当前位置： SCI文献检索 > JOURNAL OF GENERAL INTERNAL MEDICINE期刊下所有文献 > Differences between generalists and specialists in characteristics of patients receiving gastrointestinal procedures.

Differences between generalists and specialists in characteristics of patients receiving gastrointestinal procedures.

Abstract：

BACKGROUND:As a result of market forces and maturing technology, generalists are currently providing services, such as colonoscopy, that in the past were deemed the realm of specialists. OBJECTIVE:To determine whether there were differences in patient characteristics, procedure complexity, and clinical indications when gastrointestinal endoscopic procedures were provided by generalists versus specialists. DESIGN:Retrospective cohort study. PATIENTS:A random 5% sample of aged Medicare beneficiaries who underwent rigid and flexible sigmoidoscopy, colonoscopy, and esophagogastroduodenoscopy (EGD) performed by specialists (gastroenterologists, general surgeons, and colorectal surgeons) or generalists (general practitioners, family practitioners, and general internists). MEASUREMENTS:Characteristics of patients, indications for the procedure, procedural complexity, and place of service were compared between generalists and specialists using descriptive statistics and logistic regression. MAIN RESULTS:Our sample population had 167,347 gastrointestinal endoscopies. Generalists performed 7.7% of the 57, 221 colonoscopies, 8.7% of the 62,469 EGDs, 42.7% of the 38,261 flexible sigmoidoscopies, and 35.2% of the 9,396 rigid sigmoidoscopies. Age and gender of patients were similar between generalists and specialists, but white patients were more likely to receive complex endoscopy from specialists. After adjusting for patient differences in age, race, and gender, generalists were more likely to have provided a simple diagnostic procedure (odds ratio [OR] 4.2; 95% confidence interval [95% CI] 4.0, 4.4), perform the procedure for examination and screening purposes (OR 4.9; 95% CI, 4. 3 to 5.6), and provide these procedures in rural areas (OR 1.5; 95% CI 1.4 to 1.6). CONCLUSIONS:Although generalists perform the full spectrum of gastrointestinal endoscopies, their procedures are often of lower complexity and less likely to have been performed for investigating severe morbidities.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Meyer GS,Cheng EY,Elting J

doi

10.1046/j.1525-1497.2000.06039.x

subject

Has Abstract

pub_date

2000-03-01 00:00:00

pages

188-94

issue

3

eissn

0884-8734

issn

1525-1497

pii

jgi06039

journal_volume

15

pub_type

杂志文章

相关文献

JOURNAL OF GENERAL INTERNAL MEDICINE文献大全
  • The relationship of patient characteristics to physician delivery of advice to stop smoking.

    abstract：:To investigate the frequency of physician delivery of advice to stop smoking and patient characteristics affecting whether physicians deliver such advice, the authors surveyed 97 current cigarette smokers seen in two specialty and one general medicine clinic at a university medical center. Approximately two thirds of ...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/BF02596170

    authors： Ockene JK,Hosmer DW,Williams JW,Goldberg RJ,Ockene IS,Biliouris T,Dalen JE

    更新日期：1987-09-01 00:00:00

  • National Survey of Medical Spanish Curriculum in U.S. Medical Schools.

    abstract：BACKGROUND:Patients with limited English proficiency (LEP) may be at risk for medical errors and worse health outcomes. Language concordance between patient and provider has been shown to improve health outcomes for Spanish-speaking patients. Nearly 40 % of Hispanics, a growing population in the United States, are cate...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-015-3309-3

    authors： Morales R,Rodriguez L,Singh A,Stratta E,Mendoza L,Valerio MA,Vela M

    更新日期：2015-10-01 00:00:00

  • Do physicians spend more time with non-English-speaking patients?

    abstract：OBJECTIVE:To determine whether physicians at a general internal medicine clinic spend more time with non-English-speaking patients. DESIGN:A time-motion study comparing physician time spent with non-English-speaking patients and time spent with English-speaking patients during 5 months of observation. We also tested p...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1046/j.1525-1497.1999.00338.x

    authors： Tocher TM,Larson EB

    更新日期：1999-05-01 00:00:00

  • Association between length of residence and cardiovascular disease risk factors among an ethnically diverse group of United States immigrants.

    abstract：BACKGROUND:Although differences in cardiovascular disease (CVD) risk factors between immigrants and nonimmigrants have been examined previously, the effect of acculturation on CVD risk factors in immigrants has been less well studied. OBJECTIVE:To determine the association between length of U.S. residence (proxy for a...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-007-0163-y

    authors： Koya DL,Egede LE

    更新日期：2007-06-01 00:00:00

  • Chapter 12: systematic review of prognostic tests.

