUTI) is one of the first 6 conditions Medicare is targeting to reduce payment associated with hospital-acquired conditions under Congressional mandate. This study was to determine the positive predictive value (PPV) and sensitivit...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e31818af83d

    authors: Zhan C,Elixhauser A,Richards CL Jr,Wang Y,Baine WB,Pineau M,Verzier N,Kliman R,Hunt D

    更新日期:2009-03-01 00:00:00

  • Predictors of patients' perceived need for medication to prevent fracture.

    abstract:BACKGROUND:Adherence with medications to prevent fractures is suboptimal. Patients' perceived need for medication is an important predictor of medication-use behavior. OBJECTIVE:Estimate the associations of patients' perceived need of medication for fracture prevention with objective indicators of fracture risk, patie...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318202915e

    authors: Schousboe JT,Davison ML,Dowd B,Thiede Call K,Johnson P,Kane RL

    更新日期:2011-03-01 00:00:00

  • Tasks in statistical inference for studying variation in medicine.

    abstract::When studying variation in medicine, traditional hypothesis-testing procedures are too limited to obtain useful inferences except in special situations. More generally, full probability modelling is necessary. Even a relatively simple example can illustrate this point rather dramatically. The development and applicati...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199305001-00017

    authors: Rubin DB

    更新日期:1993-05-01 00:00:00

  • Formularies, therapeutics, and outcomes: new opportunities.

    abstract::The increasing prominence of drug therapies in health care and their rapidly rising costs have led to a dramatic escalation of interest in the use of outcomes data for therapeutics and formulary decisions. The expanded use of formulary submission dossiers, effectiveness data, health outcomes analysis, and pharmacoecon...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000119396.81986.19

    authors: Fullerton DS,Atherly DS

    更新日期:2004-04-01 00:00:00

  • Differential effect of early or late implementation of prior authorization policies on the use of Cox II inhibitors.

    abstract:BACKGROUND:State Medicaid programs introduce many types of prescribing restrictions to manage pharmaceutical use and expenditure. Little is known about the differential effect of implementing prior authorization (PA) policies at market entry versus waiting until several years later when prescribing behavior may already...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000204056.31664.36

    authors: Roughead EE,Zhang F,Ross-Degnan D,Soumerai S

    更新日期:2006-04-01 00:00:00

  • A comparison of clinical performance of primary care and traditional internal medicine residents.

    abstract:OBJECTIVE:To compare primary care and traditional Internal Medicine residents in their adherence to preventive medicine guidelines, performance in the management of chronic diseases, and utilization of resources. DESIGN:Prospective cohort study. SETTING:Urban Internal Medicine residency program. PARTICIPANTS:Sixteen...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199908000-00007

    authors: Wong MD,Hollenberg JP,Charlson ME

    更新日期:1999-08-01 00:00:00

  • Physician gender affects how physician nonverbal behavior is related to patient satisfaction.

    abstract:BACKGROUND:Physician and patient gender both influence medical communication. Nonverbal behavior is generally under-researched in the medical encounter but plays an important role for patient outcomes such as satisfaction. OBJECTIVE:This article aims at identifying how specific physician nonverbal behaviors predict an...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e31817e1877

    authors: Mast MS,Hall JA,Köckner C,Choi E

    更新日期:2008-12-01 00:00:00

  • Identification of differential item functioning using item response theory and the likelihood-based model comparison approach. Application to the Mini-Mental State Examination.

    abstract:BACKGROUND:An important part of examining the adequacy of measures for use in ethnically diverse populations is the evaluation of differential item functioning (DIF) among subpopulations such as those administered the measure in different languages. A number of methods exist for this purpose. OBJECTIVE:The objective o...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.mlr.0000245251.83359.8c

    authors: Orlando Edelen MO,Thissen D,Teresi JA,Kleinman M,Ocepek-Welikson K

    更新日期:2006-11-01 00:00:00

  • Health perceptions of primary care patients and the influence on health care utilization.

