C M Ashton

..We evaluate the evidence that poor communication is a cause of disparities and propose some remedies drawn from the communication sciences...

..To estimate the burden of comorbid conditions and to describe patterns of inpatient and outpatient service use by veterans with diabetes mellitus...

..Thus, it might be less likely to have geographic variations...

..Lessons learned about CHF in the course of the CHF QUERI will be applicable to all people with heart failure and to all health care systems--VA as well as non-VA--that care for them...

..To evaluate the validity of three criteria-based methods of quality assessment: unit weighted explicit process-of-care criteria; differentially weighted explicit process-of-care criteria; and structured implicit process-of-care criteria...

..Utilization and outcome data indicate the need for major efforts to assure quality of care and to devise innovative ways of delivering comprehensive services...

..Little data exist supporting the association of quality of care and nonfatal adverse outcomes in hospitalized patients, yet those outcomes are routinely scrutinized in quality assessment efforts...

..The objective of this study was to evaluate the convergent validity of 3 types of utility measures: standard gamble, time tradeoff, and rating scale...

..This study estimates the effect of a prospective payment system based on diagnosis-related groups (DRGs) nationwide in the Department of Veterans Affairs...

..9 days vs 7.2 to 8.2 days, p < 0.01). CONCLUSIONS: Complications are frequent among patients discharged alive with CHF, COPD, or DM. The patients who experienced complications were more ill on admission and had longer hospital stays...

..The direct costs per visit averaged more than three times what the VA would have reimbursed the private sector...

..However, women veterans still use VA hospitals at about one-half the rate for men. Regardless, the VA system will continue to be an important source of health care for women...

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..01). CONCLUSIONS: A data-gathering work-rounds style is associated with better process and outcome. Residency programs should provide formal instruction to trainees in the conduct of work rounds...

..The paper discusses how the authors plan to develop a set of consensus standards that, if met, would result in substantial and much-needed improvements in the methodological and ethical quality of such trials...

..Evaluation of the effects of vertical integration should allow for reasonable adjustment time, but obviously unsuccessful strategies should not be followed or maintained...

..The purpose of this study was to determine the prevalence of peripheral arterial disease (PAD) in white, African American, and English- and Spanish-speaking Hispanic patients...

..To determine whether race/ethnicity is an independent risk factor for peripheral arterial disease (PAD)...

..In an effort to develop a more comprehensive understanding of this relationship, this study included both patient reports of their QOL and caregiver reports of patient QOL...

..It is our hope that they stimulate a broad discussion of the measurement challenges posed by conducting "state-of-the-art" health services research...

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..The objective of this study was to explore associations between the personal impact of the September 11th attacks and patients' perceptions of health and illness...

..In designing a patient-physician communication intervention, we explored patients' perceptions of the role of exercise in the treatment of peripheral arterial disease (PAD)...

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..We investigated the association of process of care measures with adverse limb and systemic events in patients with peripheral arterial disease (PAD)...

..Despite success in other depressed populations, self-management therapy produced no clinically significant effect in depression with chronic PTSD...

..This prospective study examined the longitudinal relationship between use of health care services and treatable comorbid conditions among patients with dementia...

..Our objectives are to present a conceptual model of the pain assessment process in persons with dementia and discuss methods for validating our model within this population...

..To examine whether process of hospital care differs among Hispanic, black, and white VA beneficiaries...

..Further work is needed to assess the impact of actual care patterns, for the above identified risk factors, on stroke prognosis over varying time periods...

..The purpose of this research was to determine if differences in service use exist between dementia patients with and without psychiatric comorbidity...

..We compared the incidence of prostate cancer in first-degree family members of African-Americans with that in white Americans...

..We postulated that if access to hospital care was reduced too much, or if decreased hospital use was not offset by improvements in ambulatory care, urgent care visits would increase or survival rates would fall...

..By sharing our experiences, the barriers we encountered, and our ongoing efforts to improve patient communication in the medical encounter, we hope to empower patients to communicate better with their physicians...

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..Many healthcare organizations use diagnosis-based risk adjustment systems for predicting costs. Health self-report may add information not contained in a diagnosis-based system but is subject to incomplete response...

..ICD codes can then be used in the most appropriate ways...

..CONCLUSIONS: In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure...