The feasibility of an outcome approach to quality assurance--a report from one HMO.

abstract：BACKGROUND:Consumer concerns about the restrictions of managed care may lead to distrust. OBJECTIVES:To examine whether a community's level of gatekeeping activity is associated with an individual's trust in medical care. RESEARCH DESIGN:Cross-sectional cohort (N = 49,929). SUBJECTS:Participants in a nationally repr...

journal_title：Medical care

authors： Haas JS,Phillips KA,Baker LC,Sonneborn D,McCulloch CE

更新日期：2003-05-01 00:00:00

abstract：:As interest in the problem-oriented medical record (POMR) develops, and more medical settings begin to implement the system, many observers are expressing a desire to know how well the system is being used and accepted. Moreover, settings currently using the POMR system have a need to document the effectiveness of the...

journal_title：Medical care

authors： Hammett WH,Sandlow LJ,Bashook PG

更新日期：1976-10-01 00:00:00

abstract：:In comparison to the living conditions that existed before 1949, the People's Republic of China (PRC) represents a remarkable story of achievement. Western knowledge about the PRC has recently increased by leaps and bounds as detente with the United States has allowed many Americans to witness the "awakening of the dr...

journal_title：Medical care

authors： Louie R

更新日期：1978-07-01 00:00:00

abstract：OBJECTIVES:To examine the prevalence of obesity and its relationship with pressure ulcers among nursing home (NH) populations, and whether such relationship varies with certified nursing assistant (CNA) level in NHs. DATA AND STUDY POPULATION: The 1999-2009 nationwide Minimum Data Sets were linked with Online Survey of...

journal_title：Medical care

authors： Cai S,Rahman M,Intrator O

更新日期：2013-06-01 00:00:00

abstract：:Hospital cost-containment programs should themselves be cost-effective, targeting high-cost physicians (which requires adjusting for case mix) and patients (which requires early identification). In this study, clinical data available within 24 hours of admission from an electronic medical record system were used to de...

journal_title：Medical care

authors： Tierney WM,Fitzgerald JF,Miller ME,James MK,McDonald CJ

更新日期：1995-01-01 00:00:00

abstract：:Substantial differences in the use of pediatric medical resources reinforce the need for identifying and understanding factors that influence the use of medical services for children. This research assesses the simultaneous impact of sociodemographic characteristics, health attitudes and beliefs, psychologic distress,...

journal_title：Medical care

authors： Horwitz SM,Morgenstern H,Berkman LF

更新日期：1985-08-01 00:00:00

abstract：OBJECTIVE:The purpose of this study was to identify hospital organizational characteristics consistently associated with adherence to multiple clinical practice guidelines (CPGs). We examined the relationship between organizational and patient population characteristics and adherence to three screening CPGs implemented...

journal_title：Medical care

authors： Vaughn TE,McCoy KD,BootsMiller BJ,Woolson RF,Sorofman B,Tripp-Reimer T,Perlin J,Doebbeling BN

更新日期：2002-12-01 00:00:00

abstract：:When studying variation in medicine, traditional hypothesis-testing procedures are too limited to obtain useful inferences except in special situations. More generally, full probability modelling is necessary. Even a relatively simple example can illustrate this point rather dramatically. The development and applicati...

journal_title：Medical care

authors： Rubin DB

更新日期：1993-05-01 00:00:00

abstract：OBJECTIVES:Adverse outcome rates are increasingly used as yardsticks for the quality of hospital care. However, the validity of many outcome studies has been undermined by the application of one outcome to all patients in large, diagnostically diverse populations, many of which lack evidence of a link between anteceden...

journal_title：Medical care

authors： Wray NP,Peterson NJ,Souchek J,Ashton CM,Hollingsworth JC

更新日期：1997-08-01 00:00:00

abstract：BACKGROUND:Nearly half of US births are financed by Medicaid, and one-third of births occur by cesarean delivery, at double the cost of vaginal delivery. With the goal of reducing unnecessary cesarean use and improving value, in 2009 Minnesota's Medicaid program introduced a blended payment rate for uncomplicated birth...

journal_title：Medical care

authors： Kozhimannil KB,Graves AJ,Ecklund AM,Shah N,Aggarwal R,Snowden JM

更新日期：2018-08-01 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

authors： Hibbard JH,Weeks EC

更新日期：1987-11-01 00:00:00

abstract：OBJECTIVE:To identify consistent provision of clinical preventive services, we sought to benchmark all acute care Veterans Affairs Medical Centers (VAMCs) against each other nationally on the basis of multiple evidence-based, performance measures to identify facilities performing consistently higher and lower than expe...

journal_title：Medical care

authors： Doebbeling BN,Vaughn TE,Woolson RF,Peloso PM,Ward MM,Letuchy E,BootsMiller BJ,Tripp-Reimer T,Branch LG

更新日期：2002-06-01 00:00:00

abstract：:This article assesses the extent to which formally provided comprehensive community care tends to substitute for informal care provided by family and friends to impaired elderly persons living in the community. Using simultaneous equations causal modeling techniques to control for selective targeting and other interve...

journal_title：Medical care

authors： Greene VL

更新日期：1983-06-01 00:00:00

abstract：:Between 1989 and 1992, the Agency for Health Care Policy and Research (AHCPR) awarded funding to 14 special projects known as Patient Outcomes Research Teams (PORTs). These large, complex projects form the centerpiece of the first generation of research under the Medical Treatment Effectiveness Program. In carrying ou...

