Abstract:
:There are various reasons why physicians order laboratory tests. Earlier studies have shown that in many cases test-ordering behavior lacks efficiency, resulting in excessive laboratory utilization. Throughout the years various attempts have been made to improve this situation. This review, based on the literature of the past 20 years, gives a survey of interventions and their effectiveness. Various types of education are discussed: general, cost-control oriented and education by means of guidelines, protocols, decision support systems, and feedback (on test ordering or cost). The discussion addresses the quality and apparent restrictions of the studies, and provides possible causes of the widely varying, but mostly low success rates. The long-term effectiveness of interventions aiming at better laboratory ordering is rather unfavorable.
journal_name
Med Carejournal_title
Medical careauthors
Axt-Adam P,van der Wouden JC,van der Does Edoi
10.1097/00005650-199309000-00003subject
Has Abstractpub_date
1993-09-01 00:00:00pages
784-94issue
9eissn
0025-7079issn
1537-1948journal_volume
31pub_type
杂志文章,评审相关文献
MEDICAL CARE文献大全abstract:BACKGROUND:Applying disease-specific guidelines to people with multimorbidity may result in complex regimens that impose treatment burden. OBJECTIVES:To describe and validate a measure of healthcare task difficulty (HCTD) in a sample of older adults with multimorbidity. RESEARCH DESIGN:Cross-sectional and longitudina...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3182a977da
更新日期:2014-03-01 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:Utility techniques are the most commonly used means to assess patient preferences for health outcomes. However, whether utility techniques produce valid measures of preference has been difficult to determine in the absence of a gold standard. OBJECTIVE:To introduce and demonstrate two methods that can be us...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199906000-00007
更新日期:1999-06-01 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:Risk adjustment is useful for adjusting health care payments based on patients' health status. OBJECTIVE:This work seeks to examine how well pharmacy- and diagnosis-based risk adjusters predict child health expenditures in Medicaid populations. RESEARCH DESIGN:We used 1994-1995 Medicaid claims files for al...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000182551.87591.73
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:The 3 primary administrative data sets developed by the Centers for Medicare and Medicaid services (CMS) to support the Medicare Part D program implementation represent a valuable source of data for health services researchers. This paper describes the structure of the Medicare Part D program and the related...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318041385f
更新日期:2007-10-01 00:00:00
abstract::This article analyzes reported data on length of stay of discharged patients from the 1977 National Nursing Home Survey. Assuming that patients admitted to nursing homes are one of two types, short-stayers and long-stayers, the statistically best-fitting proportions and expected lengths of stay for the two types are d...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198103000-00011
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVES:Although information technology (IT) may improve efficiency and quality of patient care, the adoption of clinical IT by physicians has been limited. This study investigates the relationships between physician practice revenue and use of clinical IT. RESEARCH DESIGN:We undertook a cross-sectional analysis of...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000241089.98461.e5
更新日期:2007-02-01 00:00:00
abstract::This study analyzes the relationship between medical student participation in rural training programs, including preceptorships, and the decision to locate medical practice in rural areas. Data consist primarily of responses to questionnaires mailed in 1972 to all graduates of United States medical schools in 1965. St...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197503000-00004
更新日期:1975-03-01 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:BACKGROUND:Monitoring mental health treatment outcomes for populations requires an understanding as to which patient information is needed in electronic format and is feasible to obtain in routine care. OBJECTIVE:To examine whether bipolar disorder outcomes can be accurately predicted and how much clinical detail is n...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3182422aec
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Labor unions have been a weak force in the medical marketplace. OBJECTIVES:To briefly review the history of physicians' and nurses' labor unions, explore the ethics of unions in medicine, and offer a solution that simultaneously serves patients and professionals. RESEARCH DESIGN:A selective review of the l...
