Abstract：
INTRODUCTION:Although women will account for almost 11% of veterans by 2040, we know little about their health and functioning, particularly compared to men. OBJECTIVE:To compare women and men veterans' health-related quality of life (HRQOL) and VA health care utilization and to see if previously described associations between HRQOL, subsequent VA health care utilization, and mortality in male veterans would generalize to women veterans. METHODS:Prospective cohort study of all veterans who received medical care from an Upper Midwest Veterans Affairs facility between 10/1/96 and 3/31/98 and returned a mailed questionnaire. RESULTS:Women's effective survey response rate was 52% (n = 1,500); men's, 58% (n = 35,000). In the following year, 9% of women and 12% of men had at least one hospitalization. One percent of women and 3% of men died in the post-survey year. After adjustment, women's HRQOL was higher than men's; for every 10-point decrement in overall physical or mental functioning, women and men had similarly increased risk/odds of subsequently dying, being hospitalized at a VA facility, or making a VA outpatient stop. Among younger women and women who received VA care outside of the Twin City metro area, poorer overall mental or physical health functioning was associated with fewer primary care stops; among their male counterparts, it was associated with more primary care stops. CONCLUSION:Compared to men, women veterans receiving VA health care in the upper Midwest catchment area had better HRQOL and used fewer health services. Although VA health care utilization was similar across gender after adjusting for HRQOL, poorer mental or physical health was associated with fewer primary care stops for selected subgroups of women.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Singh JA,Murdoch Mdoi
10.1007/s11606-007-0254-9subject
Has Abstractpub_date
2007-09-01 00:00:00pages
1260-7issue
9eissn
0884-8734issn
1525-1497journal_volume
22pub_type
杂志文章,多中心研究abstract：:The call for value-based medicine has augmented the role of primary care physicians, potentially exacerbating the already-acknowledged shortage of primary care physicians in the current delivery landscape. Lifetime earnings for primary care physicians are millions lower than those for other specialties, and the burden...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05759-5
更新日期：2020-05-01 00:00:00
abstract：BACKGROUND:Patients frequently experience suboptimal transitions from the hospital to the community, which can increase the likelihood of readmission. It is not known which care coordination services can lead to improvements in readmission rates. OBJECTIVE:To evaluate the effects of two care coordination interventions...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-017-4218-4
更新日期：2018-05-01 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：: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
更新日期：1997-05-01 00:00:00
abstract：:Despite improved knowledge about the benefits and harms of treatments for chronic back pain in the past several decades, there is a large and consequential mismatch between treatments found safe and effective and those routinely covered by health insurance. As a result, care for back pain has, if anything, deteriorate...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05099-z
更新日期：2019-09-01 00:00:00
abstract：OBJECTIVES:To develop and evaluate a web-based curriculum to introduce first year medical students to the knowledge and attitudes necessary for working with limited English proficient (LEP) patients through interpreters. METHOD:Six hundred and forty first year medical students over 4 consecutive years took this curric...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2005.0193.x
更新日期：2005-10-01 00:00:00
abstract：:The quality of diabetes care delivered to patients falls below the expectations of practice guidelines and clinical trial evidence. Studies in many jurisdictions with varying health care systems have shown that recommended processes of care occur less often than they should; hence, outcomes of care are inadequate. Man...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-006-0027-x
更新日期：2007-02-01 00:00:00
abstract：BACKGROUND:Pay-for-performance (P4P) has been used expansively to improve quality of care delivered by physicians. However, to what extent P4P works through the provision of information versus financial incentives is poorly understood. OBJECTIVE:To determine whether an increase in information feedback without changes ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05004-8
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:The patient-centered medical home (PCMH) has clinical benefits for chronic disease care, but the association with patient-reported outcomes such as health-related quality of life (HRQoL) is unexplored in patients with multimorbidity (two or more chronic diseases). OBJECTIVE:To examine if greater clinic-leve...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05429-1
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:High-quality communication about end-of-life care results in greater patient and family satisfaction. End-of-life discussions should occur early during the patient's disease trajectory and yet is often addressed only when patients become severely ill. As a result, end-of-life discussions are commonly initiat...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05615-1
更新日期：2020-04-01 00:00:00
abstract：:Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is an immune-mediated syndrome that remains under-recognized despite a growing body of literature. This syndrome has been predominantly described in young females with a constellation of symptoms, including personality changes, autonomic dysfunction and neu...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-011-1641-9
更新日期：2011-07-01 00:00:00
abstract：:Patients with medically unexplained symptoms (MUS) have little or no demonstrable disease explanation for the symptoms, and comorbid psychiatric disorders are frequent. Although common, costly, distressed, and often receiving ill-advised testing and treatments, most MUS patients go unrecognized, which precludes effect...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-006-0067-2
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:Adverse drug events after hospital discharge are common and often serious. These events may result from provider errors or patient misunderstanding. OBJECTIVE:To determine the prevalence of medication reconciliation errors and patient misunderstanding of discharge medications. DESIGN:Prospective cohort stu...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-012-2168-4
更新日期：2012-11-01 00:00:00
