Family practice research journal最新文献_第6页

Assessing bad debt in New Hampshire and Vermont office-based practices. 评估坏账在新罕布什尔州和佛蒙特州的办公室为基础的做法。

Family practice research journal Pub Date : 1993-12-01

S J Weiner

{"title":"Assessing bad debt in New Hampshire and Vermont office-based practices.","authors":"S J Weiner","doi":"","DOIUrl":"","url":null,"abstract":"Objective: Bad debt is one measure of the cost of medical indigence on health care institutions. This two-part study identifies a methodology for and presents findings from measuring bad debt in a collection of office-based practices.Methods: In Part I of the study, data were gathered on site from 26 practices in Sullivan County, New Hampshire, after first conducting a survey of bad debt losses at these offices. Survey findings were compared to on-site findings and it was determined that only the practices with computerized record-keeping systems were able to supply accurate data by survey alone. In Part II, 71 randomly chosen computerized practices in New Hampshire and Vermont (identified in a screen of 275 practices) were surveyed on bad debt.Results: The practices from Part II wrote off an average of $23,115 per physician in 1990 from bad debt in a region in which primary care physician income averages approximately $70,000.Conclusions: The author calculates that bad debt losses are greater than either Medicare or Medicaid losses. Uninsured patients account for 21.6% of office visits but 45% of practice write-offs. Bad debt accounts for a 16% loss from total earnings from regular office visits. Office-based practices in this study are shouldering a significant portion of the cost of care of their uninsured and underinsured patients.","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 4","pages":"331-42"},"PeriodicalIF":0.0,"publicationDate":"1993-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19273298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The structure and activity of primary care research networks. 初级保健研究网络的结构和活动。

Family practice research journal Pub Date : 1993-12-01

J W Beasley

引用次数: 0

Sleep, psychological distress, and somatic symptoms in perimenopausal women. 围绝经期妇女的睡眠、心理困扰和躯体症状

Family practice research journal Pub Date : 1993-12-01

J L Shaver, V M Paulsen

{"title":"Sleep, psychological distress, and somatic symptoms in perimenopausal women.","authors":"J L Shaver, V M Paulsen","doi":"","DOIUrl":"","url":null,"abstract":"Objective: Self-report and somnographic data from 135 volunteer, disease-free, women (37-59 years) were used to determine the prevalence of perceived poor sleep and to compare women with and without \"poor\" sleep on menopausal status, somnographic sleep, psychological distress, and somatic symptom cluster frequencies.Methods: Data from identical measures done on two groups of perimenopausal-age women, one recruited for menopausal age and the other for same age but sleep problems plus controls, were tested using a two-way analysis of variance for the main effects of recruitment group and the presence or absence of \"poor\" sleep as well as the joint effects of both.Results: \"Poor\" sleep was reported by more than one-third of the women, but menopausal status and perceived sleep quality were not statistically related. Women with \"poor\" sleep took longer to fall asleep, spent longer in bed, and had higher scores for psychological distress and for four out of five somatic symptom clusters (p < or = 0.03), compared to women with \"good\" sleep.Conclusion: In sum, midlife women reporting poor sleep are likely to have trouble falling asleep and to have higher psychological distress and somatic symptoms, especially musculoskeletal discomfort and fatigue, coinciding with their perceived poor sleep.","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 4","pages":"373-84"},"PeriodicalIF":0.0,"publicationDate":"1993-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19273302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Family medicine in Minnesota: office costs and productivity. 明尼苏达州的家庭医学:办公室成本和生产力。

Family practice research journal Pub Date : 1993-12-01

K Kephart, C J Kaemmerer, S M Brown

引用次数: 0

Clinical decision-making following abnormal Papanicolaou smear reports. 巴氏涂片异常报告后的临床决策。

