Abstract：
:A prospective study of 79 patients with recent hip fracture revealed prior functional impairments with community mobility (49%), using a bathtub (40%), walking outdoors (26%), and stair-climbing (18%). Eighty-six per cent of patients (mean age 77.9 years) were admitted from home, with 95% surviving to discharge but only 28% returning directly home following surgical repair. In-hospital complications included confusion (49%), urinary tract infection (33%), and heart rhythm disturbance (26%). Mean length of stay was 21.7 days and mean hospital charges were $11,052. The outliers (15%) averaged 60.6 days in length of stay and $28,190 in charges. Stepwise multivariate regression revealed that lengths of stay varied significantly with prefracture functional status, presence of intertrochanteric fractures, and in-hospital complications, but not with patient age. Examination of these findings in relation to prospective reimbursement led to the conclusion that hip fracture patients are particularly vulnerable in the era of new hospital strategies to avoid high-cost patients and curtail hospital costs.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Campion EW,Jette AM,Cleary PD,Harris BAdoi
10.1007/BF02596300subject
Has Abstractpub_date
1987-03-01 00:00:00pages
78-82issue
2eissn
0884-8734issn
1525-1497journal_volume
2pub_type
杂志文章abstract：BACKGROUND:As a result of market forces and maturing technology, generalists are currently providing services, such as colonoscopy, that in the past were deemed the realm of specialists. OBJECTIVE:To determine whether there were differences in patient characteristics, procedure complexity, and clinical indications whe...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2000.06039.x
更新日期：2000-03-01 00:00:00
abstract：BACKGROUND:Undertreatment of osteoporosis after hip or wrist fracture has been well documented, but the reasons for current patterns of care are poorly understood. OBJECTIVE:We tested the role of physician and patient characteristics in predicting undertreatment when osteoporosis management was clearly indicated after...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0697-7
更新日期：2008-09-01 00:00:00
abstract：OBJECTIVE:To determine whether selected socially rehabilitated former heroin addicts maintained on methadone can continue successful rehabilitation while maintained on methadone by primary care physicians rather than licensed clinics. This procedure has been termed "medical maintenance." DESIGN:Cohort study with 42-11...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02600025
更新日期：1994-03-01 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：:In 1989, the internal medicine residency training program at St. John's Episcopal Hospital changed from a standard one-in-four on-call system to a night float system of resident on call. Using a confidential questionnaire that assessed the opinions of medical nurses, the nurses were asked which system they preferred, ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599842
更新日期：1995-07-01 00:00:00
abstract：OBJECTIVE:To determine the prevalence and frequency of mastalgia and its association with psychiatric conditions and unexplained pain syndromes. DESIGN, SETTING, AND PARTICIPANTS:Cross-sectional mailed survey completed by 1,219 female veterans enrolled at the VA Puget Sound Health Care System in 1998. MEASUREMENTS:Br...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2006.00378.x
更新日期：2006-03-01 00:00:00
abstract：BACKGROUND:Multi-faceted depression care programs based within the healthcare system have been found to be effective, but may not fully address the needs of African American Intimate Partner Violence (IPV) survivors, many of whom are not seeking depression care in healthcare settings. OBJECTIVES:To develop and evaluat...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-012-2270-7
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:Depression is common among older patients yet is often inadequately treated. Patient beliefs about antidepressants are known to affect treatment initiation and adherence, but are often not expressed in clinical settings. OBJECTIVE:To explore attitudes toward antidepressants in a sample of depressed, communi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2005.00296.x
更新日期：2006-02-01 00:00:00
abstract：BACKGROUND:Many national guidelines recommend the use of patient provider agreements (PPAs) when prescribing opioids for chronic pain. There are no standards for PPA content, readability, or administration processes. OBJECTIVE:Conduct a national survey of providers who use PPAs to describe the process of administering...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06364-2
更新日期：2021-01-08 00:00:00
abstract：BACKGROUND:Urine drug testing (UDT) is an essential tool to monitor opioid misuse among patients on chronic opioid therapy. Inaccurate interpretation of UDT can have deleterious consequences. Providers' ability to accurately interpret and document UDT, particularly definitive liquid chromatography-tandem mass spectrome...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05514-5
更新日期：2020-01-01 00:00:00
abstract：OBJECTIVE:To study an office-based strategy for increasing influenza vaccine delivery to high-risk patients at a university hospital general medicine practice. DESIGN:Historically controlled study of physician practices in an outpatient general medicine setting. SETTING:A group practice with two separate offices: a f...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599008
更新日期：1994-12-01 00:00:00
abstract：BACKGROUND:The relationship between worklife factors, clinician outcomes, and time pressure during office visits is unclear. OBJECTIVE:To quantify associations between time pressure, workplace characteristics ,and clinician outcomes. DESIGN:Prospective analysis of data from the Healthy Work Place randomized trial. P...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05343-6
更新日期：2020-02-01 00:00:00
abstract：BACKGROUND:Quite often medical students or novice residents have difficulty in ruling out diseases even though they are quite unlikely and, due to this difficulty, such students and novice residents unnecessarily repeat laboratory or imaging tests. OBJECTIVE:To explore whether or not a carefully designed short trainin...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2004.30257.x
更新日期：2004-05-01 00:00:00
abstract：BACKGROUND:The transition from pediatric to adult care is a critical period for young adults with childhood-onset conditions. General internists are tasked with participating in the care of this vulnerable population. Existing guidelines regarding transition do not fully address structural or organizational characteris...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-019-05226-w
更新日期：2019-10-01 00:00:00
abstract：BACKGROUND:To appropriately manage uncontrolled hypertension, clinicians must decide whether blood pressure (BP) is above goal due to a need for additional medication or to medication nonadherence. Yet, clinicians are poor judges of adherence, and uncertainty about adherence may promote inertia with respect to medicati...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-016-3757-4
更新日期：2016-11-01 00:00:00
abstract：PURPOSE:To compare the effects of three methods of values clarification (VCM): balance sheet; rating and ranking; and a discrete choice experiment (DCE) on decision-making about colorectal cancer (CRC) screening among adults in the US and Australia. METHODS:Using online panels managed by a survey research organization...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-013-2701-0
更新日期：2014-03-01 00:00:00
abstract：INTRODUCTION:Whether the clinical vignettes presented at the Society of General Internal Medicine (SGIM) annual meeting could be of educational value to third year students in the Internal Medicine clerkship has not been studied. OBJECTIVE:To explore the relevance and learning value of clinical vignettes from the SGIM...
