Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Physicians: Individuals licensed to practice medicine.Practice Management, Medical: The organization and operation of the business aspects of a physician's practice.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Group Practice: Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.Professional Practice: The use of one's knowledge in a particular profession. It includes, in the case of the field of biomedicine, professional activities related to health care and the actual performance of the duties related to the provision of health care.United StatesPrivate Practice: Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice.Physicians, Primary Care: Providers of initial care for patients. These PHYSICIANS refer patients when appropriate for secondary or specialist care.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Practice Management: Business management of medical, dental and veterinary practices that may include capital financing, utilization management, and arrangement of capitation agreements with other parties.Hospital-Physician Joint Ventures: A formal financial agreement made between one or more physicians and a hospital to provide ambulatory alternative services to those patients who do not require hospitalization.Physician's Role: The expected function of a member of the medical profession.Dentist's Practice Patterns: Patterns of practice in dentistry related to diagnosis and treatment.Medicine: The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.Specialization: An occupation limited in scope to a subsection of a broader field.Physicians' Offices: The room or rooms in which the physician and staff provide patient care. The offices include all rooms in the physician's office suite.Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Physician Incentive Plans: Compensatory plans designed to motivate physicians in relation to patient referral, physician recruitment, and efficient use of the health facility.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Professional Practice Location: Geographic area in which a professional person practices; includes primarily physicians and dentists.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Office Visits: Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes, and the genital tract in the male. Common urological problems include urinary obstruction, URINARY INCONTINENCE, infections, and UROGENITAL NEOPLASMS.Independent Practice Associations: A partnership, corporation, association, or other legal entity that enters into an arrangement for the provision of services with persons who are licensed to practice medicine, osteopathy, and dentistry, and with other care personnel. Under an IPA arrangement, licensed professional persons provide services through the entity in accordance with a mutually accepted compensation arrangement, while retaining their private practices. Services under the IPA are marketed through a prepaid health plan. (From Facts on File Dictionary of Health Care Management, 1988)Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.Ontario: A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)Fees, Medical: Amounts charged to the patient as payer for medical services.Physician-Patient Relations: The interactions between physician and patient.Physicians, Women: Women licensed to practice medicine.Education, Medical, Continuing: Educational programs designed to inform physicians of recent advances in their field.Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Hospital-Physician Relations: Includes relationships between hospitals, their governing boards, and administrators in regard to physicians, whether or not the physicians are members of the medical staff or have medical staff privileges.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.Managed Care Programs: Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.Efficiency, Organizational: The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.Electronic Prescribing: The use of COMPUTER COMMUNICATION NETWORKS to store and transmit medical PRESCRIPTIONS.Investments: Use for articles on the investing of funds for income or profit.Referral and Consultation: The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.Personnel Staffing and Scheduling Information Systems: Computer-based systems for use in personnel management in a facility, e.g., distribution of caregivers with relation to patient needs.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Programming, Linear: A technique of operations research for solving certain kinds of problems involving many variables where a best value or set of best values is to be found. It is most likely to be feasible when the quantity to be optimized, sometimes called the objective function, can be stated as a mathematical expression in terms of the various activities within the system, and when this expression is simply proportional to the measure of the activities, i.e., is linear, and when all the restrictions are also linear. It is different from computer programming, although problems using linear programming techniques may be programmed on a computer.Medical Records Systems, Computerized: Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.Prepaid Health Plans: Contracts between an insurer and a subscriber or a group of subscribers whereby a specified set of health benefits is provided in return for a periodic premium.Health Facility Size: The physical space or dimensions of a facility. Size may be indicated by bed capacity.

*  Changing physician practice behavior to measure and improve clinical outcomes.

