David W Baker

..The incidence of weight gain is highest during young adulthood. Our study aims to describe weight gain patterns among young adults and to evaluate physician recognition of and counseling for rapid weight gain...

..Low health literacy and low cognitive abilities both predict mortality, but no study has jointly examined these relationships...

..To determine whether inadequate functional health literacy adversely affects use of physician outpatient services...

..Because most estimates of the uninsured are cross-sectional, the true number of individuals whose health is at risk from being uninsured is unclear...

..Experts recommend that health care providers (HCPs) collect patients' race/ethnicity, but HCPs worry that this may alienate patients...

..We assessed the feasibility of collecting race/ethnicity data from patients using their own preferred racial/ethnic terms...

..Although individuals' health insurance coverage changes frequently, previous analyses have not accounted for changes in insurance coverage over time...

..Uninsured adults in late middle age are more likely to have a health decline than individuals with private insurance...

..Electronic health records (EHRs) may be used to assess quality of care...

..We sought to determine whether low health literacy levels independently predict overall and cause-specific mortality...

..Experts recommend that health care providers (HCPs) collect patients' race/ethnicity and language, but we know little about public attitudes towards this...

..This study determined the prevalence of LVSD with the use of a limited screening echocardiogram among patients with risk factors for HF but no prior HF...

..This study analyzed mortality trends from 1991 to 1997 for 23,505 Medicare patients hospitalized with a first admission for HF at 29 Northeast Ohio hospitals...

..To determine changes in the use of do-not-resuscitate (DNR) orders and mortality rates following a DNR order after the Patient Self-determination Act (PSDA) was implemented in December 1991...

..This study analyzed whether inadequate functional health literacy is an independent risk factor for hospital admission...

..It is unclear whether publicly reporting hospitals' risk-adjusted mortality affects market share and mortality at outlier hospitals...

..Length of hospital stay continues to decline, but the effect on postdischarge outcomes is unclear...

..It is unclear whether publicly reporting hospitals' risk-adjusted mortality leads to improvements in outcomes...

..Electronic health record (EHR) systems have the potential to revolutionize quality improvement (QI) methods by enhancing quality measurement and integrating multiple proven QI strategies...

..The optimal strategy for promoting self-care for heart failure (HF) is unclear...

..CONCLUSION: Participation in a QI collaborative for HF was associated with better communication, education, and knowledge, and lower health care use. Collaboratives may be a useful method for disseminating quality improvement strategies...

..If this trial shows that the "Teach to Goal" approach is superior, it would support the value of incorporating these design principles into educational interventions for other diseases...

..However, minorities were less comfortable providing race/ethnicity information and were more worried than non-Hispanic whites about the potential misuse of this information...

..Little is known about whether disparities occur within or between hospitals for national Hospital Quality Alliance (HQA) measures...

....

..Although South Asians are at higher risk for coronary heart disease (CHD) than most other U.S. racial/ethnic groups, very little research has addressed this disparity...

..Racial and ethnic minority groups have lower levels of leisure-time physical activity (LTPA) than whites, but it is unclear how much of this is explained by differences in socioeconomic status and health...

..Health care organizations should consider the routine use of adjusted methods to measure disparities in order to better inform disparity reduction initiatives...

..We examined the effect of a MDEP targeted to patients with low literacy on knowledge and assessed the association between literacy and knowledge improvement...

..We evaluated the association between health literacy, self-reported physical and mental health functioning, and health-related activity limitations among new Medicare managed care enrollees...

..Deficits in information transfer between inpatient and outpatient physicians are common and potentially dangerous...

..This study analyzed whether socioeconomic status in older middle age continues to be associated with 10-year survival after data are controlled for baseline health status...

..We examined racial and ethnic disparities in analgesic prescription among a national sample of emergency department patients...

..This study examined whether providing pre-visit paper quality reminders could further improve performance, especially for physicians whose performance had not improved much during the first year...

..Moreover, the same clinical information, such as a patient requesting a strong analgesic, changes the likelihood of prescribing opioids in opposite directions for different physicians...

..Improved control of hypertension, primary prevention of myocardial infarction, and more widespread use of secondary prevention measures are essential...

..SROH may not be comparable across cultural groups. We assessed if differences in SROH between non-Hispanic whites (NHW), Latinos, and Asians were explained primarily by differences in socioeconomic status (SES) or language and nativity...

..To determine the effect of standardized outreach on the receipt of preventive services for patients whose physicians record that the patient refused the service...

....

....

..Simple hypertension outcome measures may not indicate which patients receive poor care. This could be problematic as incentives increase...

..However, because cultural and language differences may create measurement bias, it is unclear whether observed differences in self-reported overall health reflect true differences in health...

..We conclude that the nature of the relationship between literacy and health may vary depending upon the outcome under examination...

..Health education interventions must incorporate strategies that can improve retention of health information and actively engage patients in long-term learning...

..This will enable administration of Health LiTT on the same touchscreen used for other patient-reported outcomes, as well as real-time scoring and reporting of health literacy scores...

..The objective of this study was to examine changes in junior medical student-patient encounters after initiation of residency work hours and implementation of a large hospitalist practice at our academic medical center...

