Nancy Keating

..We assessed whether the presence of a tumor board, either general or cancer specific, was associated with recommended cancer care, outcomes, or use in the Veterans Affairs (VA) health system...

..4% in 2006 to 1.9% in 2010. The authors of this report assessed whether health insurance expansion was associated with use of mammography and earlier stage at breast cancer diagnosis...

..Most studies have focused on care in fee-for-service Medicare; whether spillover effects exist in settings without financial incentives for more care is unknown...

..This population of mostly older men is medically vulnerable to a variety of treatment-associated adverse effects...

..Physicians often rely on colleagues for new information and advice about the care of their patients...

..We described follow-up care for breast cancer survivors, examined how surveillance testing varies by the types of physicians seen, and assessed changes in testing rates over time...

..These findings are reassuring in light of recent trends towards more aggressive primary breast cancer therapy...

..Learning how focused expertise affects processes and outcomes of care will contribute to decisions about physician training and staffing of medical groups...

..We compared aggressiveness of end-of-life care of older metastatic cancer patients treated in the Veterans Health Administration (VHA) and those under fee-for-service Medicare arrangements...

..We assessed whether androgen deprivation therapy is associated with an increased incidence of diabetes and cardiovascular disease...

..Younger and better educated patients have more active roles in decisions, but whether patients' roles in decisions differ by characteristics of the decision itself is unknown...

..These results suggest that physicians may have managed potential conflicts to avoid compromising the patient-physician relationship...

..Among patients with chronic medical conditions, unrelated conditions are often undertreated...

..Variations in hospice use are not well understood...

..Guidelines recommend advanced care planning for terminally ill patients with <1 year to live. Few data are available regarding when physicians and their terminally ill patients typically discuss end-of-life issues...

..We evaluated the relationship between androgen deprivation therapy and incident diabetes and cardiovascular disease in men of all ages with prostate cancer...

..Prior research has documented racial disparities in patterns of care and outcomes for women with breast cancer...

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..Recent experiences of survey researchers suggest that physicians are becoming less willing to complete surveys...

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..We surveyed cancer physicians to understand how patients' age and comorbidity influence adjuvant chemotherapy recommendations and whether physician or practice characteristics also affect these recommendations...

..To describe the physicians with whom breast cancer patients discuss treatment options and assess whether discussing surgical options with a medical oncologist is associated with type of surgery and satisfaction...

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..Few data are available regarding the consequences of patients' problems with interpersonal aspects of medical care...

..Informing patients of available treatment alternatives is an important element of informed consent. We examined and compared patients' and their surgeons' reports of discussing treatment alternatives for early stage breast cancer...

..We assessed whether consultation with a medical oncologist before surgery was associated with use of definitive surgery, axillary node dissection, and type of surgery...

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..Nearly half of all medical visits are to specialist physicians, yet little is known about patients' outpatient experiences with specialists or how patients' characteristics and experiences are related to trust in specialist physicians...

..Health care organizations use many strategies to influence physician behavior and the care delivered, but the effect of such strategies on quality is not known...

..The Veterans Health Administration (VHA) is the largest integrated health care system in the United States. Studies suggest that the VHA provides better preventive care and care for some chronic illnesses than does the private sector...

..We examined outpatient care in the 2 years before breast cancer diagnosis to identify women at high risk for limited care and assess the relationship of the physicians seen and number of visits with stage at diagnosis...

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..Social networks may influence screening behaviors. We assessed whether screening for breast, prostate, or colorectal cancer is influenced by the actual screening behaviors of siblings, friends, spouses, and coworkers...

..We identified factors associated with underuse of surveillance mammography and examined whether variation was explained by differences in follow-up care...

..To assess the physical and mental health status of older long-term cancer survivors...

..30). CONCLUSIONS: Increases in the market share of managed care do not appear to influence the receipt of equally effective primary treatments for cancer in the fee-for-service sector...

..To determine whether the place of death for patients with cancer is associated with patients' quality of life (QoL) at the end of life (EOL) and psychiatric disorders in bereaved caregivers...

..We surveyed surgeons to understand how their recommendations for lobectomy were influenced by age, the presence and severity of smoking-related lung disease, or by characteristics of the surgeons and their practices...

..Multiple treatment options exist for many medical conditions. The extent to which physicians should involve the patient in the choice the treatment to be delivered is not well understood...

..We assessed whether measuring processes of diabetes care using administrative data without medical record data is likely to underdetect compliance with accepted standards for certain groups of patients...

..Finally, it is unclear how well nursing homes and the pharmacies they work with will work across Part D plans, and vigilance will be required as the benefit proceeds...

..Receiving a cancer diagnosis is a stressful event that may increase risks of suicide and cardiovascular death, especially soon after diagnosis...

..To compare hospice care delivered at home with hospice care delivered in institutional settings, such as the nursing home...

..The effect of Part D will depend on the restrictiveness of the prior authorization and appeals processes, which is currently unknown...

..LHRH agonists are associated with initial testosterone rises that may cause clinical disease flares in men with metastatic prostate cancer...

..Our results show that instead of cutting spending, policies designed to target services to patients most likely to benefit could increase the value of medical spending...

..However, these changes did not translate into worse discharge outcomes...

..We compared trial patients' attributes and outcomes by these enrollment settings...

..We examined data on claims in rejected status for one large long-term care pharmacy as of December 2006. There was considerable variation across PDPs in both rejection rates and reasons for rejection...

..Many terminally ill patients enroll in hospice only in the final days before death or not at all. Discussing hospice with a health care provider could increase awareness of hospice and possibly result in earlier use...

..To identify characteristics of nursing homes and residents associated with particularly long or short hospice stays...

..These results highlight the importance of organizational and payment factors in the delivery of home health care services...

..Such efforts should reduce administrative burden and better allow physicians to help patients obtain needed medications...

..However, replicating these results using data from a broader, more representative sample of hospices is needed before making changes to the per diem system...

..We examined the factors associated with PLND use among men undergoing open RP (ORP) and minimally invasive RP (MIRP)...

..To explore the implications of current approaches used by health plans and purchasers to identify preferred hospitals for tiered networks using cost and quality information...

..Few studies have assessed associations of surgeons' practice volume with processes of care that lead to better outcomes...

..Providing patient education about diabetes care processes should be tested as a means of increasing ambulatory care to prevent diabetes complications...

..We assessed receipt of definitive local therapy for early-stage breast cancer by race/ethnicity and age and examined trends over time...

..The authors of this report assessed whether chemotherapy or radiation therapy was associated with a disruption in employment during the year after a breast cancer diagnosis...

..Minimally invasive radical prostatectomy (MIRP) has diffused rapidly despite limited data on outcomes and greater costs compared with open retropubic radical prostatectomy (RRP)...

..We surveyed surgical residents to learn their perspectives and training experience with discussing end-of-life care and WWLST with patients...

..We assessed utilization, complications, lengths of stay, and salvage therapy rates for MIRP versus open radical prostatectomy assessed whether MIRP surgeon volume is associated with better outcomes...

..Moreover, the work will provide insight into different techniques for the analysis of observational data. ..

..If managed care penetration is negatively associated with the delivery of care, interventions targeted toward policy-makers, providers, and patients will be needed to counteract the effects of market forces. ..

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