journal_title:Medical care
pub_type: 评论,杂志文章
doi:10.1097/MLR.0000000000000123
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:The relative performance of three widely used generic health status measures (EQ-5D, a modified HUI3 [mHUI3], and SF-12) was compared within a general population sample. MATERIALS AND METHODS:Data were taken from a cohort of persons identified from the patient list of a large general practice in York, UK. T...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.MLR.0000044901.57067.19
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Among older women with early-stage breast cancer, patients with a short life expectancy (LE) are much less likely to benefit from adjuvant radiation therapy (RT). Little is known about the impact of physicians and regional factors on the use of RT across LE groups. OBJECTIVE:To determine the relative contri...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31827631b0
更新日期:2013-04-01 00:00:00
abstract::To study associations between payer and provision of services for patients hospitalized for coronary atherosclerosis, the authors analyzed abstracts of 24,424 discharges from California acute care hospitals during 1989. Services examined included receipt of coronary artery bypass surgery, percutaneous transluminal cor...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199507000-00007
更新日期:1995-07-01 00:00:00
abstract::To enhance the efficient utilization of health providers, medical care researchers are increasingly concerned with the measurement of task performance. One job analysis methodology that is widely used is the task inventory technique, characterized by retrospective self-reporting. The purpose of this study was to valid...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197502000-00002
更新日期:1975-02-01 00:00:00
abstract::Sequential analysis can be used as an early warning system about potential unintended consequences of health policy decisions, generating follow-up investigations, but it should not be used as causal evidence. ...
journal_title:Medical care
pub_type: 评论,杂志文章
doi:10.1097/MLR.0000000000000896
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Barriers to colorectal cancer (CRC) screening are not well understood. OBJECTIVES:We sought to compare barriers to CRC screening reported by primary care physicians (PCPs) and by average-risk adults, and to examine characteristics of average-risk adults who identified lack of provider recommendation as a ma...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000173599.67470.ba
更新日期:2005-09-01 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::Mental health services were included in comprehensive benefits available with no out-of-pocket expenses to enrollees in the Seattle Prepaid Health Care Project. This study was designed to examine the characteristics of users as compared to nonusers of mental health services and to examine the possibility of lower use ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197909000-00005
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:Difference-in-differences (DID) estimation has become increasingly popular as an approach to evaluate the effect of a group-level policy on individual-level outcomes. Several statistical methodologies have been proposed to correct for the within-group correlation of model errors resulting from the clustering...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0000000000000830
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The appropriate use of medications can influence quality performance measures and costs. Drug-related morbidity and mortality represents a public health challenge due to the ineffective and unsafe consequences of medication use. This article addresses the impact of team-based care that incorporates comprehen...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31826ecf9a
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Estimates of the costs of medical care vary across patient populations, data sources, and methods. The objective of this study was to compare 3 approaches for estimating the incidence costs of colorectal cancer (CRC) care using similar patient populations, but different data sources and methods. METHODS:We ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181a4f482
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To explore the relationship between type of initial care as well as the likelihood of recurrence and consequent care seeking behavior. RESEARCH DESIGN:Prospective observational cohort recruited from 208 randomly selected North Carolina practices. Cohort study examined the recurrence of low back pain among pa...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199902000-00006
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Case-mix adjustment is widely used in health services research to ensure that groups being compared are equivalent on variables predicting outcome. There has been considerable development and testing of comorbidity indices derived from diagnostic codes recorded in administrative databases, but increasingly, ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000185749.04875.cb
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Federal, state, and local governments provide substantial subsidies to so-called "safety-net" hospitals, in part, to offset the loss in revenue associated with providing a disproportionate share (DSH) of care to low-income and uninsured patients, with the goal to improve access to care for uninsured and ensu...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181e3572c
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inp...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000680
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:Reliability and validity are as necessary for predrafted advance directive forms as they are for all clinical assessment instruments. Performance of predrafted advance directive forms with both lay persons and clinicians is relevant. Evidence relating to test- retest reliability, content validity, and criter...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199610000-00006
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Eliminating barriers to care is important for improving health service use. However, the barriers to mental health care have not been well investigated. OBJECTIVES:This study was designed to provide information about the barriers to mental health service use and to identify clinical factors associated with ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000196954.67658.95
更新日期:2006-02-01 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