The United States Preventive Services Task Force (USPSTF) has recommended against testicular self-examinations (TSE) or clinical examination for testicular cancer screening. However, in this recommendation there was no consideration of the significant fiscal cost of treating advanced disease versus evaluation of benign disease. In this study, a cost-utility validation for TSE was performed. The...

BACKGROUND The utilization rate for orthopaedic services (office visits and surgery) is not well known. The purpose of this study was to determine the utilization rates for orthopaedic office visits and surgical procedures in a large population of captured lives. METHODS The study population comprised an average of 134,902 persons per month who were enrolled under a capitated insurance plan b...

Interest in innovative health care delivery models has surged in recent years, partly owing to measures such as the Affordable Care Act which have expanded insurance coverage and spotlighted the need to contain health care costs. The goal of these innovations is to increase physician capacity without sacrificing quality of care. One innovation that has been proposed as a low-cost alternative to...

BACKGROUND Health information technology (HIT) may improve health care quality and outcomes, in part by making information available in a timelier manner. However, there are few studies documenting the changes in timely availability of data with the use of a sophisticated electronic medical record (EMR), nor a description of how the timely availability of data might differ with different types ...

BACKGROUND The National Asthma Education Prevention Program's (NAEPP) Expert Panel Report 3 (EPR3) guidelines have stressed the need for environmental control measures for asthma, but there is limited evidence of their efficacy. OBJECTIVE To examine the effectiveness of an in-home asthma intervention program for children and adults in Connecticut, we conducted a panel study to analyze quality...

Chronic rhinosinusitis (CRS) is a common disease affecting up to 12.5% of the adult population in America, approximately 31 million people [1]. Based on sheer numbers, the disease greatly impacts the health care system and the national economy as a whole. One survey found that over 22 million office visits per year in the United States are related to a CRS diagnosis [2]. In 1996 alone, national...

BACKGROUND Managed care is practiced in both traditional institutional health maintenance organization (HMO) settings and in a variety of complex and decentralized office-based arrangements. This study examines how practice setting affects physician perceptions of the quality of professional practice and patient care in a managed care environment. PARTICIPANTS AND METHODS A survey was conduct...

may revolutionize family medicine by allowing family physicians the ability to communicate with patients and provide medical services or advice online. They also contend that by offering more comprehensive access to health information, the Web platforms empower patients to take more control of their health, and that online doctoring will save money for both patients and doctors. The former won’...

BACKGROUND Postpartum depression occurs in 10% to 20% of women who have recently given birth, but fewer than half of cases are recognized. The purpose of this review is to discuss the potential benefit of mass screening for improving postpartum depression recognition and outcomes. METHODS A review of the literature was conducted by searching MEDLINE, using the key words "depression," "postpar...

IMPORTANCE New models of health care delivery for dermatological care have the potential to increase access and improve patient-centered outcomes. OBJECTIVE To compare effectiveness of a direct-access, online model for follow-up dermatologic care in pediatric and adult patients with atopic dermatitis with that of in-person office visits. DESIGN, SETTING, AND PARTICIPANTS This was a 1-year, ...