Abstract:
BACKGROUND:Increasing recognition of the failure to translate research findings into practice has led to greater awareness of the importance of using active dissemination and implementation strategies. Although there is a growing body of research evidence about the effectiveness of different strategies, this is not easily accessible to policy makers and professionals. OBJECTIVES:To identify, appraise, and synthesize systematic reviews of professional educational or quality assurance interventions to improve quality of care. RESEARCH DESIGN:An overview was made of systematic reviews of professional behavior change interventions published between 1966 and 1998. RESULTS:Forty-one reviews were identified covering a wide range of interventions and behaviors. In general, passive approaches are generally ineffective and unlikely to result in behavior change. Most other interventions are effective under some circumstances; none are effective under all circumstances. Promising approaches include educational outreach (for prescribing) and reminders. Multifaceted interventions targeting different barriers to change are more likely to be effective than single interventions. CONCLUSIONS:Although the current evidence base is incomplete, it provides valuable insights into the likely effectiveness of different interventions. Future quality improvement or educational activities should be informed by the findings of systematic reviews of professional behavior change interventions.
journal_name
Med Carejournal_title
Medical careauthors
Grimshaw JM,Shirran L,Thomas R,Mowatt G,Fraser C,Bero L,Grilli R,Harvey E,Oxman A,O'Brien MAkeywords:
subject
Has Abstractpub_date
2001-08-01 00:00:00pages
II2-45issue
8 Suppl 2eissn
0025-7079issn
1537-1948journal_volume
39pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract:BACKGROUND:Valid and comparable measures of health outcomes are needed for clinical trials, studies on quality of healthcare, and population health monitoring. OBJECTIVE:To examine comparability of patient-reported health status across populations. RESEARCH DESIGN:Logistic regression analysis of health status across ...
journal_title:Medical care
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/MLR.0b013e3182239489
更新日期:2011-10-01 00:00:00
abstract::We evaluated the quality of care of physician's extenders (PEs: 23 physician's assistants, 7 primary care nurse practitioners) in Air Force primary medicine clinics, as part of an evaluation of PEs' assuming a considerable portion of the care, formerly provided by physicians in the military medical system. Physician's...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198109000-00007
更新日期:1981-09-01 00:00:00
abstract:BACKGROUND:Medication adherence may be a proxy for healthy behaviors and other factors that affect outcomes. Prior studies of the association between placebo adherence and health outcomes have been limited primarily to men enrolled in clinical trials and cardiovascular disease outcomes. We examined associations between...
journal_title:Medical care
pub_type: 杂志文章,随机对照试验
doi:10.1097/MLR.0b013e318207ed9e
更新日期:2011-05-01 00:00:00
abstract::The authors assess the factorial validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) for use in a clinical sample of disadvantaged, older adults with significant comorbidities. Confirmatory factor analysis was performed using LISREL VIII on data obtained from baseline face-to-face interview...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199606000-00004
更新日期:1996-06-01 00:00:00
abstract::In a longitudinal, prospective study of patient's decisions about influenza vaccination, the stability of attitudes about the flu and flu shots, the stability of flu shot decisions, and the relationship of attitude shifts to compliance were studied. In both 1981 and 1982 for 216 patients at high risk for complications...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198506000-00002
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:The negative impact of pain on health-related quality of life has been documented for persons with human immunodeficiency virus (HIV). Furthermore, pain could be an important factor in seeking medical care. However, the relationship between pain and health service utilization is poorly understood. OBJECTIVE...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000108744.45327.d4
更新日期:2004-02-01 00:00:00
abstract::With no additional effort to revise adult day health care (ADHC) services or the types of patients who receive them, it would appear that adding an ADHC program to a VA Medical Center would not achieve the desired objectives. The authors discuss here the advantages, disadvantages, and feasibility of 2 options for prog...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Though demand for mental health services (MHS) among US veterans is increasing, MHS utilization per veteran is decreasing. With health and social service needs competing for limited resources, it is important to understand the association between patient factors, MHS utilization, and clinical outcomes. OBJE...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/mlr.0b013e3181cafbe3
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Conceptual equivalence of measures is essential in research that compares health across diverse racial/ethnic groups. Cognitive interviews are pretest methods to explore the conceptual equivalence of survey items. Systematic approaches for using these methods are emerging. OBJECTIVE:We describe an interacti...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000245425.65905.1d
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:The association between volume of patients treated and quality of care has important implications for patient referral policies and approaches to quality improvement. Most studies have focused on hospital volume alone and health outcomes. OBJECTIVES:The objective of this work was to examine the association ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200011000-00004
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Although cardiac procedures are commonly used to treat cardiovascular disease, they are costly. Administrative data sources could be used to track cardiac procedures, but sources of such data have not been validated against clinical registries. OBJECTIVES:To examine accuracy of cardiac procedure coding in a...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3182329778
更新日期:2013-04-01 00:00:00