..Despite the documented benefits of colorectal cancer screening, patient participation rates remain low. Physician recommendation has been identified as a significant predictor of screening completion...

..Although many hospitalists work with clinical coordinators, few studies have evaluated their impact...

..Checklists may reduce errors of omission for critically ill patients...

..We aimed to determine who would be falsely classified as low risk using this approach...

....

..This study examined the association between intermittent lack of health insurance coverage and use of preventive health services...

..To our knowledge, how well they reflect actual quality of care has not been studied. We sought to evaluate the validity of performance measures for coronary artery disease (CAD) using an ambulatory EHR...

..Patients with limited literacy were more likely to report feelings of shame as a result of disclosure (p < 0.05). Health care providers must recognize the potential shame patients might experience as a result of literacy screening...

..Patients with an expired order for screening colonoscopy might be persuaded to follow through with screening by such an intervention...

..We sought to investigate patients' ability to recall spoken medical instructions in the context of a hypothetical clinical encounter, and whether limited health literacy would adversely affect performance on the task...

..Little is known about patient enrollment in, and use of, patient portals after explicit invitation from providers...

..However, after accounting for age, sex, and heart rate recovery, educational status was a weaker predictor (HR = 1.3; 95% CI: 1.0 to 1.7). CONCLUSIONS: Educational status is independently associated with an abnormal heart rate recovery...

..However, physician misconceptions or gaming potentially limit programs...

..We examined the relation between body mass index, exercise, overall health, and physical functioning...

..We compared EHR-based assessment with manual chart review to determine the accuracy of automated cardiac risk estimation and determination of candidates for antiplatelet or lipid-lowering interventions...

..Our study goal was to assess the effects of a brief patient video on breast cancer knowledge and attitudes among Latina women at a community health center...

..Physician-directed approaches have not eliminated the underuse of effective preventive therapies...

..We assessed knowledge, attitudes, and behavior regarding CRC screening to inform the development of messages that promote screening among Hispanic/Latino patients...

..We assessed racial/ethnic disparities using the Hospital Quality Alliance Inpatient Quality of Care Indicators...

....

..Preliminary results provide no justification for targeting certain subgroups with susceptibility to certain chronic conditions rather than broad policy interventions...

..Patient-reported physical limitations are widely used to assess health status or the impact of disease. However, patients' mental health may influence their reports of their physical limitations...

..Public health messages should target diverse populations. The current levels of physical activity attained by this population do not appear to protect against weight gain...

..Studies demonstrating the value of hospitalists to medical student education have been performed in traditional resident covered ward service settings (RCWS)...

....

..Implications and recommendations for message development are discussed...

..Caregivers often assist with medication reminding and activities of daily living. No prior studies have examined the health literacy levels among paid non-familial caregivers...

..In this study, the association between health literacy and the prevalence of health risk behaviors was examined among older adults...

..The purpose of this paper is to describe the development and pilot testing of a new bilingual computer-based health literacy assessment tool...

..Millions of Americans are intermittently uninsured. The health consequences of this are not known...

..Deficits in information transfer between inpatient and outpatient physicians are common and potentially dangerous...

..Adverse events resulting from medication error are a serious concern. Patients' literacy and their ability to understand medication information are increasingly seen as a safety issue...

..This tool should be useful for measuring quality of care for large patient populations and determining the effectiveness of quality improvement activities...

..The authors compared emergency physicians' responses and per-participant costs between a US 2 dollar bill and a 250 US dollars lottery...

..We describe recent trends in payments from different payer classes and assess their relative importance to the financial solvency of emergency departments...

..This study compares a single session self-management HF training program against a multiple session training intervention and examines whether their effects differ by literacy level...

..To examine whether dissatisfaction with one's usual source of care (USC) and perceived access difficulties to one's USC were associated with nonurgent emergency department (ED) use...

..01). Evaluation of the effects of external feedback on practice behavior requires sufficient time for organizational and individual clinician change to occur. Physician liaisons may play a role in facilitating this change...

..There are many opportunities to improve patients' knowledge of their chronic disease(s), and efforts need to consider their health literacy skills...

..Many older adults in Medicare managed care programs have low health literacy, and this may affect use of preventive services...

..We evaluated the effects of the Institute of Healthcare Improvement's Breakthrough Series (IHI BTS) on quality of care for chronic heart failure (CHF)...

..Delayed or inaccurate communication between hospital-based and primary care physicians at hospital discharge may negatively affect continuity of care and contribute to adverse events...

..Modifications to the National Cholesterol Education Program (NCEP) guidelines lowered optional low-density lipoprotein cholesterol (LDL-C) treatment goals...

..Despite high cardiovascular risk among adults with diabetes mellitus, aspirin use has been low...

..abstract_text> ..

..The pathways described above will be sequentially added to the models to determine the change in the beta coefficients for literacy to determine the degree to which each pathway mediates the relationship between literacy and mortality. ..

..Dissemination: This study will produce computerized tools and educational materials that will allow rapid dissemination to over 1000 sites that use the Epic(R) ambulatory product. ..