Abstract:
OBJECTIVE:To evaluate the effectiveness of an outcomes-management program designed to provide high-quality patient care, generate data for outcomes research, and decrease costs in a managed-care environment. METHODS:An outcomes-management program was launched in June 1994, based on the elimination of wasteful or ineffective therapies through the systematic development of practice guidelines and collaborative care paths, with concomitant definition of desired outcomes. Over 3 months, care paths were developed for our most common surgical procedures. A matched control outcomes study was undertaken for the most commonly performed gynecologic oncology procedure: total abdominal hysterectomy and oophorectomy with pelvic and para-aortic node sampling for endometrial cancer. Thirty consecutive women treated on the care path were compared with 29 matched controls accrued during the period of care-path planning and with 73 controls from the period preceding care-path planning. Patient satisfaction with care-path treatment was assessed by a survey sent 2 weeks after discharge. RESULTS:Median length of hospital stay decreased significantly, from 6 days before care-path planning to 4 days after care-path implementation (P < .001). Median laboratory costs decreased by 74% (P < .001), medication costs by 35% (P < .001), room costs by 29% (P < .001), and total hospital costs by 20% (P < .002). Incremental improvements were observed during care-path planning. There were no readmissions for complications in the care-path group. According to the survey results, patient satisfaction with care was very high among care-path patients. CONCLUSIONS:A physician-driven outcomes-management program in an academic setting permits the delivery of high-quality care and supports outcomes research while decreasing costs.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Morris M,Levenback C,Burke TW,Dejesus Y,Lucas KR,Gershenson DMdoi
10.1016/S0029-7844(97)00008-2subject
Has Abstractpub_date
1997-04-01 00:00:00pages
485-92issue
4eissn
0029-7844issn
1873-233Xpii
S0029-7844(97)00008-2journal_volume
89pub_type
杂志文章abstract:OBJECTIVE:To describe obstetric health care providers' responses and counseling approaches to patients' disclosures of marijuana use during first prenatal visits. METHODS:We performed a content analysis of audio-recorded patient-health care provider first prenatal visits for obstetrics health care providers' responses...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001343
更新日期:2016-04-01 00:00:00
abstract::Patient choices and plans may sometimes carry increased risk or include alternatives that individual physicians feel uncomfortable supporting or recommending. We consider in this commentary how the ethical principles of respect for autonomy and nonmaleficence can be balanced using, among other examples, the choice by ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182167413
更新日期:2011-05-01 00:00:00
abstract::A chemotherapeutic combination consisting of VM-26-vincristine-cisplatin was used to treat 44 consecutive patients with primary advanced or recurrent endometrial carcinomas. Nine complete remissions (20.5%) and 14 partial remissions (31.8%) were recorded. The median duration of remission in responders was 8 months (ra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract::The management of polycystic ovarian disease in women not desiring pregnancy is controversial. To avoid the progressive androgenic effects on peripheral target organs, some advocate the use of oral contraceptives. This study reports the effects of a preparation with 50 micrograms ethinyl estradiol and 2 mg cyproterone...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-02-01 00:00:00
abstract::This study was designed to compare single-point prevalence estimates with a cumulative prevalence estimate of human papillomavirus (HPV) type 16 in cervical smears. The influence of the menstrual cycle and the long-term effect of HPV 16 positivity on the development of cervical intraepithelial neoplasia (CIN) were mon...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:To evaluate whether preoperative dilation and curettage (D&C) lowers the risk of unexpected cancer at hysterectomy. METHODS:Women with complex atypical endometrial hyperplasia on sampling from January 2000 to May 2008 who underwent hysterectomy within 6 months were identified using a pathology database. Pati...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181b190d5
更新日期:2009-09-01 00:00:00
abstract::An assay has been developed and evaluated that quantifies the surface tension lowering ability of amniotic fluid surfactant. The formation of stable foam following vigorous shaking of amniotic fluid was evaluated by the addition of various amounts of dipalmitoyl lecithin in a solution of ethanol and saline and by fine...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00
abstract:OBJECTIVE:To evaluate whether prophylactic dronabinol, a synthetic tetrahydrocannabinol, reduces pain during medical abortion. METHODS:We conducted a randomized, double-blind, placebo-controlled trial of women undergoing medical abortion with mifepristone and misoprostol up through 70 days of gestation. All participan...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0000000000003850
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Chylous ascites is a rare phenomenon caused by extravasation of chyle from the lymphatic system. In Western countries, the majority of adult cases are due to occlusion of the lymphatics secondary to a lymphoma or other malignancy. CASE:A middle-aged woman with reports of fecal urgency, incomplete bowel evac...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000285479.79030.94
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:Case reports of suspected adverse pregnancy outcomes associated with prenatal exposure to angiotensin-converting enzyme inhibitors, particularly oligohydramnios, prolonged neonatal anuria, and defects of ossification of the skull dome, prompted us to examine pregnancy outcome in a large cohort of pregnant wom...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:To evaluate an evidence-based collaborative depression care intervention adapted to obstetrics and gynecology clinics compared with usual care. METHODS:A two-site, randomized controlled trial included screen-positive women (Patient Health Questionnaire-9 score of at least 10) who met criteria for major depre...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/AOG.0000000000000231
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To compare umbilical cord and maternal serum peak gentamicin concentration, gentamicin elimination, and clinical outcomes between women who received once-daily compared with standard, thrice-daily dosing for clinical chorioamnionitis. METHODS:We randomly assigned 38 laboring women, at least 34 weeks gestatio...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.AOG.0000151106.87930.1a
