Abstract：
:We describe an outcome-based approach to quality assurance in primary care and present data from an initial study made to explore its usefulness. A questionnaire, which asked patients to report on the status of their problem in terms of the amount of symptoms, activity limitation, and anxiety it caused, was mailed to adults who had been seen a month previously for upper respiratory tract infection, sore throat, or urinary tract infection. Outcome standards developed for these conditions indicated that patients should report no symptoms, activity limitation, or anxiety. Of the 127 patients who responded, 17% failed to meet these standards. A review of their medical records was conducted to test the value of using substandard problem-status outcome as an indicator of important deficiencies in care. Definite deficiencies in care were found for 57% of those with substandard outcomes and for 2% of those with acceptable outcomes. Corrective action was judged likely to benefit 95% of the cases with substandard outcome and 7% of those with acceptable outcomes. Data from the medical records were insufficient to explain the reasons for substandard outcome in all cases, thus emphasizing the need to examine also patient- and system-related variables not evident in the medical record. An approach to quality assurance that is based on measuring outcome and then determining the reasons for poor outcome in useful for uncovering correctable errors in the delivery of primary care. In order for the approach to be effective in improving care, the outcome measures used must be sensitive to the role of primary care in assisting partients to resolve health problems.
journal_name
J Community Healthjournal_title
Journal of community healthauthors
Mushlin AI,Appel FA,Barr DMdoi
10.1007/BF01498506subject
Has Abstractpub_date
1978-07-01 00:00:00pages
292-305issue
4eissn
0094-5145issn
1573-3610journal_volume
3pub_type
杂志文章abstract：:Self-care has become a topic of widespread interest in recent years. However, few studies of the content and methods of self-care are available to inform health education program design. The present study identified common illnesses that were reported by 258 western university students and how those illnesses were typ...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/BF01325140
更新日期：1990-10-01 00:00:00
abstract：:In 1990, the American Academy of Pediatrics (AAP) Committee on Injury and Poison Prevention issued a policy statement, "Safe Transportation of Newborns Discharged from the Hospital," recommending that hospitals adopt comprehensive policies, procedures and education programs for the discharge of newborns in child safet...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/BF02283059
更新日期：1995-08-01 00:00:00
abstract：:This study presents estimates of the prevalence of perceived needs and unmet needs among people with HIV disease in the United States for six areas of community services: mental health, drug treatment, home care, housing, transportation, and entitlements. The prevalence of service needs and unmet needs within racial, ...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/BF01321517
更新日期：1993-02-01 00:00:00
abstract：:Recent developments in the courts have indicated an increased vulnerability of the tobacco industry to civil lawsuits brought because of tobacco-related illness. Much of the recent public discussion has dealt with how to attack the public health problem of childhood smoking, and the judicial system may also be of help...
journal_title：Journal of community health
pub_type： 杂志文章,评审
doi：10.1023/a:1018721120980
更新日期：1998-10-01 00:00:00
abstract：:Adverse childhood experiences (ACEs) have been linked to increased use of tobacco products later in life. However, studies to date have ignored smokeless tobacco products. To address this, data from the 2011 Behavioral Risk Factor Surveillance System, which interviewed adults 18 years and over (N = 102,716) were analy...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-016-0179-5
更新日期：2016-10-01 00:00:00
abstract：:A general introduction of this article is as follows: Reliable and timely health information is an essential foundation of public health action and health systems strengthening, both nationally and internationally (Aqil et al. in Health Policy Plan 24(3): 217-228, 2009; Bradshaw et al. in initial burden of disease es...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-011-9414-2
更新日期：2012-02-01 00:00:00
abstract：:An environmental and economic evaluation of the smoke-free law in Massachusetts provides a broad appreciation of how a state-wide smoking ban affects the health of patrons and workers as well as the industries that are commonly concerned about the effects of smoking bans on business. The aim of this study is to evalua...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-007-9048-6
更新日期：2007-08-01 00:00:00
abstract：:The results of a four year demonstration project of preventive services for Medicare managed care enrollees suggest that health promotion programs can impact health behaviors and outcomes. The study provided selected preventive services to 1,800 Medicare enrollees in a managed care environment. Participants were rando...
