The American journal of managed care
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To determine whether a designation of frailty using the Adjusted Clinical Groups-diagnoses based computerized predictive model (ACG Dx-PM) can identify an elderly population who (1) have the clinical characteristics of frailty and (2) are frail as determined by the validated Vulnerable Elders Survey (VES), and to determine the ability of these tools to predict adverse outcomes. ⋯ The ACG frailty tag identified an elderly population with clinical characteristics of frailty and performed with moderate success compared with the VES. Both tools predicted adverse outcomes in older HMO members. A combined screening approach for frailty using predictive modeling with a function-based survey deserves further study.
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Randomized Controlled Trial
Financial incentives and physician commitment to guideline-recommended hypertension management.
To examine the impact of financial incentives on physician goal commitment to guideline-recommended hypertension care. ⋯ Financial incentives may constitute an insufficiently strong intervention to influence goal commitment when providers attribute performance to external forces beyond their control.
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Randomized Controlled Trial
Identification of and intervention to address therapeutic gaps in care.
To determine if therapeutic gap identification, notification of community pharmacists, and intervention results in increased gap closure, reduced gap closure time, and fewer adherence gaps reopening. ⋯ Independent community pharmacists reduced gaps in care and had fewer reopened adherence gaps, suggesting improvement in adherence. A continuation study will examine the impact of the program on long-term adherence.