Medical care
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
One-to-one versus group sessions to improve prescription in primary care: a pragmatic randomized controlled trial.
The objective of the study was to evaluate the effectiveness of 2 educational strategies aimed at improving prescribing standards in primary care. ⋯ A single, short educational session to primary care doctors can improve their prescribing standards during long periods of > or = 9 months. Of the 2 strategies followed in the trial, one-to-one education has shown to be the most effective. Results also show that the effectiveness of these interventions increases when presented together with written material.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of different monetary incentives on the return rate of a national mail survey of physicians.
Mail surveys of physicians have been characterized by lower response rates than general population surveys, raising concerns about nonresponse bias. Although monetary incentives have routinely been used to improve survey response among physicians, questions remain regarding how much of an incentive is most cost-effective. The present study seeks to further examine the effects of incentive size on response rates to a national mail survey of physicians. ⋯ Our findings suggest that changes in the magnitude of incentive do not automatically result in increases in survey response among physicians. Possible reasons for this lack of effect as well as alternatives to monetary incentives are addressed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Measuring patient expectations: does the instrument affect satisfaction or expectations?
Fulfillment of patients' expectations may influence health care utilization, affect patient satisfaction, and be used to indicate quality of care. Several different instruments have been used to measure expectations, yet little is known about how different assessment methods affect outcomes. ⋯ These different instruments elicit different numbers of expectations but do not affect patient satisfaction.
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This study was undertaken to ascertain the extent that traditional health practices are used by urban American Indian/Alaska Native (AI/AN) primary care patients, to identify related patient characteristics, to determine associations with health status and functioning, and to describe attitudes about care received. ⋯ The results in this clinical setting suggest that health care providers should anticipate use of traditional health practices among urban AI/AN patients. Use was predicted by important demographic, clinical, and cultural characteristics.
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This article examines the organizational characteristics of nursing homes associated with increasing and decreasing use of physical restraints since the implementation of the Nursing Home Reform Act (NHRA) in 1991. ⋯ Although the period used in this analysis represents a time frame in which the restraint reduction mandates of the NHRA were in effect, these results show that some nursing homes have increased their use of physical restraints. The organizational characteristics of these nursing homes differ from those that decreased their use of physical restraints.