Family practice research journal Pub Date : 1993-12-01

D G Ferris, M D Miller, P Wagner, E Walaitis, F H Lawler

{"title":"Clinical decision-making following abnormal Papanicolaou smear reports.","authors":"D G Ferris, M D Miller, P Wagner, E Walaitis, F H Lawler","doi":"","DOIUrl":"","url":null,"abstract":"Objective: Interpretation of abnormal Papanicolaou smear reports and the subsequent management of the patient frequently present significant decision-making problems for clinicians. The purpose of this study was to evaluate family physician clinical decision-making strategies for abnormal cervical cytology reports using simulation techniques.Methods: One hundred fifteen practicing family physicians evaluated two simulations of women with abnormal cervical cytology, the first with inflammatory cytology and the second with a high-grade squamous intraepithelial lesion.Results: Most physicians (66%) selected an etiology evaluation and specific treatment approach to an inflammatory report, while 26% of respondents chose empiric treatment. For the high-grade squamous intraepithelial lesion simulation, 88% of physicians chose the appropriate management response of colposcopic evaluation.Conclusions: Practice experience, level of involvement, clinician gender, and type of cervical cytology classification influenced family physician clinical decision-making. The majority of responses to an inflammatory or high-grade squamous intraepithelial lesion report was appropriate based on current scientific data.","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 4","pages":"343-53"},"PeriodicalIF":0.0,"publicationDate":"1993-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19273299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Collaborating with nonphysician professionals in practice-based research. Dizziness Research Group. 在基于实践的研究中与非医师专业人员合作。头晕研究组。

Family practice research journal Pub Date : 1993-09-01

J Dallara, P D Sloane, R McNutt, L S Sadowski, K E Bailey

引用次数: 0

Hypertension management: relationship between visit interval and control. 高血压管理:访视间隔与控制的关系。

Family practice research journal Pub Date : 1993-09-01

M L Parchman, R S Bisonni, F H Lawler

引用次数: 0

Immunization barriers in Minnesota private practices: the influence of economics and training on vaccine timing. 明尼苏达州私人诊所的免疫障碍:经济学和培训对疫苗接种时间的影响。

Family practice research journal Pub Date : 1993-09-01

R K Zimmerman, J E Janosky

{"title":"Immunization barriers in Minnesota private practices: the influence of economics and training on vaccine timing.","authors":"R K Zimmerman, J E Janosky","doi":"","DOIUrl":"","url":null,"abstract":"Objective: Identify barriers to immunization and evaluate the timing of immunization in private practice settings.Methods: Design was a comparison of childhood immunization data with a survey of physicians who administered the vaccines. Setting was primary care offices in rural and urban/suburban Minnesota. Subjects were children under 7 years old who were receiving either Diphtheria, Tetanus, and Pertussis vaccine, Diphtheria and Tetanus vaccine, or the first Measles, Mumps and Rubella vaccine and their primary care physicians. Main outcome measures were time from birth to the third Diphtheria, Tetanus, and Pertussis vaccine (DTP) and from birth to the first Measles, Mumps, and Rubella vaccine (MMR) and their determinants.Results: The third Diphtheria, Tetanus, and Pertussis vaccine and first Measles, Mumps, and Rubella vaccine were late in 32% and 41% of children, respectively. We observed a significant difference, based upon insurance status, in Diphtheria, Tetanus, and Pertussis vaccine timing (p = 0.0001) but not in Measles, Mumps, and Rubella vaccine timing. Significant correlates of earlier Diphtheria, Tetanus, and Pertussis immunization include physician residency training, suburban/urban practice locale, and the likelihood that the physician would refer children based upon insurance coverage to health departments for immunization.Conclusions: Important determinants of immunization in the private sector include reimbursement and physician training about prevention.","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 3","pages":"213-24"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19284532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epidural analgesia for labor in a community hospital. 社区医院分娩时硬膜外镇痛。

Family practice research journal Pub Date : 1993-09-01

D A Bright

引用次数: 0

Informational yield of comprehensive Geriatric Home Assessment. 综合老人家庭评估的信息产出。

Family practice research journal Pub Date : 1993-09-01

J P Lemkau, A M Martin, C G Olsen

{"title":"Informational yield of comprehensive Geriatric Home Assessment.","authors":"J P Lemkau, A M Martin, C G Olsen","doi":"","DOIUrl":"","url":null,"abstract":"Objective: The purpose of this study was to compare the relative informational yield of Geriatric Home Assessments with medical charts of patients seen in family practice settings.Methods: The information from comprehensive Geriatric Home Assessments of 28 well-established patients, conducted by small groups of medical students in a family practice clerkship, was compared with information available in the medical charts of these patients for the previous three years.Results: For no problem studied was identification in the medical chart as high as from the Geriatric Home Assessment. Problems with family/social support, inadequate dental care, and immunization deficiencies were frequently noted in the Geriatric Home Assessment but only rarely in the medical chart. Concordance between Geriatric Home Assessment and medical charts was greatest for depression/anxiety, sensory loss, smoking, dizziness, and sleep problems.Conclusions: While evaluation of the utilization of information was beyond the scope of the current study, the results suggest the potential usefulness of complementing office care with home assessments in establishing a data base for the medical management of elderly patients in primary care settings.","PeriodicalId":77127,"journal":{"name":"Family practice research journal","volume":"13 3","pages":"275-81"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19284538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0