    abstract::This prospective study was conducted to determine the influence of primary care patients' health perceptions on their utilization of health care services. Patients' health perceptions were measured using the RAND Corporation's General Health Perceptions Questionnaire. Physicians provided scores of how they thought the...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198903001-00009

    authors: Connelly JE,Philbrick JT,Smith GR Jr,Kaiser DL,Wymer A

    更新日期:1989-03-01 00:00:00

  • Quality of acute episodic care in investor-owned ambulatory health centers.

    abstract::This article examines the quality of acute episodic care for five diagnostic categories amenable to one-visit diagnosis and treatment at the nation's largest chain of investor-owned ambulatory care centers. A total of 803 medical records were audited for five common conditions and measured against specific protocols. ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199101000-00007

    authors: Parks CL,Cashman S,Winickoff RN,Bicknell WJ

    更新日期:1991-01-01 00:00:00

  • Trends in the utilization of mammography in Washington state and British Columbia: relation to stage of diagnosis and mortality.

    abstract::To compare the utilization of an imaging technology in the United States and Canada and its effect on clinical outcomes, trends in the utilization of mammography among women aged 50 to 75 years from 1984 through 1988 in Washington State and British Columbia were examined. Also compared were trends in the stage at time...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199204000-00003

    authors: Katz SJ,Larson EB,LoGerfo JP

    更新日期:1992-04-01 00:00:00

  • Development and validation of a model for predicting inpatient hospitalization.

    abstract:BACKGROUND:Hospitalizations are costly for health insurers and society. OBJECTIVES:To develop and validate a predictive model for acute care hospitalization from administrative claims for a population including all age groups. RESEARCH DESIGN:We constructed a retrospective cohort study using a US health plan claims d...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3182353ceb

    authors: Lemke KW,Weiner JP,Clark JM

    更新日期:2012-02-01 00:00:00

  • Assessing the Effectiveness of Complex Interventions to Meet the Needs of VA Stakeholders: Experience of the Department of Veterans Affairs Evidence Synthesis Program.

    abstract:BACKGROUND:Complex health care interventions involve multiple distinct elements that contribute to their functioning. Conducting systematic reviews of complex interventions has substantial challenges. Although methodological guidance exists, less is known about the practical strategies and approaches undertaken by syst...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001158

    authors: Wilt TJ,Greer N,Duan-Porter W

    更新日期:2019-10-01 00:00:00

  • The effects of patient volume on the quality of diabetic care for Medicare beneficiaries.

    abstract:BACKGROUND:The quality of care for Medicare beneficiaries with diabetes remains suboptimal. The contributing factors at the physician level are not well characterized, especially the relationship of patient volume and physician performance. OBJECTIVE:We sought to determine associations between the number of Medicare d...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000233685.22497.cf

    authors: Holmboe ES,Wang Y,Tate JP,Meehan TP

    更新日期:2006-12-01 00:00:00

  • Encouraging preventive services for low-income children. The effect of expanding Medicaid.

    abstract::Every year since 1984, Congress has expanded Medicaid to cover an increasing proportion of low-income children. In this study, a multivariate analysis of data from the 1987 National Medical Expenditure Survey was used to determine whether expanded Medicaid eligibility is likely to be effective in encouraging recommend...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199209000-00002

    authors: Short PF,Lefkowitz DC

    更新日期:1992-09-01 00:00:00

  • Physical and role functioning among persons with HIV: results from a nationally representative survey.

    abstract:BACKGROUND:Functional limitations of persons living with HIV affect their care needs and ability to perform social roles such as employment. Earlier estimates are outdated, and nationally representative estimates of prevalence and distribution of these limitations have not previously been available. OBJECTIVES:The obj...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200012000-00008

    authors: Crystal S,Fleishman JA,Hays RD,Shapiro MF,Bozzette SA

    更新日期:2000-12-01 00:00:00

  • Disenrollment from an acute/long-term managed care program (PACE).

