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 from the 1996 Canadian census and 2000 physician billing claims. Risk ratios, linear regression, multilayer maps, and spatial analysis were used to examine utilization by area for women age 45 to 64 years. SETTING:Residential population of inner city Toronto, Canada, with a 1996 population of 780,000. PARTICIPANTS:Women age 45 to 64 residing in Toronto's inner city in the year 2000. MEASUREMENTS AND MAIN RESULTS:Among 113,762 women age 45 to 64, 27,435 (24%) had received a mammogram during 2000 and 91,542 (80%) had seen a physician. Only 21% of women had a mammogram in the least advantaged group (low income--high immigration), compared with 27% in the most advantaged group (high income--low immigration) (risk ratio, 0.79; 95% confidence interval, 0.75 to 0.84). Multilayer maps demonstrated a low income-high immigration band running through Toronto's inner city and low mammography rates within that band. There was substantial geographic clustering of study variables. CONCLUSIONS:We found marked variation in mammography rates by area, with the lowest rates associated with low income and high immigration. Spatial patterns identified areas with low mammography and low physician visit rates appropriate for outreach and public education interventions. We also identified areas with low mammography and high physician visit rates appropriate for interventions targeted at physicians.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Glazier RH,Creatore MI,Gozdyra P,Matheson FI,Steele LS,Boyle E,Moineddin Rdoi
10.1111/j.1525-1497.2004.30270.xsubject
Has Abstractpub_date
2004-09-01 00:00:00pages
952-61issue
9eissn
0884-8734issn
1525-1497pii
JGI30270journal_volume
19pub_type
杂志文章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
更新日期:1995-06-01 00:00:00
abstract::This article highlights the timely situation that resident physicians, faculty, and staff are facing after the recent highly publicized murders of Black Americans and its impact on our healthcare communities. We discuss our experiences of how the hospital can serve as a meeting place for anti-racism, as well as how an...
journal_title:Journal of general internal medicine
pub_type: 社论
doi:10.1007/s11606-020-06291-2
更新日期:2020-10-20 00:00:00
abstract::Increasing emphasis on value in health care has spurred the development of value-based and alternative payment models. Inherent in these models are choices around program scope (broad vs. narrow); selecting absolute or relative performance targets; rewarding improvement, achievement, or both; and offering penalties, r...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-017-4125-8
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:To determine patient characteristics associated with patient and proxy perceptions of physicians' recommendations for life-prolonging care versus comfort care, and with acceptance of such recommendations. DESIGN:Cross-sectional. SETTING:Five teaching hospitals in Denver, Colo. PATIENTS:We studied 239 hospi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1525-1497.2000.07004.x
更新日期:2000-04-01 00:00:00
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
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To examine how Asian race/ethnicity affects patients' health care experiences and satisfaction with care. DESIGN:Telephone interview using random-digit dialing, stratified to over-sample adults living in areas with disproportionately large numbers of minorities. PARTICIPANTS AND SETTING:White (N = 3,205) an...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2004.30143.x
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To compare specialist and primary care physician participation in California's Medicaid fee-for-service and managed care programs. DESIGN:Cross-sectional survey. PARTICIPANTS:A probability sample stratified by county and by race of 962 specialist physicians and 713 primary care physicians practicing in the ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Little information exists regarding the impact of Medicare Part D on generic drug use. OBJECTIVE:To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. DESIGN, PARTICIPANTS, AND MEASUREMENTS:Difference-in-difference analysis of pharmacy claim...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0742-6
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:The greater the severity of illness of a patient, the more likely the patient will have a poor hospital outcome. However, hospital-wide severity of illness scores that are simple, widely available, and not diagnosis-specific are still needed. Laboratory tests could potentially be used as an alternative to es...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05282-2
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:There is growing interest in developing systems to overcome barriers for acquiring and interpreting family health histories in primary care. OBJECTIVE:To examine the capacity of three different electronic portals to collect family history from patients and deposit valid data in an electronic health record (...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s11606-013-2442-0
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Patient-provider sexual risk behavior discussions occur infrequently but may be facilitated by high-quality sexual risk screening tools. OBJECTIVE:To develop the Sexual Risk Behavior Inventory (SRBI), a brief computer-administered patient-reported measure. DESIGN:Qualitative item development/quantitative i...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-018-4496-5
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Network meta-analysis (NMA) is a popular tool to compare multiple treatments in medical research. It is frequently implemented via Bayesian methods. The prior choice of between-study heterogeneity is critical in Bayesian NMAs. This study evaluates the impact of different priors for heterogeneity on NMA resul...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06357-1
更新日期:2021-01-05 00:00:00
abstract:BACKGROUND:Interpreter services for medical care increase physician-patient communication and safety, yet a "formal certification" process to demonstrate interpreter competence does not exist. Testing and training is left to individual health care facilities nationwide. Bilingual staff are often used to interpret, with...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0344-8