The behavior of 165 physicians in 2 settings (suburban and urban) was studied. ... Physician practice behavior often produces poor clinical outcomes in the management of cardiovascular disease risk factors in ... Physician's Practice Patterns / standards*. Practice Guidelines as Topic / standards*. Quality of Health Care / standards*. ... Physician practice behavior often produces poor clinical outcomes in the management of cardiovascular disease risk factors in ...
biomedsearch.com/nih/Changing-physician-practice-behavior-to/17077421.html

*  Practice Patterns of Young Physicians, 1991: [United States]

... interviewed physicians who participated in the previous survey of early career physicians PRACTICE PATTERNS OF YOUNG PHYSICIANS ... interviewed physicians who participated in the previous survey of early career physicians PRACTICE PATTERNS OF YOUNG PHYSICIANS ... a simple random sample of physicians who participated in PRACTICE PATTERNS OF YOUNG PHYSICIANS, 1987 (ICPSR 9277). The ... Practice Patterns of Young Physicians, 1991: [United States] (ICPSR 6145) Principal Investigator(s): Hadley, Jack ...
icpsr.umich.edu/icpsrweb/ICPSR/studies/6145

*  Drug prescription pattern for asthma among nigerian doctors in general practice: A cross-sectional survey

... Ademola E. Fawibe, ... resident doctors (trainees in general/family practice), and Fellows in general/family practice (doctors with postgraduate ... doctors, without any significant difference in the prescription pattern, according to the working status and practice setting ... and doctors in private practice (P,0.001) significantly prescribed IV methylxanthines, more than other categories of doctors. ...
pubmedcentralcanada.ca/pmcc/articles/PMC3339208/

*  Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features...

... physician's practice patterns; reminder$; feedback$; decision support$; and expert system. We also systematically searched the ... Information In Practice Improving clinical practice using clinical decision support systems: a systematic review of trials to ... physicians, physician assistants, or nurse practitioners) directly involved in patient care; and assessment of improvements in ... Practical approaches to providing better preventive care: are physicians a problem or a solution?Am J Prev Med1988; 4:27-48. ...
bmj.com/content/330/7494/765.full?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1119602172370_1371&stored_search=&FIRSTINDEX=0&sortspec=relevance&volume=330&firstpage=765&resourcetype=1,2,3,4

*  Chronic laryngitis associated with gastroesophageal reflux: prospective assessment of differences in practice patterns between...

... prospective assessment of differences in practice patterns between gastroenterologists and ENT physicians. Ahmed TF, Khandwala ... Because of this dichotomy we designed this study to assess the practice pattern differences among ENT physicians and ... prospective assessment of differences in practice patterns between gastroenterologists and ENT physicians.. Ahmed TF, Khandwala ... prospective assessment of differences in practice patterns between gastroenterologists and ENT physicians.. ...
https://childrenallergyclinic.wordpress.com/2010/04/15/chronic-laryngitis-associated-with-gastroesophageal-reflux-prospective-assessment-of-differences-in-practice-patterns-between-gastroenterologists-and-ent-physicians/

*  A Study of Two Methods of Determining When to Begin or Change Anti-HIV Treatment - Full Text View - ClinicalTrials.gov

Physician's Practice Patterns. Additional relevant MeSH terms: HIV Infections. Lentivirus Infections. Retroviridae Infections. ... Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your ... decision making based on plasma HIV RNA quantitation in addition to current clinical practice in patients with ,= 300 CD4+ ... Patients are randomized to a decision making strategy for initiating or changing therapy based on current clinical practice ...
https://clinicaltrials.gov/show/NCT00001069?order=304

*  "Influence of bedrest or ambulation in the clinical treatment of acute deep vein thrombosis on patient outcomes: a review and...

Evidence-Based Practice, *Humans, *Patient Selection, *Physician's Practice Patterns, *Research Design, *Stockings, ...
https://works.bepress.com/amy_sparks/58/

*  'Bending the Curve': What Really Drives Health Care Spending | The Heritage...

Variation in Physician Practice Patterns. Several studies have directly examined physician practice patterns and their ... The authors assessed physician practice patterns by asking physicians about their routine follow-up intervals and their ... they argue that a more plausible explanation is regional variation in doctors' practice patterns and patients' preferences, ... It is also possible that physicians in high-spending regions may practice at the "right" level, while the physicians in low- ...
heritage.org/health-care-reform/report/bending-the-curve-what-really-drives-health-care-spending

*  Depression treatment during outpatient visits by U.S. children and adolescents.

