Abstract:
OBJECTIVE:To examine the association of clinic HIV-focused features and advanced HIV care experience with Pneumocystis carinii pneumonia (PCP) prophylaxis and development of PCP as the initial AIDS diagnosis. DESIGN:Nonconcurrent prospective study. SETTING:New York State Medicaid Program. PARTICIPANTS:Medicaid enrollees diagnosed with AIDS in 1990-1992. MEASUREMENTS AND MAIN RESULTS:We collected patient clinical and health care data from Medicaid files, conducted telephone interviews of directors of 125 clinics serving as the usual source of care for study patients, and measured AIDS experience as the cumulative number of AIDS patients treated by the study clinics since 1986. Pneumocystis carinii pneumonia prophylaxis in the 6 months before AIDS diagnosis and PCP at AIDS diagnosis were the main outcome measures. Bivariate and multivariate analyses adjusted for clustering of patients within clinics. Of 1,876 HIV-infected persons, 44% had PCP prophylaxis and 38% had primary PCP. Persons on prophylaxis had 20% lower adjusted odds of developing PCP (95% confidence interval [CI] 0.64, 0.99). The adjusted odds of receiving prophylaxis rose monotonically with the number of HIV-focused features offered by the clinic, with threefold higher odds (95% CI 1.6, 5.7) for six versus two or fewer such features. Patients in clinics with three HIV-focused features had 36% lower adjusted odds of PCP than those in clinics with one or none. Neither clinic experience nor specialty had a significant association with prophylaxis or PCP. CONCLUSIONS:PCP prevention in our study cohort appears to be more successful in clinics offering an array of HIV-focused features.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Turner BJ,Markson L,Cocroft J,Cosler L,Hauck WWdoi
10.1046/j.1525-1497.1998.00003.xsubject
Has Abstractpub_date
1998-01-01 00:00:00pages
16-23issue
1eissn
0884-8734issn
1525-1497journal_volume
13pub_type
临床试验,杂志文章,多中心研究abstract::Americans are living longer - a mark of success in public health and medical care - but more will live the last few years with progressive illness and disability. The dominant conception of care delivery separates "aggressive" or life-extending care from "palliative" or death-accepting care, with an assumed "transitio...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2001.90901.x
更新日期:2001-05-01 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:Overall suicide mortality rates are higher among American Indians than in the general population and are particularly high among Indians residing in the upper Midwest. The identification, during encounters with health care providers, of individuals at high risk of suicide is a potential intervention strategy....
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599598
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Patient-centered care--including the domains of access and communication--is an important determinant of positive clinical outcomes. OBJECTIVE:To explore associations between race and HIV-infected patients' experiences of access and communication. DESIGN:This was a cross-sectional survey. PARTICIPANTS:Nin...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-008-0788-5
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Individualized selection of antiretroviral (ARV) therapy is complex, considering drug resistance, comorbidities, drug-drug interactions, and other factors. HIV-ASSIST (www.hivassist.com) is a free, online tool that provides ARV decision support. HIV-ASSIST synthesizes patient and virus-specific attributes to...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05531-4
更新日期:2020-05-01 00:00:00
abstract::The objective of this study was to assess reasons for physicians' noncompliance with computer-generated preventive care reminders. In an academic general internal medicine practice, a survey of physicians' reasons for noncompliance found that 55% of reminders were not complied with. Reasons included "not applicable" i...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599049
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:There is a growing focus on improving the quality and value of health care delivery for high-cost patients. Compared to fee-for-service Medicare, less is known about the clinical composition of high-cost Medicare Advantage populations. OBJECTIVE:To describe a high-cost Medicare Advantage population and iden...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4759-1
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:Middle-aged men are at high risk of suicide. While about half of those who kill themselves visit a primary care clinician (PCC) shortly before death, in current practice, few spontaneously disclose their thoughts of suicide during the visits, and PCCs seldom inquire about such thoughts. In a randomized controll...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05769-3
更新日期:2020-07-01 00:00:00
abstract::We describe a half-day workshop to teach third-year medical students three focused end-of-life care skills: breaking bad news, discussing advance directives, and assessing and managing pain. Our workshop included a readers' theater exercise and three role-play exercises. In two of the workshops, faculty members played...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2004.30115.x
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Patient-provider sexual risk behavior discussions occur infrequently but may be facilitated by high-quality sexual risk screening tools. OBJECTIVE:To develop the Sexual Risk Behavior Inventory (SRBI), a brief computer-administered patient-reported measure. DESIGN:Qualitative item development/quantitative i...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-018-4496-5
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Concern about the link between clinical supervision and safe, quality health care has led to widespread increases in the supervision of medical trainees. The effects of increased supervision on patient care and trainee education are not known, primarily because the current multifacted and poorly operationali...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0179-3
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Disclosure of medical errors is encouraged, but research on how patients respond to specific practices is limited. OBJECTIVE:This study sought to determine whether full disclosure, an existing positive physician-patient relationship, an offer to waive associated costs, and the severity of the clinical outco...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2006.00465.x
更新日期:2006-07-01 00:00:00
abstract::The authors conducted an observational study of attending rounds to determine the current status of this form of clinical teaching in a university-based internal medicine department. Using two forms of measurement, questionnaires and timed observations, we found that 63% of attending physician time was spent in the co...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599208
