Abstract:
:The human immunodeficiency virus (HIV) epidemic and the prevalence of HIV-positive persons in the population has provoked marked anxiety among hospital staffs of acquiring nosocomially transmitted HIV infections. A national telephone survey of key staff in a sample of 561 acute-care hospitals was undertaken to describe the extent of asymptomatic HIV testing of patients, and variations between hospitals in testing practices. The interviews with the chiefs of medicine and surgery and the directors of nursing confirm the high level of anxiety among staff members about acquiring HIV from patients. In three of four hospitals, one or more of the three key clinical staff report asymptomatic testing of at least some patients. In 16.4% of the hospitals where asymptomatic testing is undertaken, one or more staff report that patients are either sometimes or never informed before testing and 38% are not counselled before testing. In 4.2% of the hospitals in which testing identified seropositive patients, infected persons are not always notified; one or more staff interviewed in 25.2% of the hospitals report that seronegative patients may not always be notified of results; likewise, 33.1% of the hospitals do not always include positive test results in hospital records, and 37.7% sometimes or always transfer seropositive patients to another hospital. A major finding is that there is a lack of congruence between the reports of the three different staff members interviewed in each hospital. These conclusions consider the likelihood of developing uniform practices between and within hospitals.
journal_name
Med Carejournal_title
Medical careauthors
Freeman HEdoi
10.1097/00005650-199102000-00001subject
Has Abstractpub_date
1991-02-01 00:00:00pages
87-96issue
2eissn
0025-7079issn
1537-1948journal_volume
29pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract::The application of health status measures in policy research relies considerably on patterns of mortality, life expectancy, and health status indicators, such as hospital readmission and institutionalization rates. In recent years the state of the art in health status measurement has advanced substantially with the de...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/00005650-198903001-00002
更新日期:1989-03-01 00:00:00
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
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Hospitalization is a difficult experience, especially for patients with dementia. Understanding whether better continuity of care (COC) reduces hospitalizations can indicate interventions that might help curb hospitalizations. OBJECTIVE:To estimate the causal impact of COC on hospitalizations and different ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001386
更新日期:2020-11-01 00:00:00
abstract::The authors describe a new model for classifying hospitalized patients with acquired immunodeficiency syndrome (AIDS) according to their severity of illness. In the first phase of the project, a clinical model indicating the relative severity of AIDS complications was formulated, based on the clinical literature and e...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198904000-00009
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:Clinical practice guidelines quickly become outdated. One reason they might not be updated as often as needed is the expense of collecting expert judgment regarding the evidence. The RAND-UCLA Appropriateness Method is one commonly used method for collecting expert opinion. We tested whether a less expensive...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.MLR.0000100583.76137.3E
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVES:To contrast the interpretations of treatment effect estimates using risk adjustment and instrumental variable (IV) estimation methods using observational data when the effects of treatment are heterogeneous across patients. We demonstrate these contrasts by examining the effect of breast conserving surgery p...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318070c069
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Administrative databases are increasingly being used to study the incident dialysis population and have important advantages. However, traditional methods of risk adjustment have limitations in this patient population. OBJECTIVE:Our objective was to develop a prognostic index for 1-year mortality in inciden...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318202aa0b
更新日期:2011-03-01 00:00:00
abstract::Earlier studies have established substantial gender differences in the likelihood of obtaining a psychotropic drug prescription, and a correlation, especially among women, with such family characteristics as family responsibilities, marital separation, divorce or widowhood, and the presence of family stressors such as...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199004000-00001
更新日期:1990-04-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Nearly 38 million Americans have hearing loss. Understanding how sensory deficits such as hearing loss, which limit communication, impact satisfaction has implications for Medicare value-based reimbursement mechanisms. The aim of this study was to characterize the association of functional hearing...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001419
更新日期:2021-01-01 00:00:00
abstract::Past research in continuity of medical care has generally examined its determinants or its consequences. A model is proposed which combines these lines of research and incorporates a continuity measure as a process and specifying variable. The validity of this model is tested with a set of data consisting of 1,410 per...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197910000-00004
更新日期:1979-10-01 00:00:00
abstract:OBJECTIVE:Test whether physicians' counseling patients for smoking cessation with an autonomy supportive rather than controlling style would increase patients' active involvement in the counseling session and increase maintained abstinence. DESIGN:Randomized trial of 27 community-based physicians using two interview s...
