Abstract:
PURPOSE:We wanted to estimate excess risk of in-hospital mortality associated with medical injuries identified using an injury surveillance system, after controlling for risk of death resulting from comorbidities. METHODS:The Wisconsin Medical Injuries Prevention Program (WMIPP) screening criteria were used to identify medical injuries, defined as "any untoward harm associated with a therapeutic or diagnostic healthcare intervention," among discharge diagnoses for all 562,317 patients discharged from 134 acute care hospitals in Wisconsin in 2002. We then derived estimates for crude and adjusted relative risk of in-hospital mortality associated with the presence of a medical injury diagnosis. Logistic regression adjusted for baseline risk of mortality using a comorbidity index, age, sex, Diagnosis Related Groups, hospital characteristics, and clustering within hospital. RESULTS:There were 77,666 discharges that met WMIPP criteria for at least 1 medical injury (13.8%). Crude risk ratios for death ranged from 1.27 to 2.4 for those with medical injuries within 1 of 4 categories: drugs/biologics; devices, implants, and grafts; procedures; and radiation. After adjustment, estimates of excess mortality decreased, and significance persisted only for injuries related to procedures (39%; 95% confidence interval [CI], 28%-52%) and devices, implants, and grafts (16%; 95% CI, 3%-30%). CONCLUSIONS:Estimates of excess mortality that do not account for baseline mortality risk may be exaggerated. Findings have implications for the care family physicians provide in the hospital and for the advice they give their patients who are concerned about the risks of hospitalization.
journal_name
Ann Fam Medjournal_title
Annals of family medicineauthors
Meurer LN,Yang H,Guse CE,Russo C,Brasel KJ,Layde PMdoi
10.1370/afm.553subject
Has Abstractpub_date
2006-09-01 00:00:00pages
410-6issue
5eissn
1544-1709issn
1544-1717pii
4/5/410journal_volume
4pub_type
杂志文章abstract:PURPOSE:We wanted to obtain perspectives of mothers and daughters on facilitators of and barriers to with adolescent girls' timely access to risk-appropriate reproductive care. METHODS:We conducted 5 separate focus groups with Latina and black mothers and their adolescent daughters. All participants resided in impover...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.601
更新日期:2006-11-01 00:00:00
abstract:PURPOSE:This report describes outcomes of an ongoing quality-improvement project (VitalSign6) in a large US metropolitan area to improve recognition, treatment, and outcomes of depressed patients in 16 primary care clinics (6 charity clinics, 6 federally qualified health care centers, 2 private clinics serving low-inco...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
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journal_title:Annals of family medicine
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journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1350
更新日期:2012-05-01 00:00:00
abstract:PURPOSE:We wanted develop a reliable and valid objective measure of patient-physician collaborative decision making, the Rochester Participatory Decision-Making Scale (RPAD). METHODS:Based on an informed decision-making model, the RPAD assesses physician behavior that encourages patient participation in decision makin...
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doi:10.1370/afm.305
更新日期:2005-09-01 00:00:00
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更新日期:2010-01-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 杂志文章
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更新日期:2020-07-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 杂志文章
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更新日期:2013-05-01 00:00:00
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更新日期:2004-03-01 00:00:00
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journal_title:Annals of family medicine
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更新日期:2009-09-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2179
更新日期:2018-03-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1353
更新日期:2012-03-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.62
更新日期:2004-03-01 00:00:00
abstract::Large panel sizes are often held responsible for worse access to appointments in primary care. We evaluated the relationship between appointment backlog, panel size, and primary care clinician time in clinic, using Spearman correlation and multiple regression in a retrospective analysis. We found no independent associ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2313
更新日期:2018-11-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2007-05-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1622
更新日期:2014-05-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1370/afm.2288
更新日期:2018-09-01 00:00:00
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journal_title:Annals of family medicine
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abstract:PURPOSE:Traditionally first-void urine specimens are used to test for Chlamydia trachomatis. In contrast, midstream urine specimens are traditionally recommended for microscopy and culture of presumptive bacterial urinary tract infections. The ability to test for both C trachomatis and urinary tract infection on a sing...
journal_title:Annals of family medicine
pub_type: 杂志文章
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journal_title:Annals of family medicine
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
abstract:PURPOSE:Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physician...
journal_title:Annals of family medicine
pub_type: 杂志文章,评审
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更新日期:2018-05-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.682
更新日期:2007-07-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1541
更新日期:2013-09-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2535
更新日期:2020-07-01 00:00:00
abstract:PURPOSE:The purpose of this study was to determine the relationship between the number of patients under a primary care physician's care (panel size) and primary care quality indicators. METHODS:We conducted a cross-sectional, population-based study of fee-for-service and capitated interprofessional and non-interprofe...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1864
更新日期:2016-01-01 00:00:00
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journal_title:Annals of family medicine
pub_type: 杂志文章,meta分析,评审
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更新日期:2009-01-01 00:00:00
abstract:PURPOSE:Little is known regarding the effects of psychological factors on data collection in research studies. We examined whether Five Factor Model (FFM) personality factors-Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness-predicted missing data in a randomized controlled trial (RCT). METHODS...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.920
更新日期:2009-03-01 00:00:00