Journal of general internal medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Perceived access problems among patients with diabetes in two public systems of care.
We examined the prevalence of access problems among public clinic patients after participating in trials of automated telephone disease management with nurse follow-up. ⋯ Many of these public sector patients with diabetes reported that they failed to obtain health services because they perceived financial and nonfinancial access problems. Automated telephone disease management calls with telephone nurse follow-up improved patients' access to care. Despite the impact of the intervention, county clinic patients were more likely than VA patients to report access problems in several areas.
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Multicenter Study
Measuring compliance with preventive care guidelines: standardized patients, clinical vignettes, and the medical record.
To determine how accurately preventive care reported in the medical record reflects actual physician practice or competence. ⋯ These data indicate that physicians perform more preventive care than they report in the medical record. Thus, benchmarks of preventive care by individual physicians and institutions that rely solely on the medical record may be misleading, at best.
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Multicenter Study
Prevalence and determinants of intimate partner abuse among public hospital primary care patients.
To determine the prevalence, sociodemographic determinants, and depression correlates of intimate partner abuse among an ethnically diverse population of women patients. ⋯ Because a substantial proportion of women patients in primary care settings are abused, screening for partner abuse and depression is indicated. In contrast to other studies, lower socioeconomic status was not associated with partner abuse history.
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To identify what factors men consider important when choosing treatment for prostate cancer, and to assess why men reject watchful waiting as a treatment option. ⋯ In discussing treatment options for localized prostate cancer, clinicians, including primary care providers, should recognize that patients' decisions are often based on specific beliefs regarding each therapy's intrinsic characteristics, supporting evidence, or pattern of complications. Even if patients do not recall a physician recommendation against watchful waiting, this option may not be chosen because of fear of future consequences.