    abstract:BACKGROUND:The Program of All-Inclusive Care for the Elderly (PACE) is an acute/long-term managed care plan designed to care for the most frail and vulnerable Medicare beneficiaries. To our knowledge, this is a first study to examine patterns and predictors of disenrollment from PACE. OBJECTIVE:PACE, with its comprehe...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000188920.19129.89

    authors: Temkin-Greener H,Bajorska A,Mukamel DB

    更新日期:2006-01-01 00:00:00

  • Regression analysis in health services research: the use of dummy variables.

    abstract::Dummy variables frequently are used in regression analysis but often in an incorrect fashion. A brief review of examples in the medical care literature showed that the interpretation of dummy variable regression coefficients and their significance was often incorrect or unclear. This article shows how dummy variables ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198209000-00008

    authors: Polissar L,Diehr P

    更新日期:1982-09-01 00:00:00

  • Dimensions of consumer-assessed quality of Medicare managed-care health plans.

    abstract:OBJECTIVES:We investigated relationships at the health-plan level among member ratings of and reports on plans in the Consumer Assessment of Health Plans Survey (CAHPS). We sought a more parsimonious description of the reports that can be used in analyses of the distribution and correlates of consumer-assessed quality....

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200002000-00006

    authors: Zaslavsky AM,Beaulieu ND,Landon BE,Cleary PD

    更新日期:2000-02-01 00:00:00

  • Physician decision making and variation in hospital admission rates for suspected acute cardiac ischemia. A tale of two towns.

    abstract::The authors tested the "uncertainty hypothesis," which holds that variations in rates of hospitalization or surgeries across small geographic areas reflect differences in physicians' decision making when confronting uncertainty. A small-areas variation analysis of suspected acute cardiac ischemia (ACI) admissions in n...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199411000-00002

    authors: Green LA,Becker MP

    更新日期:1994-11-01 00:00:00

  • Measuring disparities: bias in the Short Form-36v2 among Spanish-speaking medical patients.

    abstract:BACKGROUND:Many national surveys have found substantial differences in self-reported overall health between Spanish-speaking Hispanics and other racial/ethnic groups. However, because cultural and language differences may create measurement bias, it is unclear whether observed differences in self-reported overall healt...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e31820fb944

    authors: Sudano JJ,Perzynski A,Love TE,Lewis SA,Murray PM,Huber GM,Ruo B,Baker DW

    更新日期:2011-05-01 00:00:00

  • Identifying in-hospital venous thromboembolism (VTE): a comparison of claims-based approaches with the Rochester Epidemiology Project VTE cohort.

    abstract:BACKGROUND:Efforts to identify hospital-acquired complications from claims data by applying exclusion rules to discharge diagnosis codes exhibit low positive predictive value (PPV). The PPV improves when a variable is added to each secondary diagnosis to indicate whether the condition was "present-on-admission" (POA) o...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3181589b92

    authors: Leibson CL,Needleman J,Buerhaus P,Heit JA,Melton LJ 3rd,Naessens JM,Bailey KR,Petterson TM,Ransom JE,Harris MR

    更新日期:2008-02-01 00:00:00

  • An introduction to multiple time series analysis.

    abstract::An expository account of multiple time series analysis is presented. Modeling several related time series together makes it possible to ascertain dynamic leading, lagging, and feedback relationships among the series; to produce more efficient forecasts and, in some situations; to develop control schemes. Procedures fo...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:

    authors: Tiao GC

    更新日期:1993-05-01 00:00:00

  • Construct validity and factor structure of survey-based assessment of cost-related medication burden.

    abstract:BACKGROUND:Millions of Americans are burdened by out-of-pocket prescription costs. Although many survey measures have been developed to assess this burden, the construct validity and the factor structure of these instruments have not been rigorously assessed. OBJECTIVES:To characterize the factor structure and the con...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000286

    authors: Burcu M,Alexander GC,Ng X,Harrington D

    更新日期:2015-02-01 00:00:00