C I Kiefe

..Current standards, e.g. HEDIS, use delayed patient measures that may over or under-estimate overall performance...

..The purpose of this study was to compare processes and outcomes of AMI care among patients undergoing interhospital transfer with special attention to the impact on mortality in rural hospitals...

..This study investigated whether socioeconomic factors explain racial/ethnic differences in regular smoking initiation and cessation...

..Health care financing is changing rapidly in the United States. We investigated whether and how health care access is changing concurrently with changes in financing, with special attention to a minority population...

..We investigated how health care system and patient characteristics influence appointment-keeping after discharge from an acute care hospitalization...

..Achievable Benchmarks of Care (ABCs) are standards of excellence attained by top performers in a peer group and are easily and reproducibly calculated from existing performance data...

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..Incarceration is associated with increased cardiovascular disease mortality, but prospective studies exploring mechanisms of this association are lacking...

..Within the United States, little is known about regional disparities in blood pressure (BP), their changes over time, or explanations for their existence...

..The ABC methodology has been well accepted in multiple quality improvement projects. This approach lends objectivity and reliability to benchmarks that have been a widely used, but until now, arbitrarily defined tool...

..Previous studies have shown that women younger than 55 years have higher hospital mortality rates after acute myocardial infarction (MI) than age-matched men. We examined whether such mortality differences have decreased in recent years...

..Issues of cost and quality are gaining importance in the delivery of medical care, and whether quality of care is better in teaching vs nonteaching hospitals is an essential question in this current national debate...

..54; 95% CI, 0.34-0.86). CONCLUSION: Collaboration between generalists and cardiologists, rather than solo care by either, was associated with better HF processes and outcomes of care...

..Secular trends for weight gain are continuing in CARDIA, but the magnitude of weight gain differed among the four race-sex groups...

..CONCLUSION: Compared with whites, black women reported significantly less BMD testing and prescription and nonprescription osteoporosis therapy. This disparity was not fully explained by other demographic or risk factor differences...

..Wider use of EMS by patients with suspected MI may offer considerable opportunity for improvement in public health...

..We assessed the relationship between change in serum creatinine levels up to 3.0 mg/dL and death and ESRD among elderly survivors of hospitalization for acute myocardial infarction...

..The mean age of the underlying population was 36 years, 89% were blue-collar or unskilled workers, 50% were African Americans and 20% were female...

..The dental visit is a unique opportunity for tobacco control. Despite evidence of effectiveness in dental settings, brief provider-delivered cessation advice is underutilized...

..We assessed whether drug use predicted decline in general self-rated health (GSRH) in a community-based cohort, healthy at baseline...

..Younger stroke survivors may have reduced access to physician care and medications because they are more frequently uninsured...

..Treatment disparities for socioeconomically disadvantaged populations have been widely reported, but few studies have sought explanations for these disparities...

..To assess whether active and passive smokers are more likely than non-smokers to develop clinically relevant glucose intolerance or diabetes...

..The Accreditation Council for Graduate Medical Education has suggested various methods for evaluation of practice-based learning and improvement competency, but data on implementation of these methods are limited...

..The availability of Internet-based continuing medical education is rapidly increasing, but little is known about recruitment of physicians to these interventions...

..Our goal is to identify potential differences in thrombolytic medication delays and thrombolytic-associated bleeding events by severity of kidney disease...

..It is assumed that the performance of more senior residents is superior to that of interns, but this has not been assessed objectively...

..We linked administrative data with physician data from the American Medical Association physician survey to identify characteristics of primary care offices associated with best chlamydia screening practices...

..To determine if medication assistance programs (MAPs) provided by pharmaceutical companies were used differently by African Americans and Whites...

..Medication access is crucial to secondary stroke prevention. We assessed medication access and associated barriers to care across region and time in a national sample of US stroke survivors...

..Further investigation into the reasons for ethnic differences in survival and progression of kidney disease is warranted...

..Because of the move toward performance-based reimbursement, identification of top-performing hospitals has acquired new importance...

..This is counterintuitive given the known 4-fold greater incidence of end-stage renal disease (ESRD) in African Americans. We describe racial differences in the rate of progression to ESRD and address the competing risk of mortality...

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..Future studies should include social factors, such as income and education, and consider additional characteristics that may modify or confound associations between alcohol and blood pressure...

..In the choice and definition of quality of care indicators, there may be an inherent tension between feasibility, generally enhanced by simplicity, and validity, generally enhanced by accounting for clinical complexity...

..We assessed how variability in providing β-blockers to ambulatory postmyocardial infarction (MI) patients was influenced by physician and patient level characteristics...

..Little is known about NSAID-related ethnic/racial disparities. We focused on differences in patient NSAID risk awareness, patient-doctor NSAID risk communication, and NSAID risk-avoidance behavior...

..The conceptualization of patient complexity is just beginning in clinical medicine...

..Participation assessment of internet-delivered interventions varies by the selection of measure and factor. Further research assessing the potential for these measures to predict intervention effectiveness is needed...

..Low Chlamydia trachomatis screening rates create an opportunity to test innovative continuing medical education (CME) programs. Few studies of Internet-based physician learning have been evaluated with objective data on practice patterns...