Physician's Practice Patterns / statistics & numerical data. Product Labeling. Psychotherapy. Retrospective Studies. Serotonin ...
biomedsearch.com/nih/Depression-treatment-during-outpatient-visits/16310120.html

*  Sara Bleich

Physician practice patterns of obesity diagnosis and weight-related counseling. Sara N Bleich. Department of Health Policy and ... Do physician beliefs about causes of obesity translate into actionable issues on which physicians counsel their patients?. Sara ... Do physician beliefs about causes of obesity translate into actionable issues on which physicians counsel their patients?. Sara ... physicians*poverty*social class*weight loss*delivery of health care*health care surveys*primary health care*health promotion* ...
https://labome.org/expert/usa/johns/bleich/sara-bleich-1160905.html

*  CONTRARY BRIN: Water and Wrenches, Belts and Suspenders: A rational approach to exploring Mars & Beyond

It has not had sufficient impact on physician practice patterns. The reasons are complex and not entirely financial.. Physician ... Dr. Brin, your beloved Navy has turned into a bunch of wimps.. Navy captain demoted for berating her crew She was accused of ... Dr. Brin said this already, but just as we had to 'assume' that there were Weapons of Mass Destruction in Iraq, that if there ... Few doctors really bother to have long conversations on the merits of this or that option, sadly.. Now, back to it. Tonight I ...
davidbrin.blogspot.com/2010/02/water-and-wrenches-belts-and-suspenders.html?showComment=1289409102335

*  Physician Assistant G Jobs, Employment in Florida | Indeed.com

26 Physician Assistant G Jobs available in Florida on Indeed.com. one search. all jobs. ... Installation of a system for monitoring physician practice patterns in.... 30+ days ago - save job - more.... ... 6) Have passed a physical examination by a licensed physician, physician assistant, or certified advanced registered nurse ... Palliative Medicine Physician - Associate Member Moffitt Cancer Center - 237 reviews - Tampa, FL 33612 The Assistant or ...
indeed.com/q-Physician-Assistant-G-l-Florida-jobs.html

*  Why Aren't We All in Therapy? | Psychiatric Times

The looming specter of emotional and physical exhaustion in residency often takes hold well into a physician's career. So what ... 1. The Physician's Foundation (2016, September 21). 2016 Survey of America's Physicians: Practice Patterns & Perspectives. ... About the authors: Dr. Whitmore and Dr. Salg are second-year general psychiatry residents in the department of psychiatry at ... half of doctors in practice say they would not recommend medicine as a career to their children and over a quarter would not ...
psychiatrictimes.com/blogs/residents-blog/why-arent-we-all-therapy?cid=related_teaser

*  Fluid resuscitation practice patterns in intensive care units of the USA: a cross-sectional survey of critical care physicians ...

This survey of 502 physicians from 4 clinical specialties of various ICU practice settings revealed that practice patterns in ... Fluid resuscitation practice patterns in intensive care units of the USA: a cross-sectional survey of critical care physicians ... 6). Subanalysis results suggest that practice patterns varied depending on whether a physician worked in university vs ... the results allow physicians to compare their own practice patterns to other colleagues, which could be helpful given the lack ...
https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-016-0035-2

*  Faculty Publications, 2011

Physician practice patterns of obesity diagnosis and weight-related counseling. Patient Educ Couns. 2011 Jan;82(1):123-9. Epub ... Find a Doctor. Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community ... Quality of Patient-Physician Discussions About CKD in Primary Care: A Cross-sectional Study. Am J Kidney Dis. 2011 Apr;57(4): ... Impact of Patient-Doctor Race Concordance on Rates of Weight-Related Counseling in Visits by Black and White Obese Individuals ...
hopkinsmedicine.org/gim/faculty/publications/Pubs_2011.html

*  CWRU School of Medicine | Department of Family Medicine

Flocke SA, Litaker D. Physician-Practice Patterns and Variation in the Delivery of Preventive Services. J Gen Intern Med 2007; ... Patient-physician colorectal cancer screening discussions delivery of the 5A's in practice. Am J Prev Med. 2011 Nov; 41(5): 480 ... Practice-based innovations: More relevant and transportable than NIH-funded studies. J Am Board Fam Med 2014 Nov-Dec; 27(6): ... Doctor, what's wrong with me? Factors that delay the diagnosis of colorectal cancer. Patient Educ Couns. 2011 Sep; 84(3): 352-8 ...
https://casemed.case.edu/fammed/research/publications.html

*  Diagnostic Imaging for Low Back Pain: Advice for High-Value Health Care From the American College of Physicians | Annals of...