    abstract：:A number of new biological markers are being studied as predictors of disease or adverse medical events among those who already have a disease. Systematic reviews of this growing literature can help determine whether the available evidence supports use of a new biomarker as a prognostic test that can more accurately p...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章,评审

    doi：10.1007/s11606-011-1899-y

    authors： Rector TS,Taylor BC,Wilt TJ

    更新日期：2012-06-01 00:00:00

  • Impact of Pregnancy and Gender on Internal Medicine Resident Evaluations: A Retrospective Cohort Study.

    abstract：BACKGROUND:Pregnancy and its impact on graduate medical training are not well understood. OBJECTIVE:To examine the effect of gender and pregnancy for Internal Medicine (IM) residents on evaluations by peers and faculty. DESIGN:This was a retrospective cohort study. SUBJECTS:All IM residents in training from July 1, ...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-017-4010-5

    authors： Krause ML,Elrashidi MY,Halvorsen AJ,McDonald FS,Oxentenko AS

    更新日期：2017-06-01 00:00:00

  • Adherence to screening mammography recommendations in a university general medicine clinic.

    abstract：OBJECTIVE:To determine factors predicting adherence to a health care provider's screening mammography recommendation in a general internal medicine practice. DESIGN:Prospective observational study. SETTING:An urban academic general internal medicine practice. PATIENTS:Three hundred forty-nine asymptomatic women, age...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/BF02599947

    authors： Dolan NC,Reifler DR,McDermott MM,McGaghie WC

    更新日期：1995-06-01 00:00:00

  • Suspected pulmonary embolism and lung scan interpretation: trial of a Bayesian reporting method.

    abstract：OBJECTIVE:To determine whether a Bayesian method of lung scan (LS) reporting could influence the management of patients with suspected pulmonary embolism (PE). DESIGN:1) A descriptive study of the diagnostic process for suspected PE using the new reporting method; 2) a non-experimental evaluation of the reporting meth...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/BF02600392

    authors： Becker DM,Philbrick JT,Schoonover FW,Teates CD

    更新日期：1990-07-01 00:00:00

  • Readability of patient education materials available at the point of care.

    abstract：BACKGROUND:Many patient education materials (PEMs) available on the internet are written at high school or college reading levels, rendering them inaccessible to the average US resident, who reads at or below an 8(th) grade level. Currently, electronic health record (EHR) providers partner with companies that produce P...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章,随机对照试验

    doi：10.1007/s11606-012-2046-0

    authors： Stossel LM,Segar N,Gliatto P,Fallar R,Karani R

    更新日期：2012-09-01 00:00:00

  • Annual Spending per Patient and Quality in Hospital-Owned Versus Physician-Owned Organizations: an Observational Study.

    abstract：BACKGROUND:Recent studies that compared patient spending in hospital-owned physician practices versus physician-owned groups did not compare quality of care. Past studies had incomplete measures of physician-hospital integration, or lacked patient-level data. OBJECTIVE:To measure the association between physician-hosp...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-019-05312-z

    authors： Ho V,Metcalfe L,Vu L,Short M,Morrow R

    更新日期：2020-03-01 00:00:00

  • Geographic methods for understanding and responding to disparities in mammography use in Toronto, Canada.

    abstract：OBJECTIVE:To use spatial and epidemiologic analyses to understand disparities in mammography use and to formulate interventions to increase its uptake in low-income, high-recent immigration areas in Toronto, Canada. DESIGN:We compared mammography rates in four income-immigration census tract groups. Data were obtained...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1111/j.1525-1497.2004.30270.x

    authors： Glazier RH,Creatore MI,Gozdyra P,Matheson FI,Steele LS,Boyle E,Moineddin R

    更新日期：2004-09-01 00:00:00

  • Intimate partner violence identification and response: time for a change in strategy.

    abstract：BACKGROUND:While victims of intimate partner violence (IPV) present to health care settings for a variety of complaints; rates and predictors of case identification and intervention are unknown. OBJECTIVE:Examine emergency department (ED) case finding and response within a known population of abused women. DESIGN:Ret...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-011-1662-4

    authors： Rhodes KV,Kothari CL,Dichter M,Cerulli C,Wiley J,Marcus S

    更新日期：2011-08-01 00:00:00

  • AIDS prevention in primary care clinics: testing the market.

    abstract：:To assess attitudes toward educational programs about AIDS, 540 patients and 36 of their medical providers in primary care clinics were systematically sampled to ascertain what age groups should be exposed to a pamphlet entitled "Am I at Risk for AIDS?", as well as what was acceptable content for posters and pamphlets...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/BF02596487

    authors： Mathews WC,Linn LS

    更新日期：1989-01-01 00:00:00

  • Reducing barriers to mental health and social services for Iraq and Afghanistan veterans: outcomes of an integrated primary care clinic.