..National educational initiatives may need to redefine the classic presentation of UAP to include atypical presentations to ensure appropriate quality of care...

..The purpose of this study was to examine the proportion of men who died from prostate cancer (PrCa) vs. with PrCa and assess the comorbid conditions associated with other-cause deaths...

..To determine the association between angiotensin-converting enzyme (ACE) inhibitor therapy and survival of older heart failure patients with conditions perceived by physicians as contraindications to ACE inhibitors...

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..The influence of an opinion leader intervention on adherence to Unstable Angina (UA) guidelines compared with a traditional quality improvement model was investigated...

..Recent hospital reductions in registered nurses (RNs) for hospital care raise concerns about patient outcomes...

..This report describes the first round of results for Phase II of the Alabama CABG Project, a regional quality improvement initiative...

..CONCLUSION: Permanent mesh placement was not associated with postoperative wound infection. Smoking was the only modifiable risk factor and preoperative smoking cessation may improve surgical outcomes in VHR...

..However, the best methodological approach to improvement is under debate...

..It is conceptually feasible to integrate medical and marketing approaches to quality, with important insights resulting from this integration...

..This study examined how physicians perceive pharmaceutical companies' medication assistance programs (MAPs)...

..Despite recent emphasis on educational outcomes, program directors still rely on standard evaluation techniques such as tests of knowledge and subjective ratings...

..To assess the difference in immediate (30 and 60 days after admission) and late (2-year) mortality between those who received inpatient post-myocardial infarction smoking cessation counseling and those who did not receive counseling...

..CONCLUSIONS: Among women who sought outpatient care, screening rates decreased as comorbidity increased. Whether clinicians and patients are making appropriate decisions about screening is not known...

..4 observed approximately one year earlier (p = 0.058). Acute sociopolitical events such as bioterrorist attacks present a unique opportunity to investigate changes in health care...

..Further studies are needed to determine the relationship of postinfarction lipid subfractions and mortality in older patients with coronary artery disease (CAD)...

..The working group concluded that a dedicated investment in CV outcomes research could directly improve the care delivered in the United States...

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..Previous studies have suggested an association between depression and low socioeconomic status, but few have empirically examined the effect of depressive symptoms on income and employment over time...

..To examine associations of neighborhood characteristics with six components of the insulin resistance syndrome (IRS) in young adults...

..A dynamic index of socioeconomic status may be a useful concept in understanding the effects of socioeconomic status on the natural history of hypertension...

..We studied the associations between 1) current use of oral contraceptives (OCs) and 2) glucose levels, insulin levels, and diabetes in young women...

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..Considering known functionality of GGT, these associations are consistent with a role for oxidative stress in risk for diabetes and hypertension...

..We explored how income and skin color interact to influence the blood pressure of African American adults enrolled in the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study...

..To assess the relationship between positional blood pressure change and 8-year incidence of hypertension in a biracial cohort of young adults...

..Differences in race/ethnicity related risk of early-onset renal impairment are particularly large among men and are not accounted for by the metabolic or socioeconomic factors evaluated...

..To investigate the relation between neighbourhood socioeconomic and ethnic characteristics with depressive symptoms in a population based sample...

..To interpret, within a sociological context, evidence of physician bias in the management and outcomes of coronary heart disease (CHD) treatment for African Americans vs Whites...

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..CONCLUSIONS: These results indicate that childhood SES and early family environment contribute to metabolic functioning through pathways of depression, hostility, and poor quality of social contacts...

..We examined the relation of age and race on short-term death in a large AMI population and ascertained the factors that may have contributed to differences in mortality rates...

..Because limited audit/feedback of health status information has yielded mixed results, we evaluated the effects of a sustained program of audit/feedback on patient health and satisfaction...

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..These associations were similarly positive in Whites but not significant. Substance use may be an unhealthy coping response to perceived unfair treatment for some individuals, regardless of their race/ethnicity...

..Denominator construction (algorithm 1 versus 2) contributed significantly to variability in measured quality. Our findings raise concern about interpreting depression quality reports based upon administrative data...

..Although psychosocial factors are correlated, previous studies on risk factors for hypertension have typically examined psychosocial factors individually and have yielded inconsistent findings...

..Nonmedical use of prescription opioids has emerged as a major public health problem during the last decade, but direct measures of incidence and predisposing factors are lacking...

..06) but was unrelated to other risk factor changes. Knowledge of CVD risk factors was very low in these young adults but increased with the presence of risk factors. Knowledge alone did not predict 10-year changes in risk factors...

..African American smokers are more likely to experience tobacco-related morbidity and mortality than European American smokers, and higher rates of menthol cigarette smoking may contribute to these disparities...

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..We examined the effects of self-reported experiences of racial discrimination on Black-White differences in preterm (less than 37 weeks gestation) and low-birthweight (less than 2500 g) deliveries...

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..e., M.D.s, D.M.D.s, nurses, clinical psychologists) positions per year. This will result in four and four positions in year 2, and six and four positions in years 3 to 5, respectively. ..

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