A survey of primary care physician practice patterns and adherence to acute low back problem guidelines. ... Low back pain and best practice care: A survey of general practice physicians. ... Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey. ... Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the ...
annals.org/aim/article/746774/diagnostic-imaging-low-back-pain-advice-high-value-health-care?issueno=3&atab=10

*  Hospital management of children with acute gastroenteritis : Current Opinion in Gastroenterology

The treatment of pediatric gastroenteritis: a comparative analysis of pediatric emergency physicians' practice patterns. Acad ... evaluate the current treatment practices in the treatment of AGE comparing practice patterns between Canadian and US physicians ... A manual for physician and other senior health workersWHO/FCH/CAH/0.5.1.Geneva:WHO,2005. http//www.who.int/child_adolescent_ ... A survey of North American physicians, specialized in pediatric emergency, found that several regimens are used [16▪▪]. In a ...
journals.lww.com/co-gastroenterology/Fulltext/2013/01000/Hospital_management_of_children_with_acute.5.aspx?WT.mc_id=HPxADx20100319xMP

*  Association Between Rising Professional Liability Insurance... : Obstetrics & Gynecology

... such as physician practice patterns, have been demonstrated to affect cesarean delivery decisions.9 Indeed, physicians ... One factor that has been theorized to affect physician practice patterns and decision-making is the medical-legal environment.7 ... such as changing physician practice patterns,9 influence the cesarean delivery rate. ... These findings, together with evidence that cesarean delivery rates may be affected by physician practice style, suggest that ...
journals.lww.com/greenjournal/Fulltext/2007/12000/Association_Between_Rising_Professional_Liability.10.aspx

*  adenoma of the oral cavity 2005:2010[pubdate] *count=100 - BioMedLib™ search engine

Practice Guidelines as Topic. Practice Patterns, Physicians'. *[Email] Email this result item Email the results to the ... Practice Guideline. Randomized Controlled Trial. Review. More publication types:. Addresses. Bibliography. Biography. Case ... Journal-full-title] Medical principles and practice : international journal of the Kuwait University, Health Science Centre ... and in other parts surrounded by projections of cells arranged in a trabecular pattern far into the cystic cavity. ...
bmlsearch.com/?kwr=adenoma of the oral cavity 2005:2010[pubdate]&cxts=100&stmp=b0

*  CHIROPRACTIC PEDIATRICS

... and links to information of benefit to the doctor of chiropractic and their patients. UPDATED 9-23-2017 http://www.chiro.org/ ... Practice Patterns of Doctors of Chiropractic With a Pediatric Diplomate:. A Cross-sectional Survey. BMC Complement Altern Med. ... It was written by Dr. Ron Eisenberg and Dr. Virgil Williams, staff physicians at Highland General Hospital in Oakland, ... Dr. Miller wrote a follow-up study, a cost comparison of the medical and chiropractic care provided in her earlier RTC study, ...
chiro.org/pediatrics/index.shtml

*  Study Search Results

Practice Patterns of Young Physicians, 1991: [United States] (ICPSR 6145) Hadley, Jack ...
icpsr.umich.edu/icpsrweb/ICPSR/studies?keyword=Medicare&permit[0]=AVAILABLE&dataFormat[0]=SPSS&paging.startRow=1

*  Brevet US20040039600 - System and method for predicting financial data about health care expenses - Google Brevets

In addition, detail at the DxGroup™ and Condition Category levels is helpful for profiling physician practice patterns and for ... Medical practice pattern tool. US20070126863 *. 7 avr. 2006. 7 juin 2007. Prechtl Eric F. Stereoscopic wide field of view ... Medical practice pattern tool. US7831451 *. 25 juin 2004. 9 nov. 2010. Quantitative Data Solutions, Inc.. Systems and methods ... With a typical lag of several months of reporting time between the date a physician makes a diagnosis and the date on which the ...
google.fr/patents/US20040039600

*  Volume 3, Issue 1, January 2008: Knowledge Translation and Systematic Reviews | National Rehabilitation Information Center

Physician's Practice Patterns/Role. *Policy Making. *Practice Guidelines. *Presentation of reviews. *Private Sector/ ... Embracing new clinical practice guidelines and best practice models has not protected physicians from superfluous torts; in ... ABSTRACT: BACKGROUND: A significant gap has been documented between best practice and the actual practice of surgery. Our group ... There is, however, a considerable gap between research and practice. Closing the research-to-practice gap involves changing ...
naric.com/public/reSearch/eric.ed.gov/ERICWebPortal/contentdelivery/servlet/?q=node/125

