Journal of general internal medicine
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Randomized Controlled Trial Comparative Study
Improving depression care in patients with diabetes and multiple complications.
Depression is common in patients with diabetes, but it is often inadequately treated within primary care. Competing clinical demands and treatment resistance may make it especially difficult to improve depressive symptoms in patients with diabetes who have multiple complications. ⋯ Patients with depression and diabetes who have multiple complications may benefit most from collaborative care for depression. These findings suggest that with appropriate intervention depression can be successfully treated in patients with diabetes who have the highest severity of medical problems.
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Comparative Study
Simultaneous control of intermediate diabetes outcomes among Veterans Affairs primary care patients.
Guidelines recommend tight control of hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-C), and blood pressure (BP) for patients with diabetes. The degree to which these intermediate outcomes are simultaneously controlled has not been extensively described. ⋯ While the proportion of patients who achieved minimal levels of control of HbA1c and LDL-C was high, these data indicate a low level of simultaneous control of HbA1c, LDL-C, and BP among patients with diabetes.
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To explore the effect of race on primary care quality and satisfaction among women in the Department of Veterans Affairs (VA). ⋯ While demographics and health experiences vary by race among veterans, race had no effect on primary care ratings. Future studies need to determine whether this racial equity persists in health outcomes among women veterans.
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Comparative Study
Trends in market demand for internal medicine 1999 to 2004: an analysis of physician job advertisements.
The health care marketplace has changed substantially since the last assessment of demand for internal medicine physicians in 1996. ⋯ Since 1996, demand for the majority of medical subspecialties has remained constant while relative demand has decreased for primary care and increased for hospitalists and critical care. Increase in demand for generalist-trained hospitalists appears to have offset falling demand for outpatient generalists.