abstract：CONTEXT:Patient safety indicators (PSIs) are screening tools that use administrative data to identify potential complications of care and are being increasingly used as measures of hospital safety. It is unknown whether PSIs are related to standard quality metrics. OBJECTIVE:To examine the relationship between select ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0665-2
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:African-American and low-income women have lower rates of cancer screening and higher rates of late-stage disease than do their counterparts. OBJECTIVE:To examine the effects of primary care, health insurance, and HMO participation on adherence to regular breast, cervical, and colorectal cancer screening. ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2002.10431.x
更新日期：2002-02-01 00:00:00
abstract：BACKGROUND:Food insecurity refers to limited or uncertain access to food resulting from inadequate financial resources. There is a clear association between food insecurity and obesity among women, but little is known about the relationship between food insecurity and type 2 diabetes. OBJECTIVE:To evaluate whether the...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0192-6
更新日期：2007-07-01 00:00:00
abstract：BACKGROUND:The high prevalence of comorbid physical and mental illnesses among veterans is well known. Therefore, ensuring effective communication between primary care (PC) and mental health (MH) clinicians in the Veterans Affairs (VA) health care system is essential. The VA's Patient Aligned Care Teams (PACT) initiati...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-013-2731-7
更新日期：2014-07-01 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：:The study of expressed proteins in neoplasia is undergoing a revolution with the advent of proteomic analysis. Unlike genomic studies where individual changes may have no functional significance, protein expression is closely aligned with cellular activity. This perspective will review proteomics as a method of detect...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-007-0411-1
更新日期：2008-01-01 00:00:00
abstract：:To understand the effect that termination of an established physician-patient relationship has on patient attendance patterns in a medical clinic, appointment scheduling and patient attendance were measured for 210 patients before and after 11 senior resident physicians left the clinic. There was no significant change...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599811
更新日期：1986-03-01 00:00:00
abstract：BACKGROUND:Knowledge about factors associated with provider ordering of appropriate testing is limited. OBJECTIVE:To determine physician factors associated with ordering recommended laboratory monitoring tests for high-risk medications. METHODS:Retrospective cohort study of patients prescribed a high-risk medication ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-014-2907-9
更新日期：2014-12-01 00:00:00
abstract：IMPORTANCE:Sexual minority women with and at-risk for human immunodeficiency virus (HIV) may face increased risks of violence. OBJECTIVE:To understand the relationship between sexual minority status and violence; and how high-risk sex and substance use mediate that relationship among women with and at-risk for HIV. D...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-014-2832-y
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:Although experts recommend that healthcare organizations create forums for honest dialogue about race, there is little insight into the physician perspectives that may influence these conversations across the healthcare workforce. OBJECTIVE:To identify the range of perspectives that might contribute to work...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0709-7
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:More and more Veterans are receiving care from community providers, increasing the need for effective coordination across health systems. For Veterans with chronic obstructive pulmonary disease (COPD), this need is intensified by complex comorbidity patterns that often include multiple providers co-managing ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-019-04971-2
更新日期：2019-05-01 00:00:00
abstract：:To evaluate the performance of serum iron studies as a diagnostic test for iron-deficiency anemia in a county hospital, the authors identified retrospectively all general medicine patients who had had bone-marrow aspirates for the work-up of non-macrocytic anemias from 1978 through 1983. Re-reading a sample of aspirat...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02596144
更新日期：1987-05-01 00:00:00
abstract：:The lack of effective and consistent research mentorship and research mentor training in both undergraduate medical education (UME) and graduate medical education (GME) is a critical constraint on the development of innovative and high quality medical education research. Clinical research mentors are often not familia...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-015-3295-5
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:In a prior study, we found patient satisfaction was associated with mortality. However, that study included few deaths, yielding wide confidence intervals, was criticized for possible morbidity under-adjustment, and lacked power to explore sociodemographic moderation. OBJECTIVE:To revisit the satisfaction-m...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05058-8
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:Perception of body size is a key factor driving health behavior. Mothers directly influence children's nutritional and exercise behaviors. Mothers of ethnic minority groups and lower socioeconomic status are less likely to correctly identify young children as overweight or obese. Little evaluation has been d...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-014-3002-y
更新日期：2015-01-01 00:00:00
abstract：:While great strides have been made recently in improving end-of-life care in the United States, people with dementia often die with inadequate pain control, with feeding tubes in place, and without the benefits of hospice care. In this paper, we discuss the most important and persistent challenges to providing excelle...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1111/j.1525-1497.2004.30329.x
更新日期：2004-10-01 00:00:00
abstract：BACKGROUND:Not all primary care clinics are prepared to implement care coordination services for chronic conditions, such as diabetes. Understanding true capacity to coordinate care is an important first-step toward establishing effective and efficient care coordination. Yet, we could identify no diabetes-specific inst...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-013-2566-2
更新日期：2014-01-01 00:00:00