*  share via email

Ethics and Best Practice Guidelines for Training Experiences in Global Health Authors: John A. Crump, Jeremy Sugarman and the ... Social and News Media Enable Estimation of Epidemiological Patterns Early in the 2010 Haitian Cholera Outbreak Authors: Rumi ... dr.jyotiranjan@gmail.com, drbhatiav@yahoo.com, and sonuhsubba2016@gmail.com. ...
ajtmh.org/content/journals/10.4269/ajtmh.15-0593

Samuel Bard (physician): Samuel Bard (April 1, 1742 – May 24, 1821) was an American physician. He founded the first medical school in New York.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,National Clinical Guideline CentreCanadian Intermountain Joint Venture: The Canadian Intermountain Joint Venture (CIJV) is a partnership of "government agencies, Aboriginal groups, nongovernmental organizations, industry, universities and landowners" for the implementation of the North American Waterfowl Management Plan in the inter-mountain areas of south and central British Columbia in Canada, and the south-western mountain region of Alberta. Its region of operation includes "all the mountain national parks", with boundaries delineated by the border with the United States to the south, the eastern crest of the Rocky Mountains to the east, the crest of the Coast Mountains to the west, and the boreal forest to the north.Dentists Act 1984: The Dentists Act 1984 (c. 24) is an Act of the Parliament of the United Kingdom regulating dentistry.Halfdan T. MahlerClosed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.Department of Urology, University of Virginia: {{Infobox universityCanadian Organ Replacement Registry: The Canadian Organ Replacement Registry CORR is a health organisation was started by Canadian nephrologists and kidney transplant surgeons in 1985 in order to develop the care of patients with renal failure. In the early 1990s data on liver and heart transplantation were added to the registry.Chronic disease in Northern OntarioMercuriade: Mercuriade was an Italian physician, surgeon and medical author in the 14th century. She is one of the few woman physicians known from the Middle Ages.Behavior change (public health): Behavior change is a central objective in public health interventions,WHO 2002: World Health Report 2002 - Reducing Risks, Promoting Healthy Life Accessed Feb 2015 http://www.who.American Osteopathic Board of Internal MedicineToyota NZ engine: The Toyota NZ engine family is a straight-4 piston engine series. The 1NZ series uses aluminum engine blocks and DOHC cylinder heads.List of companies listed on the Oslo Stock Exchange: The Oslo Stock Exchange (Norwegian: Oslo Børs) serves as the main market for trading in the shares of Norwegian companies. It opens at 9:00am and closes 4:30pm local time (CET).Referral (medicine): In medicine, referral is the transfer of care for a patient from one clinician to another.García Olmos L, Gervas Camacho J, Otero A, Pérez Fernández M.Ravi Iyengar: Ravi Iyengar, is a systems biologist and director of the Experimental Therapeutics Institute at the Icahn School of Medicine at Mount Sinai in New York City, as well as the Dorothy H. and Lewis Rosenstiel Professor and chairman of the Department of Pharmacology and Systems Therapeutics and director and principal investigator of the NIGMS-funded Systems Biology Center New York at The Mount Sinai Medical Center.Ideal number: In number theory an ideal number is an algebraic integer which represents an ideal in the ring of integers of a number field; the idea was developed by Ernst Kummer, and led to Richard Dedekind's definition of ideals for rings. An ideal in the ring of integers of an algebraic number field is principal if it consists of multiples of a single element of the ring, and nonprincipal otherwise.

(1/6616) Physician advice and individual behaviors about cardiovascular disease risk reduction--seven states and Puerto Rico, 1997.

Cardiovascular disease (CVD) (e.g., heart disease and stroke) is the leading cause of death in the United States and accounted for 959,227 deaths in 1996. Strategies to reduce the risk for heart disease and stroke include lifestyle changes (e.g., eating fewer high-fat and high-cholesterol foods) and increasing physical activity. The U.S. Preventive Services Task Force and the American Heart Association (AHA) recommend that, as part of a preventive health examination, all primary-care providers counsel their patients about a healthy diet and regular physical activity. AHA also recommends low-dose aspirin use as a secondary preventive measure among persons with existing CVD. To determine the prevalence of physician counseling about cardiovascular health and changes in individual behaviors, CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) for seven states and Puerto Rico. This report summarizes the results of that analysis, which indicate a lower prevalence of counseling and behavior change among persons without than with a history of heart disease or stroke.  (+info)

(2/6616) Randomised controlled trial of effect of feedback on general practitioners' prescribing in Australia.