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:There are currently roughly 10,000 Germans on the organ waiting list, and that number is over 113,000 in the USA. There is a clear need to increase support for organ donation in general and to increase the number of registered donors in particular. OBJECTIVE:The current study examines the relationship betwe...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05734-0
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The patient-centered medical home (PCMH) model has several components to improve care for patients with high comorbidity, including greater access to face-to-face primary care. OBJECTIVE:We examined whether high-comorbidity patients had larger increases in primary care provider (PCP) visits attributable to ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3833-9
更新日期:2016-12-01 00:00:00
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
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Many primary care physicians (PCPs) are ill-equipped to provide screening and counseling for inherited breast cancer. OBJECTIVE:To evaluate the outcomes of an interactive web-based genetics curriculum versus text curriculum for primary care physicians. DESIGN:Randomized two-group design. PARTICIPANTS:121 ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-014-3113-5
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:Examine patterns of alcohol use disorder (AUD) medication use and identify factors associated with prescription fill among commercially insured individuals with an index AUD visit. DESIGN:Using 2008-2018 claims data from a large national insurer, estimate days to first AUD medication using cause-specific haz...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06073-w
更新日期:2020-11-01 00:00:00
abstract:IMPORTANCE:Patients are increasingly being given access to their test results, but little is known about how preferences vary with the test under consideration or the results of the test (normal or abnormal). OBJECTIVE:This study was conducted to examine preferences for test result communication. DESIGN, SETTING, AND...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3344-0
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Patient-centered care--including the domains of access and communication--is an important determinant of positive clinical outcomes. OBJECTIVE:To explore associations between race and HIV-infected patients' experiences of access and communication. DESIGN:This was a cross-sectional survey. PARTICIPANTS:Nin...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-008-0788-5
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Obese women experience higher postmenopausal breast cancer risk, morbidity, and mortality and may be less likely to undergo mammography. OBJECTIVES:To quantify the relationship between body weight and mammography in white and black women. DATA SOURCES AND REVIEW METHODS:We identified original articles eval...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11606-009-0939-3
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To compare the analgesic efficacy of valdecoxib with placebo and naproxen sodium for relieving menstrual cramping and pain due to primary dysmenorrhea. DESIGN:Single-center, double-blind study with a 4-period, 4-sequence crossover design. Patients assessed pain intensity and pain relief at regular intervals ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2004.30052.x
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Standardized means to identify patients likely to benefit from language assistance are needed. OBJECTIVE:To evaluate the accuracy of the U.S. Census English proficiency question (Census-LEP) in predicting patients' ability to communicate effectively in English. DESIGN:We investigated the sensitivity and sp...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0693-y
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Electronic prescribing (e-prescribing) has the potential to improve the safety and efficiency of medication use, but uptake of e-prescribing in community-based settings has been limited to date. In April 2004, 2 large insurers in Massachusetts began a program to fund e-prescribing systems for targeted clinic...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0383-1
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Limitations in instrumental activities of daily living (IADL) hinder a person's ability to live independently in the community and self-manage their conditions, but its impact on hospital readmission has not been firmly established. OBJECTIVE:To test the importance of IADL dependency as a predictor of 30-da...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05982-0
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Developing a definition of what constitutes high need among Medicare beneficiaries using administrative data is an important prerequisite to evaluating value-based payment reforms. While various definitions of high need exist, their predictive validity for different patient outcomes in the following year has...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4781-3
更新日期:2019-03-01 00:00:00
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
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The Ministry of Health, Labour and Welfare of Japan has been promoting participation in scholarly activities for physicians during residency training. However, there is debate regarding whether this is worthwhile for residents. OBJECTIVE:To evaluate residents' opinions of engaging in scholarly activities an...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-0970-4
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Most guidelines recommend against PSA-based screening for prostate cancer in men ≥ 70 years of age. Adherence to these guidelines is variable. OBJECTIVE:To determine whether the use of a "Best Practice Advisory" (BPA) intervention within the electronic medical record (EMR) system can alter the rate of PSA s...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06097-2
更新日期:2020-11-01 00:00:00
abstract::The safety net, a collection of public hospitals, federally qualified health centers (FQHCs), and publicly funded community-based healthcare entities, provides essential care to middle-aged and older adults with geriatric conditions. The role of the safety net for these adults will intensify over the next two decades ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06010-x
更新日期:2020-11-01 00:00:00