Abstract:
:In the past decade physicians have identified the need to expand patient assessment to include global function and quality of life. During the same period, the busy clinic has evolved into the location where this assessment seems most appropriate. Integrating functional health assessment into a busy clinical practice is difficult because the necessary steps require time, thought, recording, and follow-up. Attention to the office ecosystem is very important before any patient care management method is introduced. The clinician must transform the results of health status screening into a specific functional diagnosis. The clinician has to understand the sensitivity, specificity, and predictive value of the measure for a preliminary diagnosis to be made. Often, additional measurements must be taken to establish a specific diagnosis. These steps encompass assessment linkage. Once the specific cause for the dysfunction is recognized, the clinician then has to determine the need for special resources. This is called the resource linkage. By following the steps outlined in this paper, the clinician should be able to overcome many obstacles for functional health status assessment in busy ambulatory settings.
journal_name
Med Carejournal_title
Medical careauthors
Wasson J,Keller A,Rubenstein L,Hays R,Nelson E,Johnson Ddoi
10.1097/00005650-199205001-00004keywords:
subject
Has Abstractpub_date
1992-05-01 00:00:00pages
MS42-9issue
5 Suppleissn
0025-7079issn
1537-1948journal_volume
30pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract:BACKGROUND:To optimize the use of patient-reported outcomes (PROs) in clinical research, it is first necessary to review the current use of these outcomes in clinical trials to determine under what circumstances they are most useful, and to reveal current limitations. PURPOSE:To investigate current patterns of use of ...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0b013e3182064aa2
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Opioid use disorders are frequently associated with medical and psychiatric comorbidities (eg, HIV infection and depression), as well as social problems (eg, lack of health insurance). Comprehensive services addressing these conditions improve outcomes. OBJECTIVE:To compare the proportion of for-profit, non...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000121
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To examine the effects of health plan enrollment [health maintenance organizations (HMO) or fee-for-service (FFS)], a change in Medicare reimbursement policy which allowed for annual rather than biennial mammograms, and Health Plan Employer Data Information Set (HEDIS) measures on stage at diagnosis among old...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3180616c51
更新日期:2007-08-01 00:00:00
abstract::Current efforts to contain health care costs include a variety of strategies aimed at the users of health services. These approaches attempt to encourage users to be more cost-conscious and to shop for lower-cost services and more efficient health care plans. The primary method for achieving this is by increasing the ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198711000-00001
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:Persons with behavioral disorders incur higher healthcare costs. Although they utilize behavioral health (BH) services others do not, they also have higher utilization of medical services OBJECTIVES:: To determine the degree to which higher costs for persons with BH disorders are attributable to utilization...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000075
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Young men who have sex with men (YMSM) have the highest rates of human immunodeficiency virus (HIV) infection in the United States. Decades into the HIV epidemic, the relationships that YMSM-serving health and social organizations have with one another has not been studied in depth. OBJECTIVES:The aim of th...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000595
更新日期:2017-02-01 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:The Affordable Care Act allowed an optional Medicaid State Plan benefit for states to establish Health Homes coordinating care for people who have chronic conditions. Differences in medical home program incentives and implementation styles are important to understand in evaluating effects on key outcomes suc...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000555
更新日期:2016-08-01 00:00:00
abstract::Although there are large-scale forces that influence the economic behavior of the health care delivery system, it is the physician who has primary authority to make decisions about the use of resources. Consequently, when considering alternative options for controlling rising health care expenditures, it is useful to ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198308000-00003
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:The Medicare Part D benefit is complicated and may be costly, especially for vulnerable low-income populations where lack of resources and limited English proficiency may be barriers to optimal plan selection. OBJECTIVES:To identify vulnerable Medicare beneficiaries and lower their expected annual out-of-po...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318202a9f2
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:Compare healthcare utilization and total payments for community-acquired pneumonia (CAP) episodes-of-care among 5 health plan designs spanning the continuum of managed care. RESEARCH DESIGN:Medical and prescription claims analysis of CAP episodes among enrollees of employer-sponsored health plans. Episode ch...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181a8116d
更新日期:2009-10-01 00:00:00
abstract::The evaluation of long-term care demonstrations has to deal with complex organizational entities, with large, heterogeneous client populations that, during the course of study, may have to change features of their organization or operation. The implications of such "real-time" changes are discussed for analyses of the...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199512000-00004
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Decades-long efforts to require parity between behavioral and physical health insurance coverage culminated in the comprehensive federal Mental Health Parity and Addiction Equity Act. OBJECTIVES:To determine the association between federal parity and changes in mental health care utilization and spending, p...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001076
