Health services research
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Health services research · Oct 2018
Randomized Controlled TrialHome Visit-Based Community Paramedicine and Its Potential Role in Improving Patient-Centered Primary Care: A Grounded Theory Study and Framework.
Community paramedicine (CP) is a model of community-based health care being used around the world. Our objective was to study the patient perspective and valuation of this type of program to understand its potential value for primary care innovation in the future. ⋯ Home-based community paramedicine programs like EPIC appear to be able to create a patient-centered, safe, responsive therapeutic relationship that is often not possible within the standard primary health care system.
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Health services research · Dec 2011
Randomized Controlled Trial"All the money in the world …" patient perspectives regarding the influence of financial incentives.
To analyze patient perspectives of the use of financial incentives in a hypertension intervention. Study Setting. Twelve Veterans Affairs primary care clinics over a 9-month period. ⋯ The findings of this study raise questions about the appropriateness and unintended consequences of employing patient-directed financial incentives in health care settings.
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Health services research · Feb 2009
Randomized Controlled Trial Multicenter StudyTranslating research into practice intervention improves management of acute pain in older hip fracture patients.
To test an interdisciplinary, multifaceted, translating research into practice (TRIP) intervention to (a) promote adoption, by physicians and nurses, of evidence-based (EB) acute pain management practices in hospitalized older adults, (b) decrease barriers to use of EB acute pain management practices, and (c) decrease pain intensity of older hospitalized adults. ⋯ The TRIP intervention improved quality of acute pain management of older adults hospitalized with a hip fracture.
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Health services research · Oct 2008
Randomized Controlled Trial Multicenter StudyTargeting primary care referrals to smoking cessation clinics does not improve quit rates: implementing evidence-based interventions into practice.
To evaluate the impact of a locally adapted evidence-based quality improvement (EBQI) approach to implementation of smoking cessation guidelines into routine practice. ⋯ EBQI stimulated practices to increase smoking cessation clinic referrals and try other less evidence-based interventions that did not translate into improved quit rates at a population level.
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Health services research · Jun 2007
Randomized Controlled TrialSocioeconomic and racial/ethnic differences in the discussion of cancer screening: "between-" versus "within-" physician differences.
To determine the extent to which socioeconomic and racial/ethnic differences in cancer screening discussion between a patient and his/her primary care physician are due to "within-physician" differences (the fact that patients were treated differently by the same physicians) versus "between-physician" differences (that they were treated by a different group of physicians). ⋯ Differences in cancer screening discussion along the different dimensions of patient SES may have arisen because of very different mechanisms and therefore call for a combination of interventions. Physicians need to be aware of the persistent disparities by patient education in clinical communication regarding cancer screening and tailor their efforts to the needs of low-education patients. Quality-improvement efforts targeted at physicians practicing in low-income communities may also be effective in addressing disparities in cancer screening communication by patient income.