The American journal of managed care
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To examine patients' reasons for using the emergency department (ED) for low-acuity health complaints, and determine whether reasons differed for frequent ED users versus nonfrequent ED users. ⋯ Frequent ED users gave similar reasons for using the ED for low-acuity health complaints compared with nonfrequent ED users. Access, convenience, cost, and quality concerns, as well as feeling that ED care was needed, were all commonly cited as reasons for using the ED.
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To evaluate 1) clinician attitudes towards incorporating cost information into decision making when ordering imaging studies; and 2) clinician reactions to the display of Medicare reimbursement information for imaging studies at clinician electronic order entry. ⋯ Although clinicians want relevant cost information, many voiced concerns about displaying cost information at clinician order entry in safety net health systems. Alternative approaches to increasing cost-consciousness may be more acceptable to clinicians.
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Randomized Controlled Trial
Attainment of diabetes-related quality measures with canagliflozin versus sitagliptin.
To evaluate attainment of diabetes-related quality measures with canagliflozin, a sodium glucose cotransporter 2 inhibitor, versus sitagliptin in patients with type 2 diabetes mellitus (T2DM). ⋯ In this study involving patients with T2DM on metformin plus sulfonylurea, after 52 weeks, patients treated with canagliflozin 300 mg demonstrated better attainment of individual and composite diabetes-related quality measures compared with patients treated with sitagliptin 100 mg.
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Multicenter Study Comparative Study
Comorbidities and cardiovascular disease risk in older breast cancer survivors.
To evaluate cardiovascular disease (CVD) risk factors in older breast cancer survivors compared with a group of women without breast cancer. ⋯ Results suggest that long-term prognosis in breast cancer patients is affected by management of preexisting conditions. Assessment of comorbid conditions and effective management of diabetes and hypertension in older breast cancer survivors may lead to longer overall survival.
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Randomized Controlled Trial
Population targeting and durability of multimorbidity collaborative care management.
A patient-centered collaborative care program for depression and uncontrolled diabetes and/or coronary heart disease (CHD) demonstrated improved clinical outcomes relative to usual care. We report clinically stratified analyses of patient outcomes to inform the duration and targeting of care management services for complex patients with multimorbidity. ⋯ Clinical benefits of a multimorbidity collaborative care management program occurred early, and were only found among patients with poor control of baseline diabetes and CHD risk factors. Targeting may maximize reach and improve affordability of complex care management.