journal_title：Journal of community health
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1023/a:1025176531596
更新日期：1997-12-01 00:00:00
abstract：:Threatened use of the smallpox virus in bioterrorist attacks recently prompted national concerns in the United States. Smallpox, the "speckled monster," was known in antiquity. In 1856, New York City opened its first hospital devoted to caring for victims of smallpox. Essentially, the hospital isolated and quarantined...
journal_title：Journal of community health
pub_type： 历史文章,杂志文章
doi：10.1007/s10900-005-5519-9
更新日期：2005-10-01 00:00:00
abstract：:In an effort to improve Health Risk Appraisals and to induce individuals to change their lifestyles, comprehensive evaluations and counseling sessions were carried out for 476 participants of an experimental preventive care program (1984). Nurse practitioners interviewed participants in their homes and collected infor...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/BF01321479
更新日期：1988-04-01 00:00:00
abstract：:Colorectal cancer (CRC) remains a leading cause of morbidity and mortality in the U.S. Disparities in access to care contribute to advanced CRC stage at diagnosis, and these disparities are most pronounced among underserved populations and ethnic minorities. We aim to evaluate race/ethnicity-specific disparities in CR...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-016-0309-0
更新日期：2017-08-01 00:00:00
abstract：:The medical inspection of immigrants arriving in the United States in the late nineteenth and early twentieth centuries was framed by a need to rapidly process large numbers of people. Scientific medicine, such as it was then, was subordinate to the existing immigration laws which reflected the influences of the power...
journal_title：Journal of community health
pub_type： 传,历史文章,杂志文章
doi：10.1007/s10900-008-9088-6
更新日期：2008-08-01 00:00:00
abstract：:Since the implementation of the Papanicolaou test, there has been a significant decline in the incidence of cervical cancer over the last 50 years. Despite this reduction, each year there are approximately 11,000 women in the United States diagnosed with cervical cancer, the second most common type of cancer in women ...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-008-9134-4
更新日期：2009-04-01 00:00:00
abstract：:Although numerous studies have established that breast cancer mortality can be significantly reduced through early detection, only a small percentage of women obtain screening mammograms at intervals recommended by the National Cancer Institute, the American Cancer Society, and other major medical organizations. This ...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/BF01323996
更新日期：1992-12-01 00:00:00
abstract：:Research indicates a high prevalence of oral disease among Albanians. There is a lack of evidence regarding oral health beliefs and practices among Albanian immigrants in the United States and abroad. This research seeks to better understand the oral health beliefs, attitudes, and practices among Albanian immigrants l...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-016-0248-9
更新日期：2017-04-01 00:00:00
abstract：:Description of the consumer food environment has proliferated in publication. However, there has been a lack of systematic reviews focusing on how the consumer food environment is associated with the following: (1) neighborhood characteristics; (2) food prices; (3) dietary patterns; and (4) weight status. We conducted...
