Arch Intern Med
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Comparative Study
Race and sex differences in consistency of care with national asthma guidelines in managed care organizations.
In the United States, morbidity from asthma disproportionately affects African Americans and women. Although inadequate care contributes to overall asthma morbidity, less is known about differences in asthma care by race and sex. ⋯ Even among patients with health insurance, disparities in asthma care for African Americans compared with whites exist and may contribute to race disparities in outcomes. Women generally reported better asthma care but may benefit from greater use of inhaled corticosteroids.
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To determine the need for placing automated external defibrillators (AEDs) in medical and dental practices, we identified cardiac arrests at these locations. ⋯ Placement of 779 AEDs in the high- and medium-incidence practices would have provided treatment for 112 patients with cardiac arrest in 7 years. To provide for the 16 cardiac arrests in low-incidence practices, an additional 1928 AEDs would be required.
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Time management in ambulatory patient visits is increasingly critical. Do patients who perceive a longer visit with internists report increased satisfaction? ⋯ Perceived ambulatory visit duration and meeting or exceeding patient expectation of time needed to be spent with the physician are determinants of patient satisfaction in an ambulatory internal medicine practice.
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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
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.