OBJECTIVE: To evaluate the effect on general practitioners' prescribing of feedback on their levels of prescribing. DESIGN: Randomised controlled trial. SETTING: General practice in rural Australia. PARTICIPANTS: 2440 full time recognised general practitioners practising in non-urban areas. INTERVENTION: Two sets of graphical displays (6 months apart) of their prescribing rates for 2 years, relative to those of their peers, were posted to participants. Data were provided for five main drug groups and were accompanied by educational newsletters. The control group received no information on their prescribing. MAIN OUTCOME MEASURES: Prescribing rates in the intervention and control groups for the five main drug groups, total prescribing and potential substitute prescribing and ordering before and after the interventions. RESULTS: The intervention and control groups had similar baseline characteristics (age, sex, patient mix, practices). Median prescribing rates for the two groups were almost identical before and after the interventions. Any changes in prescribing observed in the intervention group were also seen in the control group. There was no evidence that feedback reduced the variability in prescribing nor did it differentially affect the very high or very low prescribers. CONCLUSIONS: The form of feedback evaluated here-mailed, unsolicited, centralised, government sponsored, and based on aggregate data-had no impact on the prescribing levels of general practitioners.  (+info)

(3/6616) A comparison of three methods of setting prescribing budgets, using data derived from defined daily dose analyses of historic patterns of use.

BACKGROUND: Prescribing matters (particularly budget setting and research into prescribing variation between doctors) have been handicapped by the absence of credible measures of the volume of drugs prescribed. AIM: To use the defined daily dose (DDD) method to study variation in the volume and cost of drugs prescribed across the seven main British National Formulary (BNF) chapters with a view to comparing different methods of setting prescribing budgets. METHOD: Study of one year of prescribing statistics from all 129 general practices in Lothian, covering 808,059 patients: analyses of prescribing statistics for 1995 to define volume and cost/volume of prescribing for one year for 10 groups of practices defined by the age and deprivation status of their patients, for seven BNF chapters; creation of prescribing budgets for 1996 for each individual practice based on the use of target volume and cost statistics; comparison of 1996 DDD-based budgets with those set using the conventional historical approach; and comparison of DDD-based budgets with budgets set using a capitation-based formula derived from local cost/patient information. RESULTS: The volume of drugs prescribed was affected by the age structure of the practices in BNF Chapters 1 (gastrointestinal), 2 (cardiovascular), and 6 (endocrine), and by deprivation structure for BNF Chapters 3 (respiratory) and 4 (central nervous system). Costs per DDD in the major BNF chapters were largely independent of age, deprivation structure, or fundholding status. Capitation and DDD-based budgets were similar to each other, but both differed substantially from historic budgets. One practice in seven gained or lost more than 100,000 Pounds per annum using DDD or capitation budgets compared with historic budgets. The DDD-based budget, but not the capitation-based budget, can be used to set volume-specific prescribing targets. CONCLUSIONS: DDD-based and capitation-based prescribing budgets can be set using a simple explanatory model and generalizable methods. In this study, both differed substantially from historic budgets. DDD budgets could be created to accommodate new prescribing strategies and raised or lowered to reflect local intentions to alter overall prescribing volume or cost targets. We recommend that future work on setting budgets and researching prescribing variations should be based on DDD statistics.  (+info)

(4/6616) Out-of-hours service in Denmark: the effect of a structural change.

