OBJECTIVES To understand when patients use secure e-mail messaging with healthcare providers across several types of questions or concerns, associations between out-of-pocket costs for in-person visits and use of secure messaging, and to examine patient-reported impacts on care-seeking behavior and overall health. STUDY DESIGN Cross-sectional survey of patients in an integrated healthcare del...

OBJECTIVE If quality improvement interventions, value-based purchasing and/or certification are based on patient assessments, a common definition of quality should be shared by clinicians and patients. The study's objectives were to determine (i) how patients and clinicians define quality care, (ii) in what ways patients' and physicians' definitions differ and (iii) whether patients' definition...

Dementia is an important public health problem, though more than half of all dementia cases may go undiagnosed in primary-care settings.1 Screening is one strategy to increase detection and diagnosis of dementia in primary care, but only 24% of Canadian primary-care physicians routinely screen for dementia.2 Multiple barriers to screening have been identified, the most ubiquitous being “tyranny...

AIMS The purpose of this prospective study was to investigate whether internet-based remote monitoring offers a safe, practical, and cost-effective alternative to the in-office follow-up visits of patients with an implantable cardioverter defibrillator (ICD). METHODS AND RESULTS Forty-one patients (62 +/- 10 years, range 41-76, 83% male) with previously implanted ICD were followed for 9 month...

This report updates surveillance results for COPD in the United States. For 1999 to 2011, data from national data systems for adults aged≥25 years were analyzed. In 2011, 6.5% of adults (approximately 13.7 million) reported having been diagnosed with COPD. From 1999 to 2011, the overall age-adjusted prevalence of having been diagnosed with COPD declined (P=.019). In 2010, there were 10.3 millio...

BACKGROUND We sought to determine whether a multi-modal intervention, which included mailing a patient reminder with a colon cancer decision aid to patients and system changes allowing direct access to scheduling screening tests through standing orders, would be an effective and efficient means of promoting colon cancer screening in primary care practice. METHODS We conducted a controlled tri...

Background Increased involvement of pharmacists in patient care may increase access to health care and improve patient outcomes. Purpose To determine the effectiveness and harms of pharmacist-led chronic disease management for community-dwelling adults. Data Sources MEDLINE, Cochrane Library, CINAHL, and International Pharmaceutical Abstracts from 1995 through February 2016, and reference l...

OBJECTIVE To examine the extra cost of using higher-priced drugs as initial therapy for dermatophyte infections, because the many available effective drugs vary considerably in cost. DESIGN Cost analysis from the purchaser's perspective, comparing two prototypical regimens to treat tinea pedis: one in which all patients initially receive a lower-priced drug and those with unresponsive infecti...

BACKGROUND This study sought to describe the incidence of transitions into and out of Medicaid, characterize the populations that transition and determine if health insurance instability is associated with changes in healthcare utilization. METHODS 2000-2004 Medical Expenditure Panel Survey (MEPS) was used to identify adults enrolled in Medicaid at any time during the survey period (n = 6,247...

ated with higher rates of SSI, diarrhea, and CDI, whereas bacteriuria, although associated with health care provider– diagnosed postoperative UTI, was not associated with SSI. Because these associations are derived from small samples in an observational study, they should be interpreted cautiously, recognizing the potential for confounding. Similarly, the finding that treating bacteriuria was a...