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Seizures and epilepsy are common in older adults especially in some minorities. Despite the importance of medical care to maximize seizure control, little is known about its quality across racial groups. One indicator of quality care is the receipt of electroencephalograms (EEG), and magnetic resonance imagi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31824ebdc4
更新日期:2012-08-01 00:00:00
abstract::A population-based approach was used to analyze the utilization patterns of hospital care by Manitoba residents during the fiscal year 1991/1992. Patterns were analyzed for eight administrative regions, with use assigned to the patient's region of residence, regardless of the location of the hospitalization. Regional ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199512001-00008
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:The 2016 President's Cancer Panel Connected Health report calls for thoroughly characterizing the team structures and processes involved in coordinating care for people with chronic conditions. We developed a multilevel care coordination framework by integrating existing frameworks from the teams and care co...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0000000000000874
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Patients with multiple chronic conditions (MCCs) are a critical but undefined group for quality measurement. We present a generally applicable systematic approach to defining an MCC cohort of Medicare fee-for-service beneficiaries that we developed for a national quality measure, risk-standardized ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000853
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Rural health care workforce forecasting has not included adjustments for predictable changes in practice patterns, such as the introduction of practice guidelines. PURPOSE:To estimate the impact of a practice guideline for a single health condition on the needs of a rural health professional workforce. MET...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199903000-00006
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:The influence of payment mechanisms on physician decisions is not well understood. OBJECTIVES:The objective of this study was to test 2 null hypotheses: 1) physicians' clinical decisions would not be influenced by payment incentives; and 2) physicians would have equal concern about medical decisions made un...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000114918.50088.1c
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:: Previous research suggests, but does not definitively establish, that a high level of uninsurance in a community may negatively affect access to and quality of health care for insured persons. OBJECTIVE:: To assess the effect of the level of uninsurance in a community on access to and satisfaction with ca...
journal_title:Medical care
pub_type: 杂志文章,多中心研究
doi:10.1097/MLR.0b013e31822dc7f4
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Services targeting social determinants of health-such as income support, housing, and nutrition-have been shown to improve health outcomes and reduce health care costs for older adults. Nevertheless, evidence on the properties of effective collaborative networks across health care and social services sectors...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001097
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Earlier studies estimated annual income differences across specialties, but lifetime income may be more relevant given physicians' long-term commitments to specialties. METHODS:Annual income and work hours data were collected from 6381 physicians in the nationally representative 2004-2005 Community Tracking...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318268ac0c
更新日期:2012-12-01 00:00:00
abstract::There have been recent increases in asthma prevalence, morbidity, and mortality in the United States. There is substantial evidence that problems in health care delivery may be contributing to these recent trends. Because of these recent changes, a reduction in asthma-related morbidity has been identified as a new nat...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/00005650-199303001-00004
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:We evaluated the association of medication refill adherence with demographic and prescription characteristics to determine whether such factors could guide intervention strategies in an indigent rural population. METHODS:The study was conducted at a University-based internal medicine practice serving an indi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200212000-00016
更新日期:2002-12-01 00:00:00
abstract::Although Alzheimer's-type dementia (ATD) is characterized by global intellectual deterioration, few systematic efforts have been made to characterize overall dysfunction of ATD patients. The Sickness Impact Profile (SIP) was administered to ATD patients and family members to determine the concurrent validity of family...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198805000-00002
更新日期:1988-05-01 00:00:00
abstract::It is well-documented that ratings of medical care received personally (personal referent) yield more favorable responses than ratings of care received by people in general (general referent). Hence general items are useful in achieving greater variation in responses to satisfaction surveys. However, the validity of g...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198606000-00006
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:Adherence to medication treatment plans is important for chronic disease (CD) management. Cost-related nonadherence (CRN) puts patients at risk for complications. Native Hawaiians and Pacific Islanders (NHPI) suffer from high rates of CD and socioeconomic disparities that could increase CRN behaviors. OBJEC...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000887
更新日期:2018-04-01 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:BACKGROUND:Breast cancer is frequently diagnosed after an abnormal mammography result. Language barriers can complicate communication of those results. OBJECTIVES:We evaluated the association of non-English language with delay in follow-up. METHODS:Retrospective cohort study of women at 3 mammography facilities parti...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31822dcf2d
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Loving-kindness meditation (LKM) is a practice intended to enhance feelings of kindness and compassion for self and others. OBJECTIVES:To assess whether participation in a 12-week course of LKM for veterans with posttraumatic stress disorder (PTSD) is associated with improved positive emotions, decentering,...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000221
更新日期:2014-12-01 00:00:00