journal_title：Journal of general internal medicine
pub_type：
doi：10.1111/j.1525-1497.2006.00596.x
更新日期：2006-11-01 00:00:00
abstract：OBJECTIVES:Shared medical appointments (SMAs) are an increasingly used system-redesign strategy for improving access to and quality of chronic illness care. We conducted a systematic review of the existing literature on SMA interventions for patients with diabetes in order to understand their impact on outcomes. DATA ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-014-2978-7
更新日期：2015-01-01 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：:To determine if physician specialty is associated with underutilization and underdosing of angiotensin-converting enzyme inhibitors among patients with heart failure, we reviewed the charts of 214 outpatients with decreased systolic function at an urban academic medical center. Regardless of whether patients were care...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1997.07110.x
更新日期：1997-09-01 00:00:00
abstract：BACKGROUND:Inappropriate antibiotic use contributes to the emergence and spread of drug resistant infections. Though injection drug users are at increased risk for drug resistant infections, few studies have examined antibiotic use in this population. OBJECTIVE:To understand patterns and determinants of antibiotic use...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0859-7
更新日期：2009-02-01 00:00:00
abstract：OBJECTIVE:To report rates of cost-related skipping of medications and other treatments, assess correlates of skipping, examine changes in skipping between 1998 and 2000, and identify factors associated with changes in skipping. DESIGN, SETTING, AND PARTICIPANTS:Cross-sectional and longitudinal analyses of surveys of a...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2005.0128.x
更新日期：2005-08-01 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：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:As healthcare reimbursement shifts from being volume to value-focused, new delivery models aim to coordinate care and improve quality. The patient-centered medical home (PCMH) model is one such model that aims to deliver coordinated, accessible healthcare to improve outcomes and decrease costs. It is unclear...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-019-05594-3
更新日期：2020-04-01 00:00:00
abstract：OBJECTIVE:To identify the ethical dilemmas that internists encounter, the strategies they use to address them, and the usefulness of ethics consultation. DESIGN:National telephone survey. SETTING:Doctors' offices. PARTICIPANTS:General internists, oncologists, and critical care/pulmonologists (N = 344, 64% response r...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2004.21238.x
更新日期：2004-03-01 00:00:00
abstract：OBJECTIVE:To evaluate patient-provider agreement on whether weight and related behaviors were discussed during routine visits. DESIGN:Post-visit survey assessments of patients and providers. PARTICIPANTS:Obese patients make up the majority of all patients seen in primary care (PC). The patients and physicians were re...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0553-9
更新日期：2008-05-01 00:00:00
abstract：OBJECTIVE:To examine the characteristics and outcomes of physician-referred weight management patients relative to self-referred patients. DESIGN:Review of clinic records of all individuals contacting a weight control program during a 2-year period with follow-up throughout consecutive levels of treatment (i.e., enrol...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2002.11028.x
更新日期：2002-08-01 00:00:00
abstract：OBJECTIVES:To describe and explain the patterns of adherence to supplemental oxygen in individuals with hypoxemic chronic obstructive pulmonary disease (COPD). DESIGN:Qualitative study of a case-series of patients with COPD who use supplemental oxygen. SETTING:Denver, Colorado. PARTICIPANTS:Community-dwelling, Engli...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2002.20218.x
更新日期：2002-10-01 00:00:00
abstract：:Patients can obtain screening mammograms without a physician's referral, leading to potential problems in clinical care. Because of the complexity of self-referral and the limitations of prior studies, we examined this phenomenon in a representative sample of mammography facilities. A questionnaire was given to all wo...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1998.00209.x
更新日期：1998-10-01 00:00:00
