Abstract:
:Obese people consume significantly greater amounts of health resources. This study set out to determine if health resource utilization by obese people decreases after losing weight in a comprehensive medically supervised weight management programme. Four hundred and fifty-six patients enrolled in a single-centred, multifaceted weight loss programme in a universal health care system were studied. Patient information was anonymously linked with administrative databases to measure health resource utilization for 1 year before and after the programme. Mean body mass index (BMI) decreased by more than 15%. The mean annual physician visits (pre = 9.6, post = 9.4) did not change significantly after the programme. However, patients saw a significantly fewer number of different physicians per year following the programme (pre = 4.5, post = 3.9; P < 0.001). Mean annual number of emergency visits (pre = 0.2; post = 0.2) and hospital admissions (pre = 0.05; post = 0.08) did not change. Neither baseline BMI, nor its change during the programme, influenced changes in health resource utilization. Our study suggests that weight loss in a supervised weight management programme does not necessarily decrease short-term health resource utilization. Further study is required to determine if patients who maintain their weight loss experience a decrease in health utilization.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
van Walraven C,Dent Rdoi
10.1046/j.1365-2753.2002.00320.xsubject
Has Abstractpub_date
2002-02-01 00:00:00pages
37-44issue
1eissn
1356-1294issn
1365-2753pii
320journal_volume
8pub_type
杂志文章abstract::Following my own involvement in the rise of evidence-based medicine in General Practice in the UK, and having seen how this tide has led to a relative devaluation of other kinds of knowing this paper sets out four alternative approaches to the problem of knowledge in a way which both undermines the predominance of a s...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01724.x
更新日期:2011-10-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Drug-related morbidity is common, which results in suffering for the patients and a high cost to society. SÄKLÄK2 is a multi-professional intervention model aiming at improving drug safety in primary health care. The objective of this study was to elucidate the perceptions of the partici...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13195
更新日期:2020-02-01 00:00:00
abstract::The paper evaluates the importance of conceptions underlying practices in medicine and in medical education. It uses a study of anaesthetists' approaches to practice, and of lectures in problem-based learning, to illustrate the influence of a conception of 'applying knowledge in, or to, practice' and of its apparently...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2000.00264.x
更新日期:2000-08-01 00:00:00
abstract:RATIONALE:Clinical reasoning lies at the heart of medical practice and has a long research tradition. Nevertheless, research is scattered across diverse academic disciplines with different research traditions in a wide range of scientific journals. This polyphony is a source of conceptual confusion. AIMS AND OBJECTIVE...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13432
更新日期:2020-06-22 00:00:00
abstract::Several philosophers of medicine have attempted to answer the question "what is disease?" In current clinical practice, an umbrella term "chronic kidney disease" (CKD) encompasses a wide range of kidney health states from commonly prevalent subclinical, asymptomatic disease to rare end-stage renal disease requiring tr...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13018
更新日期:2018-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Surgical site infections are the most common healthcare-associated infections. Appropriate surgical antimicrobial prophylaxis (SAP), which is an integral part of surgical site infection SSI prevention, is one of the major preventable risks to surgical patient safety. Several clinical prac...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12658
更新日期:2017-02-01 00:00:00
abstract::Nosology is the science of defining and classifying diseases. Meta-nosology is the study of how we do this, on what principles nosological practices are based, the quality of the resulting medical taxonomy, and primarily whether/how diseases can be defined better than they are now. In modern Western medicine, there ar...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
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更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to examine the impact of the use of an inter-professional care team on patient length of stay and payer charges in a geriatric transitional care unit. METHODS:An analysis of de-identified administrative records for transitional care patients for the 12-month period (2003-2004) care...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.01114.x
更新日期:2010-02-01 00:00:00
abstract::Experience of knowledge management initiatives in non-health care organizations can offer useful insights, and strategies, to implement evidence-based practice in health care. Knowledge management offers a structured process for the generation, storage, distribution and application of knowledge in organizations. This ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00534.x
更新日期:2006-06-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Quality of life has emerged as a crucial concept for the assessment of health and the planning of health care. Desirable features for the evaluation of quality of life include comprehensiveness, self-ratedness, cultural sensitivity, practicality and psychometric soundness. An attempt to meet th...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01609.x
更新日期:2011-04-01 00:00:00
abstract:RATIONAL, AIMS AND OBJECTIVES:Individual Placement and Support (IPS) is an evidence based strategy for facilitating employment among adults with severe mental illness (SMI) where staff may lead mock job interviews to prepare clients for real-world interviews (a method with limited scalability and cost effectiveness). A...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13292
更新日期:2020-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Health-care professions have long been considered prone to work-related stress, yet recent research in Bulgaria indicates alarmingly high levels of burnout. Cloninger's inventory is used to analyse and evaluate correlation between personality characteristics and degree of burnout syndrome...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01895.x
更新日期:2012-12-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Current meta-analysis was conducted aiming to assess the efficacy and safety of recombinant human interleukin-11 (rhIL-11) in the treatment of acute leukaemia (AL) patients with chemotherapy-induced thrombocytopenia (CIT). METHODS:We searched PubMed, Embase, Chinese National Knowledge I...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13152
更新日期:2020-02-01 00:00:00
