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 fee-for-service (FFS) office, where the patients pay the cost of immunizations, and a health maintenance organization (HMO)-styled office, where the costs for immunizations are fully covered by the insurer. PATIENTS:All outpatients seen at each practice setting from October to December, 1991. INTERVENTION:For each patient visit, a simple reminder data sheet was completed by the clinician detailing the vaccination eligibility (Centers for Disease Control and Prevention criteria) and status of the patient, the reasons for failure to vaccinate eligible patients, and 1990 vaccination information. RESULTS:During the study period, 511 patients were seen by the practice (353 in the FFS office, 158 in the HMO office). 297 patients (58%) were eligible for vaccination; 219 in the FFS office, 78 in the HMO office (p < 0.01). At the end of the study period, 73% of all the eligible patients were vaccinated: 67% of the FFS patients vs 90% of the HMO patients (p < 0.01). 22% of the eligible patients refused vaccination: 27% in the FFS office vs 9% in the HMO office (p < 0.01). 11% of the eligible FFS patients vs 0% of the eligible HMO patients refused vaccination due to vaccine cost (p < 0.05). Of the eligible patients seen at the two offices in both 1990 and 1991. 50% were vaccinated in 1990 (preintervention) vs 66% in 1991 (postintervention) (p < 0.01). CONCLUSIONS:As shown in this study, a simple, low-cost office-based reminder system can significantly increase the influenza vaccination rate for high-risk outpatients and can help meet national vaccination rate goals. Vaccine cost to patients may be a barrier to vaccine acceptance, in some cases.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Merkel PA,Caputo GCdoi
10.1007/BF02599008subject
Has Abstractpub_date
1994-12-01 00:00:00pages
679-83issue
12eissn
0884-8734issn
1525-1497journal_volume
9pub_type
杂志文章abstract:OBJECTIVE:To observe and evaluate the performance of primary care internal medicine residents within the outpatient clinic milieu. DESIGN:Longitudinal descriptive study. PATIENTS/PARTICIPANTS:48 internal medicine resident encounters with two standardized patients at the University of Wisconsin General Internal Medici...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599266
更新日期:1993-04-01 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...
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更新日期:2015-11-01 00:00:00
abstract::Current healthcare systems and guidelines are not designed to adapt to care for the large and growing number of patients with complex care needs and those with multimorbidity. Minimally disruptive medicine (MDM) is an approach to providing care for complex patients that advances patients' goals in health and life whil...
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更新日期:2017-10-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Residents have a major role in teaching students, yet little has been written about the effects of resident work hour restrictions on medical student education. OBJECTIVE:Our objective was to determine the effects of resident work hour restrictions on medical student education. DESIGN:We compared student r...
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doi:10.1007/s11606-007-0196-2
更新日期:2007-07-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:1997-11-01 00:00:00
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更新日期:2009-04-01 00:00:00
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更新日期:2016-11-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
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更新日期:2006-06-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:1988-05-01 00:00:00
abstract::We sought to determine whether an Internet-based continuing medical education (CME) program could improve physician confidence, knowledge, and clinical skills in managing pigmented skin lesions. The CME program provided an interactive, customized learning experience and incorporated well-established guidelines for rec...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To identify gender differences in social and behavioral factors associated with antiretroviral adherence. DESIGN:Prospective cohort study. SETTING:Methadone maintenance program. PARTICIPANTS:One hundred thirteen HIV-seropositive current or former opioid users. MEASUREMENTS AND MAIN RESULTS:Participants we...
journal_title:Journal of general internal medicine
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doi:10.1111/j.1525-1497.2004.30445.x
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Referral from primary care to the mental health specialty sector is important but poorly understood. OBJECTIVE:Identify physician characteristics influencing mental health referral. DESIGN:Randomized controlled trial using Standardized Patients (SPs). SETTING:Offices of primary care physicians in 3 cities...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2006.00411.x
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Early detection of cognitive impairment is a goal of high-quality geriatric medical care, but new approaches are needed to reduce rates of missed cases. OBJECTIVE:To evaluate whether adding routine cognitive screening to primary care visits for older adults increases rates of dementia diagnosis, specialist ...
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更新日期:2007-06-01 00:00:00
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pub_type: 已发布勘误
doi:10.1007/s11606-018-4583-7
更新日期:2019-01-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05473-x
更新日期:2019-11-11 00:00:00
abstract:BACKGROUND:Primary care providers (PCPs) have few tools for enhancing patient self-efficacy, a key mediator of myriad health-influencing behaviors. OBJECTIVE:To examine whether brief standardized patient instructor (SPI)-delivered training increases PCPs' use of self-efficacy-enhancing interviewing techniques (SEE IT)...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
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更新日期:2013-08-01 00:00:00
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journal_title:Journal of general internal medicine
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doi:10.1007/BF02600155
更新日期:1996-11-01 00:00:00
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更新日期:2019-06-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2006-07-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599947
更新日期:1995-06-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:2018-05-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:2020-02-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0410-2
更新日期:2008-01-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2011-03-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:2019-11-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2405-5
更新日期:2013-09-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2005-11-01 00:00:00