Abstract:
PURPOSE:The purpose of this study was to examine the association between the prevalence of both diabetes-concordant and diabetes-discordant conditions and the quality of diabetes care at the family practice level in England. We hypothesized that the prevalence of concordant (or discordant) conditions would be associated with better (or worse) quality of diabetes care. METHODS:We conducted a cross-sectional study using practice-level data (7,884 practices). We estimated the practice-level prevalence of diabetes and 15 other chronic conditions, which were classified as diabetes concordant (ie, with the same pathophysiologic risk profile and therefore more likely to be part of the same management plan) or diabetes discordant (ie, not directly related in either their pathogenesis or management). We measured quality of diabetes care with diabetes-specific indicators (8 processes and 3 intermediate outcomes of care). We used linear regression models to quantify the effect of the prevalence of the conditions on aggregate achievement rate for quality of diabetes care. RESULTS:Consistent with the proposed model, the prevalence rates of 4 of 7 concordant conditions (obesity, chronic kidney disease, atrial fibrillation, heart failure) were positively associated with quality of diabetes care. Similarly, negative associations were observed as predicted for 2 of the 8 discordant conditions (epilepsy, mental health). Observations for other concordant and discordant conditions did not match predictions in the hypothesized model. CONCLUSIONS:The quality of diabetes care provided in English family practices is associated with the prevalence of other major chronic conditions at the practice level. The nature and direction of the observed associations cannot be fully explained by the concordant-discordant model.
journal_name
Ann Fam Medjournal_title
Annals of family medicineauthors
Ricci-Cabello I,Stevens S,Kontopantelis E,Dalton AR,Griffiths RI,Campbell JL,Doran T,Valderas JMdoi
10.1370/afm.1848subject
Has Abstractpub_date
2015-11-01 00:00:00pages
514-22issue
6eissn
1544-1709issn
1544-1717pii
13/6/514journal_volume
13pub_type
杂志文章abstract:PURPOSE:We undertook a study to evaluate the effectiveness of corticosteroid injections in primary care patients with greater trochanteric pain syndrome (GTPS). METHODS:We evaluated the effect of corticosteroid injections compared with expectant treatment (usual care) in a pragmatic, multicenter, open-label, randomize...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1232
更新日期:2011-05-01 00:00:00
abstract:PURPOSE:To assess the effect of a primary care-based community-links practitioner (CLP) intervention on patients' quality of life and well-being. METHODS:Quasi-experimental cluster-randomized controlled trial in socioeconomically deprived areas of Glasgow, Scotland. Adult patients (aged 18 years or older) referred to ...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1370/afm.2429
更新日期:2019-11-01 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...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.305
更新日期:2005-09-01 00:00:00
abstract:PURPOSE:Because recognition and management of patients with somatoform disorders are difficult, we wanted to determine the specificity, sensitivity, and the test-retest reliability of the 15-symptom Patient Health Questionnaire (PHQ-15) for detection of somatoform disorders in a high-risk primary care population. METH...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.985
更新日期:2009-05-01 00:00:00
abstract:PURPOSE:We undertook a study to identify distinct functional trajectories in the year before hospice, to determine how patients with these trajectories differ according to demographic characteristics and hospice diagnosis, and to evaluate the association between these trajectories and subsequent outcomes. METHODS:From...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1720
更新日期:2015-01-01 00:00:00
abstract:PURPOSE:We aimed to identify the strategies used to support patient behavior change by clinicians whose patients had an increase in patient activation. METHODS:This mixed methods study was conducted in collaboration with Fairview Health Services, a Pioneer Accountable Care Organization. We aggregated data on the chang...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1904
更新日期:2016-03-01 00:00:00
abstract:PURPOSE:We wanted to evaluate novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 years (from 2009). METHODS:We created recorded ...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1996
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Clinicians are faced with a plethora of guidelines. To rate guidelines, they can select from a number of evaluation tools, most of which are long and difficult to apply. The goal of this project was to develop a simple, easy-to-use checklist for clinicians to use to identify trustworthy, relevant, and useful...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2119
更新日期:2017-09-01 00:00:00
abstract:PURPOSE:Practice transformation in primary care is a movement toward data-driven redesign of care, patient-centered care delivery, and practitioner activation. A critical requirement for achieving practice transformation is availability of tools to engage practices. METHODS:A total of 48 practices with 109 practice si...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2382
更新日期:2019-08-12 00:00:00
abstract:PURPOSE:The US Preventive Services Task Force (USPSTF) is authorized by the US government to review and disseminate the scientific evidence for clinical preventive services. The purpose of this study was to evaluate the alignment of Medicare preventive services coverage with the recommendations of the USPSTF before imp...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1194
更新日期:2011-01-01 00:00:00
abstract::William Osler is quoted as saying, "Nothing will sustain you more potently than the power to recognize in your humdrum routine, as perhaps it may be thought, the true poetry of life-the poetry of the commonplace, of the plain, toil-worn woman, with their loves and their joys, their sorrows and their griefs."(1) A fami...
