Journal of general internal medicine
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Recent reforms in the federal Medicaid program have attempted to integrate beneficiaries into the mainstream by providing them with managed care options. However, the effects of mainstreaming have not been systematically evaluated. ⋯ Within this population of Medicaid patients, the provision of health insurance and care within the mainstream of an integrated health system was no guarantee of equal access as perceived by the patients themselves.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of computer support on younger women with breast cancer.
Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer, with particular emphasis on assisting the underserved. ⋯ Computer-based patient support systems such as CHESS may benefit patients by providing information and social support, and increasing their participation in health care. These benefits may be largest for currently underserved populations.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effectiveness of a focused educational intervention on resident evaluations from faculty a randomized controlled trial.
To improve the quality and specificity of written evaluations by faculty attendings of internal medicine residents during inpatient rotations. ⋯ A brief, focused educational intervention delivered to faculty prior to the start of a ward rotation appears to have a modest effect on faculty behavior for written evaluations and promoted higher quality feedback given to house staff.
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Comparative Study
Impact of interpreter services on delivery of health care to limited-English-proficient patients.
To determine whether professional interpreter services increase the delivery of health care to limited-English-proficient patients. ⋯ Professional interpreter services can increase delivery of health care to limited-English-speaking patients.
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Comparative Study
Doctor discontent. A comparison of physician satisfaction in different delivery system settings, 1986 and 1997.
To examine the differences in physician satisfaction associated with open- versus closed-model practice settings and to evaluate changes in physician satisfaction between 1986 and 1997. Open-model practices refer to those in which physicians accept patients from multiple health plans and insurers (i.e., do not have an exclusive arrangement with any single health plan). Closed-model practices refer to those wherein physicians have an exclusive relationship with a single health plan (i.e., staff- or group-model HMO). ⋯ This study finds that the state of physician satisfaction in Massachusetts is extremely low, with the majority of physicians dissatisfied with the amount of time they have with individual patients, their leisure time, and their incentives for high quality. Satisfaction with most areas of practice declined significantly between 1986 and 1997. Open-model physicians were less satisfied than closed-model physicians in most aspects of practices.