Medical care
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Long-term randomized controlled trials of tailored-print and small-group arthritis self-management interventions.
The objective of this study was to test the effectiveness of a mail-delivered, tailored self-management intervention (SMART) and to compare it with the classic Arthritis Self-Management Program (ASMP). ⋯ A mail-delivered arthritis self-management program, SMART, was similarly effective to the classic ASMP, with slightly better results in the first year and a slightly more rapid attenuation over the next 2 years. Results suggest that both programs are effective, and that the addition of a mail-delivered program could improve accessibility to arthritis self-management treatment.
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This study investigated the attitudes of the transplant community toward the current policy of altruistic organ donation and 6 alternative policies offering incentives to the donor family. ⋯ Specific incentives varied in their acceptability to the transplant community. Attitudes of the transplant community toward incentives were not in accord with published criticisms of incentives.
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The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, intended to address potential threats to patient privacy posed by the computerization and standardization of medical records, provides a new floor level of federal protection for health information in all 50 states. In most cases, compliance with the Privacy Rule was required as of April 2003. Yet considerable confusion and concern remain about the Privacy Rule and the specific changes it requires in the way healthcare providers, health plans, and others use, maintain, and disclose health information. Researchers worry that the Privacy Rule could hinder their access to health information needed to conduct their research. ⋯ The Privacy Rule is fundamentally changing the way that healthcare providers, health plans, and others use, maintain, and disclose health information and the steps that researchers must take to obtain health data. The Privacy Rule requires researchers who seek access to identifiable health information to obtain written authorization from subjects, or, alternatively, to demonstrate that their research protocols meet certain Privacy Rule requirements that permit access without written authorization. To ensure continued access to data, researchers will need to work more closely than before with healthcare providers, health plans, and other institutions that generate and maintain health information.
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Comparative Study
Ethnic differences in parents' perception of participatory decision-making style of their children's physicians.
The objectives of this study were to test whether there are ethnic differences in parents' perceptions of the participatory styles of their children's physicians, and to determine how Hispanic ethnicity influences the factors that are correlated with the perceptions of participatory styles. ⋯ Because patient participation is closely related to health outcomes and patient satisfaction, improving Hispanic patients' participation can be 1 avenue for diminishing ethnic disparities in health. Further research is needed to establish whether ethnic differences in children's physicians' participation style exist from physicians' perspective and whether the differences are associated with physicians' characteristics.
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Comparative Study
Comparison of the Elixhauser and Charlson/Deyo methods of comorbidity measurement in administrative data.
Comorbidity risk adjustment methods have been used widely with administrative data, and the Charlson/Deyo method is perhaps the most commonly used in the literature. However, a new method defined by Elixhauser et al. has been introduced recently and could be superior, although it has not been validated widely. ⋯ The Elixhauser comorbidity measurement method performs better than the widely used Charlson/Deyo method in the Canadian acute MI cases studied.