Arch Intern Med
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Comparative Study
Patient attitudes toward physician financial incentives.
Despite concern about the impact of financial incentives on physician behavior, little is known about patients' attitudes toward these incentives. ⋯ Most patients were uncomfortable with 1 or more of the 3 common methods used to pay physicians. Discomfort was highest with capitation and was more likely among wealthier, well-educated, white patients. With capitation increasing nationally, patients' concerns should be considered in the design of compensation agreements.
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Our objective was to systematically review the incidence of deep vein thrombosis (DVT) and the efficacy of thromboprophylaxis in critically ill adults, including patients admitted to intensive care units and following trauma, neurosurgery, or spinal cord injury. ⋯ Critically ill patients commonly develop DVT, with rates that vary from 22% to almost 80%, depending on patient characteristics. Methods of prophylaxis proven in one group do not necessarily generalize to other critically ill patient groups. More potent prophylactic regimens other than unfractionated or low-molecular-weight heparins alone may be needed with higher-risk groups.
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Comparative Study
Osteoporosis follow-up after wrist fractures following minor trauma.
Patients presenting with low-trauma wrist fractures are an ideal target population for early case finding of osteoporosis. We decided to investigate whether this early detection occurred in practice. ⋯ Only 50% of the study population had received osteoporosis follow-up after fracture. Few patients had any change in their medication use after fracture. The findings in this study population suggest that recognition of the potential for osteoporosis in such patients is inadequate. Given the magnitude of this public health care problem, it is clear that attention to case finding and treatment of osteoporosis should be increased.
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Comment Letter Comparative Study
Is treatment with aspirin combined with dipyridamole really more cost-effective than aspirin alone?