    abstract：BACKGROUND:Despite high rates of post-deployment psychosocial problems in Iraq and Afghanistan veterans, mental health and social services are under-utilized. OBJECTIVE:To evaluate whether a Department of Veterans Affairs (VA) integrated care (IC) clinic (established in April 2007), offering an initial three-part prim...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-011-1746-1

    authors： Seal KH,Cohen G,Bertenthal D,Cohen BE,Maguen S,Daley A

    更新日期：2011-10-01 00:00:00

  • Effects of a Specialized Primary Care Facility on Preventive Service Use Among Autistic Adults: a Retrospective Claims Study.

    abstract：BACKGROUND:While in some studies, the patient-centered medical home has been linked with increased receipt of preventive services among other populations, there is a paucity of literature testing the effectiveness of medical homes in serving the healthcare needs of autistic adults. OBJECTIVE:To compare the receipt of ...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-020-06513-7

    authors： Hand BN,Gilmore D,Coury DL,Darragh AR,Moffatt-Bruce S,Hanks C,Garvin JH

    更新日期：2021-01-19 00:00:00

  • Ethnic differences in the self-recognition of obesity and obesity-related comorbidities: a cross-sectional analysis.

    abstract：BACKGROUND:Obesity and its related co-morbidities place a huge burden on the health care system. Patients who know they are obese may better control their weight or seek medical attention. Self-recognition may be affected by race/ethnicity, but little is known about racial/ethnic differences in knowledge of obesity's h...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章,多中心研究

    doi：10.1007/s11606-010-1623-3

    authors： Sivalingam SK,Ashraf J,Vallurupalli N,Friderici J,Cook J,Rothberg MB

    更新日期：2011-06-01 00:00:00

  • The effect of resident involvement on community hospital charges.

    abstract：:Attempts to explain the high cost of care in teaching hospitals have yielded conflicting results. This study was conducted to compare hospital charges and lengths of stay for two groups of patients: one cared for by a resident team and the other cared for by attending physicians. The study was conducted at a universit...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/BF02602350

    authors： Dunn PM,Parker DF,Levinson W,Mullooly JP

    更新日期：1989-03-01 00:00:00

  • Advance Care Planning Prior to Death in Older Adults with Hip Fracture.

    abstract：BACKGROUND:Although hip fractures in older adults are associated with a high degree of mortality and disability, the use of advance care planning (ACP) in this population is unknown. OBJECTIVE:To determine the prevalence of ACP and need for surrogate decision-making prior to death in older adults with hip fracture and...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-020-05644-1

    authors： Kata A,Cenzer I,Sudore RL,Covinsky KE,Tang VL

    更新日期：2020-07-01 00:00:00

  • Sources of Information and Beliefs About the Health Effects of Marijuana.

    abstract：BACKGROUND:Marijuana is currently legal for recreational use in 10 states and Washington DC while a total of 34 states have implemented varying degrees of medical marijuana. The commercialization of marijuana has been accompanied by a proliferation of false claims regarding the therapeutic potential of marijuana, which...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-019-05335-6

    authors： Ishida JH,Zhang AJ,Steigerwald S,Cohen BE,Vali M,Keyhani S

    更新日期：2020-01-01 00:00:00

  • Are Improvements in Measured Performance Driven by Better Treatment or "Denominator Management"?

    abstract：BACKGROUND:Process measures of healthcare quality are usually formulated as the number of patients who receive evidence-based treatment (numerator) divided by the number of patients in the target population (denominator). When the systems being evaluated can influence which patients are included in the denominator, it ...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-015-3558-1

    authors： Harris AH,Chen C,Rubinsky AD,Hoggatt KJ,Neuman M,Vanneman ME

    更新日期：2016-04-01 00:00:00

  • A traditionally administered short course failed to improve medical students' diagnostic performance. A quantitative evaluation of diagnostic thinking.

    abstract：BACKGROUND:Quite often medical students or novice residents have difficulty in ruling out diseases even though they are quite unlikely and, due to this difficulty, such students and novice residents unnecessarily repeat laboratory or imaging tests. OBJECTIVE:To explore whether or not a carefully designed short trainin...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1111/j.1525-1497.2004.30257.x

    authors： Noguchi Y,Matsui K,Imura H,Kiyota M,Fukui T

    更新日期：2004-05-01 00:00:00

  • Impact of localizing physicians to hospital units on nurse-physician communication and agreement on the plan of care.

    abstract：BACKGROUND:A significant barrier to communication among patient care providers in hospitals is the geographic dispersion of team members. OBJECTIVE:To determine whether localizing physicians to specific patient care units improves nurse-physician communication and agreement on patients' plans of care. METHODS:We cond...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-009-1113-7

    authors： O'Leary KJ,Wayne DB,Landler MP,Kulkarni N,Haviley C,Hahn KJ,Jeon J,Englert KM,Williams MV

