The American journal of managed care
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To help health professionals understand and evaluate the concept of efficiency and its measurement in practice. ⋯ The broad meaning and the value of healthcare efficiency seem uncontroversial, yet any particular application may be confronted with conflicting perspectives and with practical challenges.
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To examine factors associated with prostate-specific antigen (PSA) testing in the multiethnic California Men's Health Study. ⋯ In this insured population for whom financial barriers are minimized, PSA screening varied by race/ethnicity and by other patient and clinical factors, possibly reflecting inconsistencies in prostate cancer screening guidelines. Despite these differences, healthcare providers have a key role in patients' likelihood of undergoing PSA screening.
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To identify factors associated with delayed radiotherapy (RT) in older women with early-stage breast cancer. ⋯ Timely RT should be facilitated through physician and patient education, navigation, and notification programs to improve quality of care. Queues for RT appointments should be evaluated on an ongoing basis to ensure adequate access. Future research should examine modifiable barriers to RT timeliness and whether delays impact long-term outcomes.
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To examine how the influence of cost-sharing on adherence to antihypertensive drugs varies across adherence levels. ⋯ Cost-sharing had a substantial negative association with adherence among low adherers and little association at higher adherence levels. At a clinical level, physicians should closely monitor adherence to antihypertensive drugs, particularly for patients with multiple comorbidities and those taking multiple drugs. At a health system level, current benefit designs should encourage adherence while limiting the cost burden of drugs for patients with multiple chronic conditions taking multiple drugs.