abstract::The Hawthorne studies in the 1930s demonstrated how difficult it is to understand workplace behaviour, and this includes professional performance. Studies of interventions to improve professional performance, such as audit, can provide useful information for those considering using such methods, but cannot replace jud...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2001.00280.x
更新日期:2001-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:This paper is the third of three related papers exploring the ways in which the principles of Learning Organizations (LOs) could be applied in Primary Care settings at the point of service delivery. METHODS:Here we provide a systematic literature review of contextual factors that either ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2004.00466.x
更新日期:2004-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Human brain connectome is a new and rapidly developing field in neuroscience. The pattern of structural and functional connectivity in the brain is not fixed but is continuously changing in response to experiences. Exploring these phenomena opens a powerful arsenal of analyses and comput...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12911
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To study which tests general practitioners used to diagnose a urinary tract infection (UTI) in children and which patient characteristics were associated with test choice. DESIGN:Retrospective chart review on the diagnosis of UTIs in children in Dutch general practices who were diagnosed as having a UTI. A t...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.01037.x
更新日期:2009-06-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The incidence of falls and fall-related injuries in older age is predicted to increase concomitantly with global population ageing, representing a serious challenge to health care systems. In spite of the availability of policy and practice guidelines for the prevention of falls and fall-...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01307.x
更新日期:2010-12-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:National policy, guided by research, suggests several patient and service benefits achieved by providing 7-day health care. Therefore, a 7-day inpatient neurophysiotherapy service was introduced at a large teaching hospital in London. The study's aim was to evaluate the effect of the 7-d...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
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更新日期:2020-06-01 00:00:00
abstract:RATIONALES, AIMS AND OBJECTIVES:The increasing dispensing of statins has raised concern about the appropriateness of prescribing to various population groups. We aimed to (1) investigate incident and prevalent statin prescribing according to indication, gender and age and (2) relate prescribing patterns to evidence on ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12462
更新日期:2016-04-01 00:00:00
abstract::The foundationalist and anti-foundationalist conceptions of medical knowledge have been at loggerheads for decades. Evidence-based medicine (EBM), the most prominent form of foundationalism, has attained wide appeal and acceptance among authorities. It proposes that evidence is the "base" upon which all clinical decis...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13273
更新日期:2020-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The goal is to fully automate the calculation of a breast ptosis measure from clinical photographs through automatic localization of fiducial points relevant to the measure. METHODS:Sixty-eight women (97 clinical photographs) who underwent or were scheduled for breast reconstruction were...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12397
更新日期:2015-10-01 00:00:00
abstract::It is important to improve our understanding about what might be the specific characteristics of mental disorders to strengthen the scientific credibility of psychiatry and to clarify its position among other medical and nonmedical sciences. On the other hand, this issue has diagnostic, research, therapeutic, legal, f...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/jep.12766
更新日期:2017-10-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Measures of safety climate are increasingly used to guide safety improvement initiatives. However, cost and respondent burden may limit the use of safety climate surveys. The purpose of this study was to develop a 15- to 20-item safety climate survey based on the Patient Safety Climate i...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12731
更新日期:2017-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Guidelines for stroke management should improve quality of care. Dissemination of guidelines, however, does not guarantee guideline adherence. The aim of this paper is to investigate barriers for guideline adherence to bring about suggestions for possible implementation strategies. METHO...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2003.00460.x
更新日期:2004-05-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Comparisons of the performance of health care providers are increasingly being used. Despite one key audience being clinicians, there has been little research on the format and content of such comparisons. Our aim was to explore clinicians' comprehension and preferences of format and cont...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01777.x
更新日期:2013-02-01 00:00:00
abstract:RATIONALE:Group B streptococcus (GBS) neonatal infection can be prevented by screening pregnant women for GBS colonization from the 34th to the 38th week of gestation, as has been recommended in France since 2001. We assessed guideline adherence among midwives and obstetricians. METHODS:From 2006 to 2008, new and mand...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01658.x
更新日期:2012-08-01 00:00:00
abstract::Often, when conducting programme evaluations or studying the effects of policy changes, researchers may only have access to aggregated time series data, presented as observations spanning both the pre- and post-intervention periods. The most basic analytic model using these data requires only a single group and models...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01504.x
更新日期:2011-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:To develop a reliable and valid questionnaire that can distinguish features of organizational culture for patient safety across subgroups such as hospitals, professions, management/non-management positions and units/wards. METHODS:We developed a Hospital Organizational Culture Questionna...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12123
更新日期:2014-06-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The American College of Cardiology and American Heart Association (ACC/AHA) statin guidelines recommend that people with risk of cardio-vascular disease (CVD) ≥7.5% over 10 years should be treated with statins. This recommendation ignores individual patient CVD risks and preferences. We c...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12473
更新日期:2017-04-01 00:00:00