abstract::The authors conducted two studies of routine medical visits, investigating the relation of physician gender, patient gender, and physician age to patient satisfaction, and the correlations between communication behaviors and satisfaction separately for different combinations of patient and physician gender. Study 1 wa...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199412000-00005
更新日期:1994-12-01 00:00:00
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
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVES:The primary objective of this study was to examine veterans' reliance on health care services provided by the Veterans Health Administration (VHA) within Minnesota and estimate the potential effect on uninsurance rates if all eligible veterans relied on VHA coverage. Secondary objectives were to compare vete...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000170403.97264.39
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:More than 70 million Americans are enrolled in a high-deductible health plan (HDHP), with high upfront cost-sharing to encourage strategies such as price shopping to mitigate out-of-pocket spending. Recent research suggests HDHP enrollees are reluctant to engage in these consumer strategies, but there is lit...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001056
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Early magnetic resonance imaging (MRI) for acute low back pain (LBP) has been associated with increased costs, greater health care utilization, and longer disability duration in workers' compensation claimants. OBJECTIVES:To assess the impact of a state policy implemented in June 2010 that required prospect...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000917
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:We evaluated the longitudinal course of the relationship between patient satisfaction and quality of life (QoL) in Chinese breast and nasopharyngeal cancer patients. METHODS:A sample of Chinese breast (n = 250) and nasopharyngeal (n = 242) cancer patients were assessed during their first outpatient visit (b...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181a393cf
更新日期:2009-08-01 00:00:00
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
更新日期:2019-10-01 00:00:00
abstract::The cost of obstetric care delivered in a cooperative care unit was compared with the cost for similar patients treated in a traditional inpatient maternity unit. The study sample contained 1,683 consecutive patients representing 23 diagnosis categories. The analysis indicates that cooperative care patients had signif...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198806000-00008
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVES:Family members and other "carepartners" often play an important role in the care and support of patients during and after hospitalization, yet little is known about how they assess their hospital experience or the factors that may influence their perceptions. METHODS:A nationwide telephone survey of 1,800 r...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199901000-00006
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:Administrative data from Manitoba, Canada document variation in procedure utilization rates over a period of 15 years. With coronary angiography and cardiovascular surgery centralized in the capital, Winnipeg, previous analyses from 1977 to 1983 found angiography and coronary artery bypass surgery (CABS) rat...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199807000-00009
更新日期:1998-07-01 00:00:00
abstract::Although much is known about who pays the annual aggregate nursing home bill, relatively little is known about payment-source patterns of individuals during their lifetimes. In this article, lifetime payment-source patterns are analyzed for elderly nursing home users, particularly the extent to which they spend down a...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199503000-00007
更新日期:1995-03-01 00:00:00
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
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To examine the relationship between estimated travel time to admitting hospital and mortality for veterans with acute ischemic stroke, controlling for patient demographic, clinical, facility-level variables, as well as select in-hospital treatments and procedures. METHODS:A longitudinal observational populat...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000366
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:A number of health care initiatives seek to improve health outcomes by increasing access to outpatient services while reducing preventable acute events. We evaluated disparities between American Indian and Alaska Native (AI/AN) and non-Hispanic white (white) Medicare enrollees in access to outpatient preventi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000698
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVES:To estimate cost and outcomes of the Arthritis Foundation aquatic exercise classes from the societal perspective. DESIGN:Randomized trial of 20-week aquatic classes. Cost per quality-adjusted life year (QALY) gained was estimated using trial data. Sample size was based on 80% power to reject the null hypoth...
journal_title:Medical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005650-200105000-00002
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Collaborative Chronic Care Models represent an evidence-based way to structure care for chronic conditions, including mental health conditions. Few studies, however, have examined the cost implications of collaborative care for mental health. OBJECTIVE:We aimed to conduct an economic analysis of implementin...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001372
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Studies evaluating patient outcomes in dialysis as a function of quality of predialysis therapeutic care are lacking. OBJECTIVE:To evaluate the association of quality of predialysis therapeutic practices with survival and hospitalization during the first year of dialysis. RESEARCH DESIGN:The AVantagE de la...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181d56926
更新日期:2012-01-01 00:00:00
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
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:By shifting a greater share of out-of-pocket medical costs to consumers, high-deductible health plans (HDHP) might discourage use of essential outpatient services. OBJECTIVE:The objective of the study was to examine the impact of an HDHP on outpatient visits and associated laboratory and radiology tests. R...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000008
更新日期:2014-01-01 00:00:00