journal_title：Journal of community health
pub_type： 杂志文章,评审
doi：10.1007/s10900-011-9524-x
更新日期：2012-08-01 00:00:00
abstract：:The purpose of this study was to identify family physicians' firearm safety counseling beliefs and behaviors. A survey was mailed to a random sample of 600 members of the American Academy of Family Physicians. A three wave mailing technique was used to maximize the response rate and yielded 271 usable surveys (55% res...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1023/a:1025172903135
更新日期：1997-10-01 00:00:00
abstract：:Consumer participation and influence were studied in one Health Systems Agency in the southeastern United States over a 20-month period (July 1976--February 1978). Consumer board members were found to be significantly less influential in agency decision making than were provider board members. This difference in influ...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/BF01323009
更新日期：1981-04-01 00:00:00
abstract：:The number of reported outbreaks of typhoid fever in the United States has recently increased. Only six were reported from 1980-1989, but seven outbreaks were reported in 1990. In August 1990, health officials in Montgomery County, Maryland, were notified of two cases of typhoid fever among persons who had attended bo...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/BF02277062
更新日期：1995-12-01 00:00:00
abstract：:Alzheimer's disease (AD) is the fourth leading cause of death in Puerto Rico. Using multi-media resources and in-person education may be an effective approach to improve knowledge and awareness of AD. The Un Café por el Alzheimer program in Puerto Rico incorporates an education component at coffee shops and a social m...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-016-0183-9
更新日期：2016-10-01 00:00:00
abstract：:Considerable recent discussion has taken place regarding the predicted future shortage of physicians, especially in primary care. Much of the attention has focused on the difficulty of recruiting new physicians into primary care practice. It is suggested that part of the solution may be increased efforts to recruit an...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-009-9165-5
更新日期：2009-10-01 00:00:00
abstract：:Vestibular rehabilitation therapy (VRT) can benefit patients with a variety of balance and vestibular disorders. This expanding field requires knowledgeable and experienced therapists; however, the practice and experience of those providing this care may vary greatly. The purpose of this study was to analyze variation...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-015-0003-7
更新日期：2015-08-01 00:00:00
abstract：:Recently, the cholera outbreak in Haiti demonstrated just how unprepared the country is to rapidly isolate an outbreak of this magnitude, and its vulnerability to the COVID-19 pandemic. This communication briefly examines the health system in Haiti and its vulnerability toward the COVID-19 outbreak. ...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-020-00825-9
更新日期：2020-06-01 00:00:00
abstract：:The objective of this study was to compare urban and suburban preschool and school age activities. A prospective survey using a convenience sample was conducted at one urban and one suburban primary care pediatric office. Questionnaires were completed for 66 urban preschool children, 70 suburban preschool children, 57...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1023/a:1015254007582
更新日期：2002-06-01 00:00:00
abstract：:A family caregiver provides unpaid assistance to a family member/friend with a chronic disease, illness or disability. The caregiving process can affect a caregiver's quality of life by reducing time for themselves, for other family members and for work. The 2000 Behavioral Risk Factor Surveillance Survey estimates th...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-016-0199-1
更新日期：2016-12-01 00:00:00
abstract：:Although the cooperation between modern and traditional medicine (TM) is increasingly promoted in health care system of nationwide, there remains many barriers. In this study, we examined the barriers and possible ways of promoting cooperation between traditional healers and modern health system. Ethnographic method i...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-010-9325-7
更新日期：2011-06-01 00:00:00
abstract：:This review aims to determine the prevalence of smoking among Saudi students and to study and to identify, synthesize and summarize the predictors that initiate smoking among students in different ages in Saudi Arabia. Different databases were searched (Web of Science, Google Scholar, Pub Med and Science Direct) with ...
journal_title：Journal of community health
pub_type： 杂志文章,评审
doi：10.1007/s10900-014-9909-8
更新日期：2014-10-01 00:00:00
abstract：:Sub-optimal screening for chronic hepatitis C virus (HCV) and chronic hepatitis B virus (HBV) among high risk groups delays diagnosis and treatment. We aimed to evaluate overall rates of HCV and HBV screening and patient knowledge of their testing result. Adults age ≥18 years undergoing elective outpatient endoscopy a...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-017-0388-6
更新日期：2018-02-01 00:00:00
abstract：:Older adults are at risk of problems of medication use including underuse, overuse, and misuse. The purposes of this study were to investigate the prevalence of the use of conventional and complementary and alternative medications (CAM) in older adults and to explore which factors related to their medication use. For ...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-014-9934-7
更新日期：2015-04-01 00:00:00
abstract：:We assessed the relationship between sun protection policies and practices at child care centers in Massachusetts. We hypothesized that centers with sun protection policies were more likely to have regular sun protection practices in place compared to centers without these policies. We conducted a telephone survey wit...
journal_title：Journal of community health
pub_type： 杂志文章
doi：10.1007/s10900-005-7283-2
更新日期：2005-12-01 00:00:00
