Abstract:
:This report examines alternative methods of paying for clinical preventive care services. First, the extent of coverage of preventive health care services in public and private health insurance plans is reviewed. Included in this review are Medicare, Medicaid, health maintenance organizations, and private health insurance plans. Second, four alternative methods for paying for preventive care are discussed. These options are: 1) fee-for-service; 2) a periodic preventive health visit fee; 3) capitation; and 4) a preventive services account. The report concludes with recommendations for constructing an equitable system for increasing access to preventive services. A multi-pronged approach is recommended involving improvements in public and private coverage of these services; development of a periodic preventive health visit fee payment mechanism; initiation of additional research and demonstration efforts designed to determine cost-effectiveness of services and payment approaches; and modifications to the current coding system that would lead to a more appropriate method for reimbursement of preventive care services.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Davis K,Bialek R,Parkinson M,Smith J,Vellozzi Cdoi
10.1007/BF02600851subject
Has Abstractpub_date
1990-09-01 00:00:00pages
S93-8issue
5 Suppleissn
0884-8734issn
1525-1497journal_volume
5pub_type
杂志文章abstract:OBJECTIVE:To evaluate the accuracy of a preliminary diagnosis based solely on patient history and physical examination in medical outpatients with abdominal or chest pain. DESIGN:Prospective observational study. SETTING:General medical outpatient clinic in a university teaching hospital. PARTICIPANTS:One hundred nin...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1997.00083.x
更新日期:1997-08-01 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: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:Medical student interest in internal medicine is decreasing. Whether the internal medicine sub-internship affects intent to pursue internal medicine is unknown. OBJECTIVE:Determine the immediate and longer-term effect of the medicine sub-internship on students' decision to pursue internal medicine residency...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1263-7
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:To identify the communication factors that are significantly associated with appropriate short-term follow-up of abnormal mammograms. DESIGN:Prospective longitudinal study involving medical record review and patient survey. SETTING:Ten academically affiliated ambulatory medical practices in the Boston metro...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1525-1497.2004.30357.x
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:The Centers for Medicare & Medicaid Services (CMS)/Premier Hospital Quality Incentive Demonstration (HQID) project aims to improve clinical performance through a pay-for-performance program. We conducted this study to identify the key organizational factors associated with higher performance. METHODS:An inv...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-0997-6
更新日期:2009-07-01 00:00:00
abstract::The authors evaluated the perceptions and adjustments of surviving spouses following patient deaths. Of 128 married patients dying in a university hospital in 1983, the surviving spouses of 105 (82%) were personally interviewed a year after the death. The physicians' perspectives were recorded through chart review. Ha...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596210
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVE:To assess the risks and benefits of surgery for herniated lumbar discs (discectomy) and to evaluate the methodologic quality of the literature. DESIGN:Literature synthesis. STUDY SELECTION AND DATA ANALYSIS: A structured MEDLINE search identified studies of standard, microsurgical, or percutaneous discectomy...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,meta分析
doi:10.1007/BF02600110
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Social connectedness exerts strong influences on health, including major depression and suicide. A major component of social connectedness is having individual relationships with close supports, romantic partners, and other trusted members of one's social network. OBJECTIVE:The objective of this study was t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05692-7
更新日期:2020-07-01 00:00:00
abstract:INTRODUCTION:With the increasing number of women Veterans enrolling in the Veterans Health Administration (VA), there is growing demand for reproductive health services. Little is known regarding the on-site availability of reproductive health services at VA and how this varies by site location and type. OBJECTIVE:To ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-012-2289-9
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Multiple payment reform efforts are under way to improve the value of care delivered to Medicare beneficiaries, yet few directly address the interface between primary and specialty care. OBJECTIVE:To describe regional variation in outpatient visits for individual specialties and the association between spec...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3745-8
更新日期:2016-11-01 00:00:00
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
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:National guidelines indicate that healthcare providers should routinely screen women of reproductive age for experience of intimate partner violence. We know little about intimate partner violence (IPV) screening and disclosure experience among women older than reproductive age. OBJECTIVE:To examine the per...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05947-3
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Racial and ethnic minority groups have lower levels of leisure-time physical activity (LTPA) than whites, but it is unclear how much of this is explained by differences in socioeconomic status and health. OBJECTIVE:To examine differences in LTPA, work-related physical activity (WRPA; heavy household chores ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.40198.x