    更新日期：2009-11-01 00:00:00

  • Patients with depression are at increased risk for secondary cardiovascular events after lower extremity revascularization.

    abstract：BACKGROUND:For patients with peripheral arterial disease (PAD), depression is associated with worse patency and recurrent symptoms in the treated leg, but its association with death or cardiovascular events in other vascular beds is unknown. OBJECTIVE:To assess the association between depression and mortality or cardi...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-008-0560-x

    authors： Cherr GS,Zimmerman PM,Wang J,Dosluoglu HH

    更新日期：2008-05-01 00:00:00

  • Predictors of physicians' responses to woman abuse: the role of gender, background, and brief training.

    abstract：OBJECTIVE:To assess the relationship between gender, background, and brief training and physicians' detection of and treatment for woman abuse. DESIGN:Quasi-experimental and correlational designs, plus control for background factors. SETTING:Two residency training programs: general internal medicine and family practi...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/BF02599714

    authors： Saunders DG,Kindy P Jr

    更新日期：1993-11-01 00:00:00

  • Defining the Resident Continuity Clinic Panel Along Patient Outcomes: a Health Equity Opportunity.

    abstract：BACKGROUND:Continuity clinics are a critical component of outpatient internal medicine training. Little is known about the population of patients cared for by residents and how these physicians perform. OBJECTIVES:To compare resident and faculty performance on standard population health measures. To identify potential...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/s11606-020-06420-x

    authors： Amat M,Glassman R,Basu N,Doolin J,Flier L,Gonzalez MR,Gosselin J,Knapp S,Yun P,Graham KL

    更新日期：2021-01-21 00:00:00

  • Intern call structure and patient satisfaction.

    abstract：:Our institution has instituted "short-call" and "nightfloat" systems to reduce the number of admissions to the traditional "long-call" housestaff. However, the nightfloat system introduces increased discontinuity to patient care, and interns may spend less time with short-call patients because they are nor required to...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1046/j.1525-1497.1997.012005308.x

    authors： Griffith CH 3rd,Wilson JF,Rich EC

    更新日期：1997-05-01 00:00:00

  • Estimated prevalences of panic disorder and depression among consecutive patients seen in an emergency department with acute chest pain.

    abstract：OBJECTIVE:1) To determine whether the frequencies of panic disorder (PD) and depression (DEP) in an emergency department (ED) population were comparable to those in other primary care groups; 2) to evaluate whether patients without the clinical diagnosis of acute cardiac ischemia (ACI) had higher frequencies of these d...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1007/BF02600087

    authors： Yingling KW,Wulsin LR,Arnold LM,Rouan GW

    更新日期：1993-05-01 00:00:00

  • Older patients' aversion to antidepressants. A qualitative study.

    abstract：BACKGROUND:Depression is common among older patients yet is often inadequately treated. Patient beliefs about antidepressants are known to affect treatment initiation and adherence, but are often not expressed in clinical settings. OBJECTIVE:To explore attitudes toward antidepressants in a sample of depressed, communi...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章

    doi：10.1111/j.1525-1497.2005.00296.x

    authors： Givens JL,Datto CJ,Ruckdeschel K,Knott K,Zubritsky C,Oslin DW,Nyshadham S,Vanguri P,Barg FK

    更新日期：2006-02-01 00:00:00

  • The patient centered medical home as curricular model: perceived impact of the "education-centered medical home".

    abstract：BACKGROUND:The patient-centered medical home (PCMH) model aims to provide patient-centered care, lower costs, and improve health outcomes. Medical students have not been meaningfully integrated in this model. AIM:To test the feasibility of a longitudinal clerkship based on PCMH principles and anchored by PCMH educatio...

    journal_title：Journal of general internal medicine

    pub_type： 杂志文章,多中心研究

    doi：10.1007/s11606-013-2389-1

    authors： Henschen BL,Garcia P,Jacobson B,Ryan ER,Woods DM,Wayne DB,Evans DB

    更新日期：2013-08-01 00:00:00

  • Clinic HIV-focused features and prevention of Pneumocystis carinii pneumonia.

    abstract：OBJECTIVE:To examine the association of clinic HIV-focused features and advanced HIV care experience with Pneumocystis carinii pneumonia (PCP) prophylaxis and development of PCP as the initial AIDS diagnosis. DESIGN:Nonconcurrent prospective study. SETTING:New York State Medicaid Program. PARTICIPANTS:Medicaid enrol...

    journal_title：Journal of general internal medicine

    pub_type： 临床试验,杂志文章,多中心研究

    doi：10.1046/j.1525-1497.1998.00003.x

    authors： Turner BJ,Markson L,Cocroft J,Cosler L,Hauck WW

    更新日期：1998-01-01 00:00:00