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Breast pain is a common complaint among lactating women. Vasospasm of the nipple should be considered in the differential diagnosis of breast pain, particularly when no other signs of infection or trauma are encountered. This report demonstrates a case of vasospasm successfully treated with nifedipine. CASE...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000214671.19023.68
更新日期:2006-09-01 00:00:00
abstract::Previous published reports have shown that fetuses affected with Down syndrome have normal biparietal diameter (BPD), high BPD-to-femur length ratio, and shorter femur length and occipitofrontal diameter. A retrospective comparison of the BPD, occipitofrontal diameter, cephalic index, femur length, and BPD/femur lengt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:To determine if scores from first attempts at the United States Medical Licensure Examination step 1 correlated with obstetrics-gynecology examination scores and identified students at risk of failure. METHODS:All students in obstetrics-gynecology clerkships at the University of Illinois at Chicago from July...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00477-9
更新日期:1999-12-01 00:00:00
abstract::This month we focus on current research in recurrent pregnancy loss. Dr. Ros discusses four recent publications, which are concluded with a "bottom-line" that is the take-home message. A complete reference for each can be found on on this page along with direct links to abstracts. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003337
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that fetal growth restriction (FGR) associated with a maternal hypertensive disorder results in worse perinatal outcome than FGR in pregnancies without maternal hypertension. METHODS:All consecutive, singleton, nondiabetic, small for gestational age (SGA) deliveries (birth weight at or...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)02169-2
更新日期:1996-08-01 00:00:00
abstract::The rising cesarean birth rate is a matter of national concern, and the goal of clinical obstetricians is to contain this trend while maintaining good maternal and perinatal outcome. Despite published reports suggesting that excellent perinatal outcome can be achieved with modest cesarean birth rates, the general incr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Almost 50% of married female residents become pregnant during their residency. The desire to have a baby and a concern about age influence the decision to become pregnant. Career concerns, financial issues, and child care are less important. In addition, support of the faculty or house staff is not a crucial factor in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::Four hundred sixty-five primary cesarean sections (10.4% of total deliveries) performed during 1977 and 1978 were reviewed and compared with 465 vaginal deliveries to ascertain factors that may be related to postpartum infection. The overall morbidity (19.7%) related to postpartum infection in the primary cesarean sec...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the length of the second stage of labor in relation to increasing maternal prepregnancy body mass index (BMI) among nulliparous parturient women, and to determine whether route of delivery differs among obese, overweight, and normal-weight women reaching the second stage of labor. METHODS:We perf...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0b013e318236fbd1
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To compare the prevalence of large-for-gestational-age (LGA) newborns across categories of body mass index (BMI) in five racial and ethnic groups. METHODS:This cohort study examined 7,468 women with gestational diabetes mellitus (GDM) who delivered a live newborn between 1995 and 2006 at Kaiser Permanente No...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318291b15c
更新日期:2013-06-01 00:00:00
abstract::Mycotic cultures of 33 couples, in which the women had a diagnosis of chronic recurrent vulvovaginitis, were prepared from the oral cavity, the rectum, the vagina, and the male ejaculate. Reservoirs of infection were found in the oral cavities of 36% of the couples, the rectum in 33%, and the ejaculate in 15%. Prostat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVE:Neonatal alloimmune thrombocytopenia is caused by platelet antigen incompatibility between the mother and fetus. Affected fetuses may have severe thrombocytopenia leading to intracranial hemorrhage before or at birth. We sought to treat this condition in utero to prevent these hemorrhages. METHODS:Eighteen w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVE:To estimate whether antenatal dietary interventions restrict maternal weight gain in obese pregnant women without compromising newborn birth weight. DATA SOURCES:PubMed and Cochrane Controlled Trials Register were searched using free-text search terms: pregnancy, obesity, overweight, dietary intervention, li...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/AOG.0b013e3182396bc6
更新日期:2011-12-01 00:00:00
abstract::Re-entering the practice of obstetrics and gynecology after a period of inactivity can pose a number of obstacles for a physician. Preparing for the leave of absence may help reduce the difficulties physicians may face upon re-entering practice. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182564947
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:To determine the incidence, features, and surgical treatment of vulvovaginal lesions in toxic epidermal necrolysis. METHODS:Acute genital lesions were studied retrospectively in 40 women hospitalized for toxic epidermal necrolysis in a dermatologic intensive care unit. A questionnaire was sent to evaluate se...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00596-6
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:To compare the safety and efficacy of outpatient and inpatient treatment of pyelonephritis in pregnancy. METHODS:We performed a randomized controlled trial of pregnant women with pyelonephritis before 24 weeks' estimated gestational age, comparing inpatient and outpatient treatment. Sixty inpatients received...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0029-7844(95)00244-l
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:A low-lying placenta or placenta previa is frequently associated with postpartum hemorrhage from a low implantation site. We describe the successful use of a thrombin-soaked uterine pack for this condition. CASE:A 30-year-old woman, gravida 3, para 0-0-2-0, had placenta previa diagnosed by ultrasound at 26 ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(94)00231-2
更新日期:1995-05-01 00:00:00
abstract::Five hundred twelve patients who presented with initial atypical cervical cytology between February 1982 and February 1983 at Naval Hospital, San Diego were randomized with respect to antibiotic treatment and interval before repeat cytologic examination. Treatment before repeat cytology did not improve the rate of rev...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-08-01 00:00:00