JAMA internal medicine
-
JAMA internal medicine · Sep 2013
Multicenter Study Comparative StudyWorsening trends in the management and treatment of back pain.
Back pain treatment is costly and frequently includes overuse of treatments that are unsupported by clinical guidelines. Few studies have evaluated recent national trends in guideline adherence of spine-related care. ⋯ Despite numerous published clinical guidelines, management of back pain has relied increasingly on guideline discordant care. Improvements in the management of spine-related disease represent an area of potential cost savings for the health care system with the potential for improving the quality of care.
-
JAMA internal medicine · Sep 2013
Randomized Controlled Trial Multicenter Study Comparative StudyEfficacy of an evidence-based clinical decision support in primary care practices: a randomized clinical trial.
There is consensus that incorporating clinical decision support into electronic health records will improve quality of care, contain costs, and reduce overtreatment, but this potential has yet to be demonstrated in clinical trials. ⋯ The integrated clinical prediction rule process for integrating complex evidence-based clinical decision report tools is of relevant importance for national initiatives, such as Meaningful Use. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01386047.
-
JAMA internal medicine · Sep 2013
Multicenter Study Comparative StudyA high risk of hospitalization following release from correctional facilities in Medicare beneficiaries: a retrospective matched cohort study, 2002 to 2010.
Little is known about the risk of individuals who are released from correctional facilities, a time when there may be discontinuity in care. ⋯ About 1 in 70 former inmates are hospitalized for an acute condition within 7 days of release, and 1 in 12 by 90 days, a rate much higher than in the general population.