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
abstract::Efforts to address the current fragmented US health care structure, including controversial federal reform, cannot succeed without a reinvigoration of community-centered health systems. A blueprint for systematic implementation of community services exists in the 1967 Folsom Report--calling for "communities of solutio...
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:Self-harm is a public health problem that requires a better understanding of mortality risk. We undertook a study to examine premature mortality in a nationally representative cohort of primary care patients who had harmed themselves. METHODS:During 2001-2013, a total of 385 general practices in England contri...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2054
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:Few studies have tested the hypothesis that children with sensory disabilities such as deafness may be at increased risk of injuries. To test this hypothesis, this study compared rates of emergency department or hospital treatment for injury among Medicaid-insured South Carolina children with and without a diag...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.740
更新日期:2007-11-01 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
abstract::The American Board of Family Medicine routinely surveys its Diplomates in each national graduating cohort 3 years out of training. These data were used to characterize early career family physicians whose services include management of pregnancy and prescribing buprenorphine. A total of 261 (5.1%) respondents both pro...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2504
更新日期:2020-03-01 00:00:00
abstract:PURPOSE:We wanted to identify characteristics of adults who do not have a usual source of care and then stratify the analysis by those who prefer vs those who do not prefer to have a usual source of care. METHODS:We analyzed data from a nationally representative sample of 9,011 adults to identify characteristics of th...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.557
更新日期:2006-07-01 00:00:00
abstract::Although primary care, including family medicine, recognizes different types of clinician-patient interaction, I argue that only interactions characterized by coprovision define care. By coprovision I mean that clinicians and patients each provide the expertise in health care that they have the capacity to contribute ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.342
更新日期:2005-11-01 00:00:00
abstract:PURPOSE:Our goal was to describe an approach to patient-centered medical home (PCMH) measurement based on delineating the desired properties of the measurement relative to assumptions about the PCMH and the uses of the measure by Blue Cross Blue Shield of Michigan (BCBSM) and health services researchers. METHODS:We de...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1472
更新日期:2013-05-01 00:00:00
abstract::I had intended to spend our spring break week in Montana with my kids and my dad, going to parks and museums together. Instead, I spent the week in the hospital, helping my dad make end-of-life choices and learning more about the importance of communication in health care settings and the preciousness of close relatio...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1908
更新日期:2016-05-01 00:00:00
abstract::Efforts to redesign primary care require multiple supports. Two potential members of the primary care team-practice facilitator and care manager-can play important but distinct roles in redesigning and improving care delivery. Facilitators, also known as quality improvement coaches, assist practices with coordinating ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1462
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:Persons with multiple chronic diseases must integrate self-management tasks for potentially interacting conditions to attain desired clinical outcomes. Our goal was to identify barriers to self-management that were associated with lower perceived health status and, secondarily, with lower reported physical func...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.722
更新日期:2007-09-01 00:00:00
abstract::As a result of a large and compelling body of evidence documenting the impacts of social determinants, such as income and education, on health outcomes, health care systems are beginning to incorporate social and economic risk data into health care delivery decisions. But there is a risk that some of these efforts cou...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2339
更新日期:2019-01-01 00:00:00
abstract:PURPOSE:We undertook a study to examine the impact of experiences shared between patient and physician and the value patients place on continuity of care. METHODS:Data on 4,454 patients collected in The Direct Observation of Primary Care (DOPC) study conducted between October 1994 and August 1995 were analyzed to asse...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.84
更新日期:2004-09-01 00:00:00
abstract:PURPOSE:Despite growing calls for team-based care, the current staff composition of primary care practices is unknown. We describe staffing patterns for primary care practices in the Centers for Medicare and Medicaid Services (CMS) Comprehensive Primary Care (CPC) initiative. METHODS:We undertook a descriptive analysi...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1626
更新日期:2014-03-01 00:00:00
abstract:PURPOSE:Primary care practices in the United Kingdom have received substantial financial rewards for achieving standards set out in the Quality and Outcomes Framework since April 2004. This article reviews the growing evidence for the impact of the framework on the quality of primary medical care. METHODS:Five hundred...
journal_title:Annals of family medicine
pub_type: 杂志文章,评审
doi:10.1370/afm.1377
更新日期:2012-09-01 00:00:00
abstract::During a night of severe pain and weakness, I found several plausible-sounding diagnoses online: occipital neuralgia, nerve damage, and meningitis. The next day, I consulted a physician who did not offer professional guidance; instead the physician suggested tests entirely based on my self-diagnoses. What resulted was...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2414
更新日期:2019-09-01 00:00:00
abstract::Two voices tell the story of an evolving doctor-patient relationship. Seizures are the first indication of squamous cell lung cancer metastatic to the brain. Both doctor and patient describe the course of the illness, treatment, and remarkable recovery, each from his own perspective. The patient describes how the canc...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.9
更新日期:2003-05-01 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
abstract:PURPOSE:In screening for type 2 diabetes, guidelines recommend targeting high-risk individuals. Our objectives were to assess the yield of opportunistic targeted screening for type 2 diabetes in primary care and to assess the diagnostic value of various risk factors. METHODS:In 11 family practices (total practice popu...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.997
更新日期:2009-09-01 00:00:00