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To determine the impact of an episode of serious cardiovascular disease on smoking behavior and to identify factors associated with smoking cessation in this setting. DESIGN:Prospective observational study in which smokers admitted to a coronary care unit (CCU) were followed for one year after hospital disch...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02597426
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Many opioid-dependent patients do not receive care for addiction issues when hospitalized for other medical problems. Based on 3 years of clinical practice, we report the Transitional Opioid Program (TOP) experience using hospitalization as a "reachable moment" to identify and link opioid-dependent persons t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1311-3
更新日期:2010-08-01 00:00:00
abstract::This study examined patient acceptance of two different advance directives. Outpatients completed the two directives and a 12-item acceptability questionnaire for each, and then stated their directive preferences. Of 128 patients enrolled, 97 (76%) responded. Overall, 47% of the respondents were satisfied with the Let...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02599143
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To decrease unnecessary antibiotic use for acute respiratory tract infections in adults in a point-of-service health care setting. DESIGN:Prospective, nonrandomized controlled trial. SETTING:An urban urgent care clinic associated with the major indigent care hospital in Denver, Colorado between October 2000...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章
doi:10.1046/j.1525-1497.2003.20410.x
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Residency programs involve trainees in quality improvement (QI) projects to evaluate competency in systems-based practice and practice-based learning and improvement. Valid approaches to assess QI proposals are lacking. OBJECTIVE:We developed an instrument for assessing resident QI proposals--the Quality Im...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0260-y
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To assess the impact of informed consent on elderly patients' colorectal cancer (CRC) screening preferences. DESIGN:Randomized, controlled trial. SETTING:Four general internal medicine practices. PATIENTS:We studied 399 elderly patients visiting their primary care provider for routine office visits. INTER...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1525-1497.2000.01079.x
更新日期:2000-01-01 00:00:00
abstract::In this short story, through a challenging case where his sound diagnostic work has seemingly gone unrecognized, an internist is reminded of what is most important in clinical care. ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1363-4
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Few patient-centered interventions exist to improve year-end residency clinic handoffs. AIM:Our purpose was to assess the impact of a patient-centered transition packet and comic on clinic handoff outcomes. SETTING:The study was conducted at an academic medicine residency clinic. PARTICIPANTS:Participants...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3009-4
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Little is known about whether more experience with an electronic health record (EHR) makes it easier for providers to meaningfully use EHRs. OBJECTIVE:To assess whether the length of time that small practice providers have been using the EHR is associated with greater ease in performing meaningful use-relat...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-2891-0
更新日期:2014-10-01 00:00:00
abstract::Mycophenolate mofetil (MM) is commonly used in patients with autoimmune diseases or who have undergone transplantation. Common side effects of MM include anemia, leukopenia, mucositis and opportunistic infections. We report an unusual case of pulmonary alveolar proteinosis (PAP) in a 67-year-old woman on MM for Wegene...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1433-7
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To compare physicians' and their patients' attitudes toward pharmaceutical gifts. DESIGN:Survey of physicians and their patients. SETTING:Two tertiary-care medical centers, one military and one civilian. PARTICIPANTS:Two hundred sixty-eight of 392 consecutively surveyed physicians, 100 of 103 randomly sele...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00048.x
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Despite growing emphasis on public reporting of health care quality data, available data are often ignored. OBJECTIVE:To evaluate the usefulness of web-based physician-level data for patients choosing a new primary care physician (PCP). DESIGN:Patients seeking a new PCP (n = 2225) were invited to view web-...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0278-1
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:We examined the clinical utility of supplementing type 2 diabetes mellitus (DM) risk counseling with DM genetic test results and counseling. RESEARCH DESIGN AND METHODS:In this randomized controlled trial, non-diabetic overweight/obese veteran outpatients aged 21 to 65 years received DM risk estimates for li...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-015-3315-5
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Approximately 20% of patients with atherosclerotic cardiovascular disease (ASCVD) suffer from depression. OBJECTIVE:To compare healthcare expenditures and utilization, healthcare-related quality of life, and patient-centered outcomes among ASCVD patients, based on their risk for depression (among those with...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05325-8
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To examine the knowledge of, counseling about, and use of prior directives among patients with HIV-related disease. DESIGN:Cross-sectional survey with personal interviews that was part of the evaluation of a multi-site AIDS Health Services Program. SETTING:Outpatient clinics and AIDS community-based organiz...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600877
更新日期:1990-11-01 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