journal_title：Medical care

authors： Maklan CW,Greene R,Cummings MA

更新日期：1994-07-01 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

authors： Ruhnke GW,Coca-Perraillon M,Kitch BT,Cutler DM

更新日期：2010-12-01 00:00:00

abstract：BACKGROUND:Indwelling urinary catheters are used postoperatively in hip fracture care. Their use beyond the immediate postoperative period may result in excess nosocomial infections. OBJECTIVES:The objectives of this study were to explore the relationship between extended indwelling urinary catheterization and outcome...

journal_title：Medical care

authors： Wald H,Epstein A,Kramer A

更新日期：2005-10-01 00:00:00

abstract：:Queues arise in medical care and serve as allocators in the absence of an effective market and when resources become perceptibly constrained. This is essentially the case in all countries where money is not the means for gaining access to medical services. A study estimated that the total wait in England was 96 days f...

journal_title：Medical care

authors： Bloom BS,Fendrick AM

更新日期：1987-02-01 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

authors： Patrick DL,Deyo RA

更新日期：1989-03-01 00:00:00

abstract：BACKGROUND:Increasing surgical access to previously underserved populations in the United States may require a major expansion of the use of operating rooms on weekends to take advantage of unused capacity. Although the so-called weekend effect for surgery has been described in other countries, it is unknown whether US...

journal_title：Medical care

authors： Glance LG,Osler T,Li Y,Lustik SJ,Eaton MP,Dutton RP,Dick AW

更新日期：2016-06-01 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

authors： Drye EE,Altaf FK,Lipska KJ,Spatz ES,Montague JA,Bao H,Parzynski CS,Ross JS,Bernheim SM,Krumholz HM,Lin Z

更新日期：2018-02-01 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

authors： Bellin LE

更新日期：1980-09-01 00:00:00

abstract：BACKGROUND:Research on frequent emergency department (ED) use shows that a subgroup of patients visits multiple EDs. This study characterizes these individuals. OBJECTIVE:The objective of this study was to determine how many frequent ED users seek care at multiple EDs and to identify sociodemographic, clinical, and co...

journal_title：Medical care

authors： Giannouchos TV,Washburn DJ,Kum HC,Sage WM,Ohsfeldt RL

更新日期：2020-02-01 00:00:00

abstract：BACKGROUND:Although there are several studies of the human and system factors that influence the outcomes of cardiac surgery, it remains difficult to draw conclusions because many do not simultaneously adjust for the characteristics of patients, physicians, and institutions. The current study explores the associations ...

journal_title：Medical care

authors： Norcini JJ,Boulet JR,Opalek A,Dauphinee WD

更新日期：2013-12-01 00:00:00

abstract：:In this study, changes in the number, site, and source of follow-up visits and allowed charges were examined for follow-up visits provided to Medicare surgical patients between 1984 and 1986. Among the 21 surgical procedures studied, follow-up visits decreased by 5.2%, after adjusting for case mix. Despite the physici...

journal_title：Medical care

authors： Kominski GF,Biddle AK

更新日期：1993-03-01 00:00:00

abstract：BACKGROUND:Many state Medicaid programs use prior authorization programs to limit spending on cyclooxygenase-2 selective nonsteroidal anti-inflammatory drugs (coxibs). However, the evidence base for the prior authorization criteria has not been examined previously. METHODS:We determined whether prior authorization was...

journal_title：Medical care

authors： Fischer MA,Cheng H,Schneeweiss S,Avorn J,Solomon DH

更新日期：2006-07-01 00:00:00

abstract：BACKGROUND:Physician and patient gender both influence medical communication. Nonverbal behavior is generally under-researched in the medical encounter but plays an important role for patient outcomes such as satisfaction. OBJECTIVE:This article aims at identifying how specific physician nonverbal behaviors predict an...

journal_title：Medical care

authors： Mast MS,Hall JA,Köckner C,Choi E

更新日期：2008-12-01 00:00:00

abstract：OBJECTIVE:Emergency departments (ED) were on the front lines for possible cases of transmission during the severe acute respiratory syndrome (SARS) epidemic. The purpose of this study was to investigate the impact of the SARS catastrophe on an urban ED. METHODS:The patients' characteristics in an urban ED were collect...

journal_title：Medical care

authors： Chen WK,Cheng YC,Chung YT,Lin CC

更新日期：2005-02-01 00:00:00

abstract：:The techniques of cost-effectiveness are employed to simplify resource allocation decisions concerned with the use of land and air transport systems in the health services of a developing country. Outcome classifications are produced for patients seen by mobile and fixed primary care units. The mobile services examine...

journal_title：Medical care

authors： Walker G,Gish O

更新日期：1977-04-01 00:00:00

abstract：BACKGROUND:Patient-centered communication (PCC) is associated with more appropriate treatment of depression in primary care. Aside from patient presentation, little is known about other influences on PCC. We investigated whether PCC is influenced by personality dispositions of primary care providers, independent of pat...

journal_title：Medical care

authors： Chapman BP,Duberstein PR,Epstein RM,Fiscella K,Kravitz RL

更新日期：2008-08-01 00:00:00

abstract：BACKGROUND:Hospital administrative health data create separate records for each hospital stay of patients. Treating a hospital transfer as a readmission could lead to biased results in health service research. METHODS:This is a cross-sectional study. We used the hospital discharge abstract database in 2013 from Albert...

journal_title：Medical care

authors： Peng M,Li B,Southern DA,Eastwood CA,Quan H

更新日期：2017-01-01 00:00:00