The Journal of ambulatory care management
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Violence permeates all parts of the West Bank and Gaza Strip. Since the onset of the Al-Aqsa Intifada on the September, 28, 2000, through October 31, 2003, more than 51,000 Palestinians have been injured and 2700 have been killed. ⋯ The children also suffer from significant mental health disorders, including 33% with acute levels of posttraumatic stress disorder, 49% with moderate levels and 15.6% low levels. In "hot" areas, 55% of the children have acute levels of posttraumatic stress disorder, 35% moderate levels, and 9% low levels.
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J Ambul Care Manage · Apr 2004
Comparative StudyPricing and costs of drugs in the United States and Sweden: a comparison based on drug acquisition costs at the patient outcome level.
Cost consequences of antihypertensive drug pricing were compared in the United States and Sweden. Because of price differences, US drug acquisition costs to prevent one cardiovascular event were 339%, 127%, and 22% higher using the most prescribed calcium channel blocker, angiotensin-converting enzyme inhibitor, and beta blocker, but 65% lower with hydrochlorothiazide. ⋯ This emphasizes not only the importance of drug pricing but also the cost-increasing influence of commercial marketing. More producer-independent and evidence-based drug information to prescribers is necessary.
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J Ambul Care Manage · Jan 2004
ReviewApproaching complementary and alternative medicine use in patients with cancer: questions and challenges.
Complementary and alternative medicine (CAM) is becoming a significant factor in the arena of cancer care. There is an increasing body of research along with widespread popularity and use by patients with cancer. ⋯ The physician-patient communication and its relevance to CAM use is emphasized. A step approach is suggested for primary care physicians including the discussion of CAM in the management of cancer in order to enrich the physician-patient dialogue and improve the quality of the clinical encounter.
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J Ambul Care Manage · Apr 2003
Computerized telephone nurse triage. An evaluation of service quality and cost.
The current reimbursement structure of health care in the United States motivates the providers of health care services to deliver these services with a cost-conscious mentality without compromising quality. This has led to the development of alternative methods of delivering health care services, one of which is computerized telephone nurse triage. This study investigates service quality from the perception of callers who used this system on behalf of a pediatric client. ⋯ Relationship to the child had an effect on the rating of service quality as men/fathers rated the level of service quality slightly lower than their female/mother counterparts. The evaluation of cost revealed that the action taken by the caller after they spoke with the nurse resulted in significant cost savings. Computerized telephone nurse triage is a well-accepted cost-saving alternative method of health care delivery that can effectively serve a variety of callers and pediatric patients.
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J Ambul Care Manage · Apr 2003
Randomized Controlled Trial Clinical TrialEffects of educational intervention in waiting room on patient satisfaction.
This study examines the effects of a low-cost educational intervention designed to occupy the waiting time in the clinic on patient satisfaction with the clinic visit. Patients waiting for appointments were randomly assigned to two groups: (1) educational intervention in the clinic waiting room (n = 160) and (2) usual clinic care (no structured education during the waiting time in the clinic; n = 160). There were significant negative correlations between satisfaction with the visit overall and the time patients waited in the clinic waiting room (r = -.17, p = .003) and their total wait time (r = -.16, p = .005). Patients who were taught while they waited in the clinics were more satisfied with their education than the control group (t = 4.26, df = 318, p < 0.001).