Journal of general internal medicine
-
To compare the utilization of health care resources and patterns of chronic disease care by patients of medical residents and patients of their attending physicians. ⋯ Our results indicate that residents' patients had higher costs than attendings' patients, but the differences would have been seriously overestimated without adjustment. We conclude that it costs about 7% more for residents to manage patients than for attendings. On the ambulatory side, the larger number of procedures and consults ordered for residents' patients appears to drive the higher costs.
-
The Institute of Medicine calls for physicians to engage patients in making clinical decisions, but not every patient may want the same level of participation. ⋯ This population-based study demonstrates that people vary substantially in their preferences for participation in decision making. Physicians and health care organizations should not assume that patients wish to participate in clinical decision making, but must assess individual patient preferences and tailor care accordingly.
-
Few studies have examined the factors associated with depression in informal caregivers of HIV-infected persons. ⋯ High caregiver burden was strongly associated with depression among HIV-infected individuals' informal caregivers, who themselves had difficult life circumstances. Informal caregivers of HIV patients may be in need of both mental health services and assistance in caregiving.
-
To determine how well a single question of self-reported erectile dysfunction compares to a gold standard clinical urologic examination. ⋯ Our single-question self-report accurately identifies men with clinically diagnosed ED, and may be useful as a referral screening tool in both research studies and general practice settings.