BACKGROUND: In Denmark, the provision of out-of-hours care by general practitioners (GPs) was reformed at the start of 1992. Rota systems were replaced locally by county-based services. The new out-of-hours service resulted in a considerable reduction in the total number of GPs on call. AIM: To describe how the patients experienced the change from a satisfaction point of view, and how the pattern of patient contact and the fee for GPs changed with the new system. METHOD: The county of Funen was chosen as the geographical area where data were collected. A questionnaire measuring patient satisfaction was posted before the change, immediately after the change, and three years later to a random selection of patients who had been in contact with the out-of-hours service within two weeks before the mailing date. All primary care services for the Danish population are stored in a database (National Health Service Registry). From this continuously updated database, the contact pattern and the fee for GPs were extracted for 1991, 1992, and 1995. RESULTS: The total number of patient contacts was reduced by 16% in the first year, but by only 6% three years later. Three years after the change, there were more than twice as many telephone consultations as before the change, and there were only a third as many home visits. After three years, the GPs' fees were reduced by 20%. There was a significant decrease in patient satisfaction, although the overall level remained high. This decrease was lower three years after the change than immediately after the new system was introduced. CONCLUSION: The new service had a major cost-effectiveness benefit, but there was a price to pay in patient satisfaction.  (+info)

(5/6616) Clinical experience and choice of drug therapy for human immunodeficiency virus disease.

To determine if providers experienced in the management of human immunodeficiency virus (HIV) disease preferred different treatment regimens than providers with less experience, we analyzed data from a national survey of primary care providers' preferred regimens for the management of 30 HIV-related medical conditions. We mailed questionnaires to 999 correct addresses of providers in > 20 cities in the United States in May 1996. We received 524 responses (response rate, 52%). We found a statistically significant association between the number of HIV-infected patients cared for by the provider and the likelihood that the provider would report prescribing highly active antiretroviral therapy and multidrug combinations for treatment of opportunistic infections. Providers with few HIV-infected patients were substantially less likely to report using new therapeutic regimens or new diagnostic tools. We concluded that the preferred regimens of experienced providers are more likely to be consistent with the latest information on treatment for HIV disease than are those of less experienced providers.  (+info)

(6/6616) Practice patterns, case mix, Medicare payment policy, and dialysis facility costs.

OBJECTIVE: To evaluate the effects of case mix, practice patterns, features of the payment system, and facility characteristics on the cost of dialysis. DATA SOURCES/STUDY SETTING: The nationally representative sample of dialysis units in the 1991 U.S. Renal Data System's Case Mix Adequacy (CMA) Study. The CMA data were merged with data from Medicare Cost Reports, HCFA facility surveys, and HCFA's end-stage renal disease patient registry. STUDY DESIGN: We estimated a statistical cost function to examine the determinants of costs at the dialysis unit level. PRINCIPAL FINDINGS: The relationship between case mix and costs was generally weak. However, dialysis practices (type of dialysis membrane, membrane reuse policy, and treatment duration) did have a significant effect on costs. Further, facilities whose payment was constrained by HCFA's ceiling on the adjustment for area wage rates incurred higher costs than unconstrained facilities. The costs of hospital-based units were considerably higher than those of freestanding units. Among chain units, only members of one of the largest national chains exhibited significant cost savings relative to independent facilities. CONCLUSIONS: Little evidence showed that adjusting dialysis payment to account for differences in case mix across facilities would be necessary to ensure access to care for high-cost patients or to reimburse facilities equitably for their costs. However, current efforts to increase dose of dialysis may require higher payments. Longer treatments appear to be the most economical method of increasing the dose of dialysis. Switching to more expensive types of dialysis membranes was a more costly means of increasing dose and hence must be justified by benefits beyond those of higher dose. Reusing membranes saved money, but the savings were insufficient to offset the costs associated with using more expensive membranes. Most, but not all, of the higher costs observed in hospital-based units appear to reflect overhead cost allocation rather than a difference in real resources devoted to treatment. The economies experienced by the largest chains may provide an explanation for their recent growth in market share. The heterogeneity of results by chain size implies that characterizing units using a simple chain status indicator variable is inadequate. Cost differences by facility type and the effects of the ongoing growth of large chains are worthy of continued monitoring to inform both payment policy and antitrust enforcement.  (+info)

(7/6616) Reactions to medical abortion among providers of surgical abortion: an early snapshot.

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(8/6616) Voluntary euthanasia under control? Further empirical evidence from The Netherlands.

Nineteen ninety-six saw the publication of a major Dutch survey into euthanasia in the Netherlands. This paper outlines the main statistical findings of this survey and considers whether it shows that voluntary euthanasia is under effective control in the Netherlands. The paper concludes that although there has been some improvement in compliance with procedural requirements, the practice of voluntary euthanasia remains beyond effective control.  (+info)


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