PURPOSE Many asthmatic patients discharged from emergency departments do not have timely follow-up visits with a primary care physician. This study was conducted to determine the effectiveness of a health professional-based intervention in improving process of care and health outcomes among asthmatic patients discharged from emergency departments. METHODS We enrolled 125 asthmatic patients, a...

America’s embattled primary care system is nearing the breaking point. Primary care clinicians are expected to provide continuity of care for patients within an increasingly fractionated medical environment. They face ever-expanding hours with no corresponding rise in reimbursement rates, leading to high levels of job-related dissatisfaction. And while much of the work of primary care involves ...

PURPOSE Individuals with serious illness often desire to discuss spiritual concerns with their physician, yet substantial barriers exist to doing so, including limited evidence of value. This study evaluated acceptability, impact on satisfaction with care and on quality of life (QOL) of a brief (5-7 minute) semi-structured exploration of spiritual/religious concerns. PATIENTS AND METHODS 118 ...

OBJECTIVE To assess the effect of differing health insurance coverage of physician office visits on the use of colorectal cancer (CRC) tests among an employed and insured population. METHOD Cohort study of persons ages 50 to 64 years enrolled in fee-for-service (FFS) or preferred provider organization (PPO) health plans, where FFS plan enrollees bear disproportionate share of office visit cov...

BACKGROUND Acute respiratory infections (ARIs) are the most common symptomatic reason to seek ambulatory care, but many ARI visits may not be necessary. OBJECTIVE To measure the proportion of primary care ARI visits that may not require an office visit. METHODS We identified 58398 ARI visits to 14 primary care practices between May 2011 and May 2012 and randomly selected 500 visits, 439 of ...

OBJECTIVES This report describes medications provided or prescribed during ambulatory medical care visits in 1992. Total ambulatory care medication therapy combines data from office-based physicians, hospital outpatient departments (OPD's), and hospital emergency departments (ED's). Drug therapy is described along three dimensions: number of drugs provided or prescribed (drug mention), whether ...

BACKGROUND Uncontrolled hypertension is a common and important risk factor for heart disease and stroke. Nevertheless, the control rate among patients taking prescribed medication and/or therapeutic lifestyle modification has remained about the same for the past several decades. METHODS We analyzed 2003 and 2004 National Ambulatory Medical Care Survey (NAMCS) data to determine hypertension co...

OBJECTIVE Examine the cost-effectiveness of a 3-week interdisciplinary pediatric chronic pain rehabilitation program. METHODS Self-reported health care utilization and parent missed work of youth with chronic pain (n = 127) at admission and 1-year follow-up were compared. Financials were calculated from program revenue and established national costs for health care and wages. RESULTS Data i...

In January 2014, the Affordable Care Act extended access to health insurance coverage to an estimated 30 million previously uninsured people. This issue brief provides state-level estimates of the increased demand for physician and hospital services that is expected to result from expanded access and assesses the sufficiency of the existing supply of providers to accommodate the anticipated inc...