Medical care
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There is considerable regional variation in Medicare outpatient visit rates; such variations may be the consequence of patient health, race/ethnicity differences, patient preferences, or physician supply and beliefs about the efficacy of frequently scheduled visits. ⋯ Medicare beneficiaries' health status, race, and preferences help explain individual office visit frequency; in particular, African-American patients appear to experience lower access to care. Yet, these factors explain a small fraction of the observed regional differences associated with physician supply and beliefs about the appropriate frequency of office visits.
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Comparative Study
Using patient-reported outcomes (PROs) to compare the providers of surgery: does the choice of measure matter?
Patient-reported outcomes (PROs) are being used to compare health care providers with little knowledge of how the choice of measure affects such comparisons. ⋯ Choice of outcome measure can determine a provider's rating. Measure selection depends on whether the priority is to avoid missing "poor" providers or avoid mislabeling average providers as "poor."
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The aim of this study was to build electronic algorithms using a combination of structured data and natural language processing (NLP) of text notes for potential safety surveillance of 9 postoperative complications. ⋯ Computer algorithms on data extracted from the electronic health record produced respectable sensitivity and specificity across a large sample of patients seen in 6 different medical centers. This study demonstrates the utility of combining NLP with structured data for mining the information contained within the electronic health record.