更新日期:1992-11-01 00:00:00
abstract:IMPORTANCE:Sexual minority women with and at-risk for human immunodeficiency virus (HIV) may face increased risks of violence. OBJECTIVE:To understand the relationship between sexual minority status and violence; and how high-risk sex and substance use mediate that relationship among women with and at-risk for HIV. D...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-014-2832-y
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:Heart failure (HF) is a leading cause of hospitalization. Clinical and socio-demographic factors have been associated with cardiac admissions, but little is known about the role of anxiety. We examined whether symptoms of anxiety were associated with cardiac hospitalizations at 12 months in HF patients. METH...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-011-1843-1
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:The growing number of primary care physicians (PCPs) reducing their clinical work hours has raised concerns about meeting the future demand for services and fulfilling the continuity and access mandates for patient-centered care. However, the patient's experience of care with part-time physicians is relative...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3104-6
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Network meta-analysis (NMA) is a popular tool to compare multiple treatments in medical research. It is frequently implemented via Bayesian methods. The prior choice of between-study heterogeneity is critical in Bayesian NMAs. This study evaluates the impact of different priors for heterogeneity on NMA resul...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06357-1
更新日期:2021-01-05 00:00:00
abstract:BACKGROUND:Our objective was to assess the performance of machine learning methods to predict post-operative delirium using a prospective clinical cohort. METHODS:We analyzed data from an observational cohort study of 560 older adults (≥ 70 years) without dementia undergoing major elective non-cardiac surgery. Post-op...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06238-7
更新日期:2020-10-19 00:00:00
abstract:BACKGROUND:Food insecurity refers to limited or uncertain access to food resulting from inadequate financial resources. There is a clear association between food insecurity and obesity among women, but little is known about the relationship between food insecurity and type 2 diabetes. OBJECTIVE:To evaluate whether the...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0192-6
更新日期:2007-07-01 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:BACKGROUND:In the 27 nursing homes located within the Veterans Affairs (VA) Central Region, the proportion of residents with pressure ulcers in 1986 varied from 2% to 16%. Three of these nursing homes were selected for study: nursing home A from the highest prevalence quintile, B from close to the median, and C from th...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02598281
更新日期:1993-12-01 00:00:00
abstract::To evaluate the performance of serum iron studies as a diagnostic test for iron-deficiency anemia in a county hospital, the authors identified retrospectively all general medicine patients who had had bone-marrow aspirates for the work-up of non-macrocytic anemias from 1978 through 1983. Re-reading a sample of aspirat...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596144
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Clinician's knowledge of a woman's cancer family history (CFH) and counseling about health-related behaviors (HRB) is necessary for appropriate breast cancer care. OBJECTIVE:To evaluate whether clinicians solicit CFH and counsel women on HRB; to assess relationship of well visits and patient risk perception...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-006-0087-y
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Patients with limited literacy skills are routinely encountered in clinical practice, but they are not always identified by clinicians. OBJECTIVE:To evaluate 3 candidate questions to determine their accuracy in identifying patients with limited or marginal health literacy skills. METHODS:We studied 305 Eng...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00532.x
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Obese women experience higher postmenopausal breast cancer risk, morbidity, and mortality and may be less likely to undergo mammography. OBJECTIVES:To quantify the relationship between body weight and mammography in white and black women. DATA SOURCES AND REVIEW METHODS:We identified original articles eval...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11606-009-0939-3
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Knowledge about factors associated with provider ordering of appropriate testing is limited. OBJECTIVE:To determine physician factors associated with ordering recommended laboratory monitoring tests for high-risk medications. METHODS:Retrospective cohort study of patients prescribed a high-risk medication ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-2907-9
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Treatment decisions about menopause are predicated on a transient duration of vasomotor symptoms. However, evidence supporting a specific duration is weak. OBJECTIVE:To estimate the natural progression of vasomotor symptoms during the menopause transition by systematically compiling available evidence using...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,meta分析
doi:10.1007/s11606-008-0655-4
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Despite compelling reasons to draw on the contributions of under-represented minority (URM) faculty members, US medical schools lack these faculty, particularly in leadership and senior roles. OBJECTIVE:The study's purpose was to document URM faculty perceptions and experience of the culture of academic med...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1478-7
更新日期:2010-12-01 00:00:00
abstract:CASE REPORT:A 32-year-old African male presented with 10 hours of severe back pain. Initial computed tomography scan of the back showed no abnormality, and initial laboratory investigations were consistent with rhabdomyolysis. Despite stopping potential causative medications, aggressive intravenous hydration, and urine...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-008-0569-1
更新日期:2008-06-01 00:00:00
abstract::This perspective describes federal efforts in the United States (U.S.) to integrate care for an especially complex, vulnerable, and costly patient population: adults eligible for both Medicare and Medicaid insurance. The goal of the paper is to demystify for clinical policy leaders and practicing clinicians the origin...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05914-y
更新日期:2020-12-01 00:00:00