journal_title:Medical care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00005650-200108000-00007
更新日期:2001-08-01 00:00:00
abstract::The health care left-a traditional source of critique and reform-has become intellectually less competent and politically less effective in carrying out its historic role in the continuing great debate over health policies and programs. Its credibility has diminished in recent years as it has come to operate on a seri...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198009000-00007
更新日期:1980-09-01 00:00:00
abstract:BACKGROUND:The number of older patients enrolling in health maintenance organizations (HMOs) is increasing. Concerns have been raised that older patients may be targeted by HMOs for more stringent cost-containment mechanisms, including reduced access to expensive specialty care. OBJECTIVES:We investigated the relation...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199912000-00002
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Medical error reporting is an essential component of patient safety enhancement. However, increasingly, the literature points to a problem of underreporting of treatment errors, mainly as a result of the fear of malpractice lawsuits and limited formal data collection systems. Few studies, if any, have examin...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000197035.12311.88
更新日期:2006-02-01 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:Most Veterans Affairs (VA) Health Care System enrollees age 65+ also have the option of obtaining care through Medicare. Reliance upon VA varies widely and there is a need to optimize its prediction in an era of expanding choice for veterans to obtain care within or outside of VA. We examined whether survey-b...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001155
更新日期:2019-08-01 00:00:00
abstract::In response to health care reform, health care providers have begun to develop interorganizational networks. At present, however, relatively little is known about factors facilitating participation in networks. To this end, organizational characteristics and views were obtained from key informants from both "Lead" and...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199505000-00001
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Current health care reform efforts are focused on reorganizing health care systems to reduce waste in the US health care system. OBJECTIVE:To compare rates of overuse in different health care systems and examine whether certain systems of care or insurers have lower rates of overuse of health care services....
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0b013e31828dbafe
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Many of the large ongoing national surveys of the US population contain a question that asks for the respondent's self-reported health status: "excellent," "very good," "good," "fair," or "poor." These surveys could be used to conduct cost-utility analyses of health care policies, treatments or other interve...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31803dce05
更新日期:2007-07-01 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:Community-acquired pneumonia (CAP) is the most common infectious cause of death in the United States. To understand the effect of efforts to improve quality and efficiency of care in CAP, we examined the trends in mortality and costs among hospitalized CAP patients. METHODS:Using the National Inpatient Samp...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181f38006
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVES:Building on Andersen's behavioral model for the utilization of health care services, we examined factors associated with utilization of physician and hospital services among adults in Canada and the United States, with a focus on socioeconomic status (enabling resources in Andersen's framework). METHODS:Usi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181adcbe9
更新日期:2009-11-01 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::Application of generic and specific measures of health status and quality of life to different diseases, conditions, states, and populations is increasing. Four strategies for using these measures are separate generic and specific measures, modified generic measures, disease-specific supplements, and batteries. The pr...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/00005650-198903001-00018
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the impact of removing prior-authorization restrictions on the use of thiazolidinediones (TZDs) and outcomes. METHODS:In a controlled interrupted time-series analysis, whereby new users of antidiabetic agents over 65 years of age in adjacent Canadian provinces with differe...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000006
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Spinal mobilization and manipulation are 2 therapies found to be generally safe and effective for chronic low back pain (CLBP). However, the question remains whether they are appropriate for all CLBP patients. RESEARCH DESIGN:An expert panel used a well-validated approach, including an evidence synthesis an...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001108
更新日期:2019-05-01 00:00:00
abstract::This study developed an index of physician hospitalization practice style distinguishing physicians more prone to hospitalize patients from physicians less prone to hospitalize. The patients of physicians with markedly differing hospitalization styles are shown to be similar in such important characteristics as age, a...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198910000-00001
更新日期:1989-10-01 00:00:00
abstract::The effect of a greater volume of patients with similar conditions being treated at a hospital on the outcomes achieved is studied using a variety of categories of patients, 15 surgical and 2 medical, and involving 550,000 patients treated in over 1,200 nonfederal United States acute care hospitals. After demonstratin...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1984-02-01 00:00:00
abstract::The published preferences for scale steps in a health-related quality-of-life scale have been noted to be contrary to some prior assumptions about their rank ordering. The differences noted are actually statistically nonsignificant, and the observed ordering has a clear intuitive explanation. Several alternative expla...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198205000-00008
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:Drug provision within the German statutory health insurance system has undergone several reforms, including the introduction of drug macrobudgets in 1993. OBJECTIVE:The objective of this study was to investigate the extent to which statutorily (SHI) and fully privately (PHI) health-insured patients were pro...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000124265.13559.02
更新日期:2004-05-01 00:00:00