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Genetic testing: a challenge to the preventive paradigm. 基因检测:对预防范式的挑战。
HMO practice
Pub Date : 1996-06-01
J D Reinhard
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引用次数: 0
A cohort analysis of pre-menopausal women with dysfunctional uterine bleeding. 绝经前妇女功能失调性子宫出血的队列分析。
HMO practice
Pub Date : 1996-06-01
S D Horn, S Prather, C A Jones

Objective: To examine the clinical and cost outcomes of patients with dysfunctional uterine bleeding (DUB) who are treated with hysterectomy or not.

Design: A retrospective analysis of DUB patients over 30 months of treatment after initial diagnosis.

Setting: Patients with DUB from an HMO with over 200,000 enrollees.

Participants: Study patients, all women with an initial diagnosis of DUB, were divided into two cohorts. Cohort 1 was women who had a hysterectomy (not for cancer); Cohort 2 was women who did not have a hysterectomy.

Main outcome measures: Visit counts and costs, prescription counts and costs, hospital costs, and procedure counts.

Results: Hysterectomy patients in our dataset tend to have more prescriptions, higher prescription costs, more visits overall, higher visit costs, higher hospitalization costs, and higher total costs per member per month (PMPM) than non-hysterectomy patients. After surgery, the hysterectomy patients' costs and utilization PMPM are higher than those for the non-hysterectomy patients.

Conclusions: There is wide variation in the treatment of patients with DUB. Clinical practice improvement studies are needed to determine the appropriate treatments based on patient characteristics to achieve better outcomes for lower costs.

目的:探讨功能失调性子宫出血(DUB)患者行子宫切除术或不行子宫切除术的临床和成本结果。设计:回顾性分析DUB患者在初次诊断后治疗超过30个月。环境:来自HMO的DUB患者，注册人数超过20万。参与者:研究患者，所有最初诊断为DUB的女性，分为两组。队列1是切除子宫的女性(不是因为癌症);队列2为未做子宫切除术的女性。主要结局指标:就诊次数和费用、处方次数和费用、医院费用和手术次数。结果:在我们的数据集中，子宫切除术患者往往比未子宫切除术患者有更多的处方，更高的处方费用，更多的总体就诊次数，更高的就诊费用，更高的住院费用和更高的每月人均总费用(PMPM)。术后子宫切除术患者的费用和对PMPM的利用均高于非子宫切除术患者。结论:DUB患者的治疗存在很大差异。临床实践改进研究需要根据患者的特点来确定适当的治疗方法，以较低的成本获得更好的结果。
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引用次数: 0
A modified health risk appraisal as a component of a senior health promotion program. 修订后的健康风险评估，作为老年人健康促进计划的组成部分。
HMO practice
Pub Date : 1996-06-01
W L Beery, H P Greenwald

Because of their comprehensive service capabilities and traditional focus on prevention, HMOs have an outstanding potential for contributing to health promotion and disease prevention among special populations. But HMOs must acknowledge the special needs of key groups and modify traditional offerings accordingly. This article describes the use of the health risk appraisal (HRA) in a program, A Healthy Future, aimed at promoting health and preventing disease among elders. Unlike ¿standard¿ HRAs, this program developed questions of special pertinence to elders and used face-to-face, human contact for communicating results. Most important, the program linked the HRA to primary care and to interventions particularly useful and acceptable to elders.

由于其综合服务能力和对预防的传统关注，卫生保健组织在促进特殊人群的健康和预防疾病方面具有突出的潜力。但hmo必须承认关键群体的特殊需求，并相应地调整传统的服务。本文描述了健康风险评估(HRA)在旨在促进老年人健康和预防疾病的“健康未来”方案中的应用。与“标准的”HRAs不同，这个项目提出了一些特别针对老年人的问题，并通过面对面的人际接触来交流结果。最重要的是，该项目将HRA与初级保健以及对老年人特别有用和可接受的干预措施联系起来。
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引用次数: 0
Enhancing motivation in substance abusers. 加强药物滥用者的动机。
HMO practice
Pub Date : 1996-06-01
R Schneider
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引用次数: 0
Hospice, bereavement intervention and use of health care services by surviving spouses. 临终关怀、丧亲干预和未亡配偶使用保健服务。
HMO practice
Pub Date : 1996-03-01
S R Connor, J K McMaster
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引用次数: 0
Using guidelines to change clinical practice: three case studies. 使用指南改变临床实践:三个案例研究。
HMO practice
Pub Date : 1996-03-01
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引用次数: 0
Restructuring health care. 重组医疗保健。
HMO practice
Pub Date : 1996-03-01
R D Lamm
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引用次数: 0
Are HMO members willing to engage in two-way communication to improve health? HMO成员是否愿意参与双向沟通以改善健康?
HMO practice
Pub Date : 1996-03-01
P J O'Connor, W A Rush, K A Rardin, G Isham
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引用次数: 0
An internist in the emergency department: the IM facilitator program. 急诊科的内科医生:IM促进者计划。
HMO practice
Pub Date : 1996-03-01
A Halpert
{"title":"An internist in the emergency department: the IM facilitator program.","authors":"A Halpert","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79628,"journal":{"name":"HMO practice","volume":"10 1","pages":"42-3"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21027111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Decreasing the number of recheck appointments for an urgent care clinic by using telephoned follow-up care by nurses. 通过护士电话随访，减少急诊诊所复查预约的次数。
HMO practice
Pub Date : 1996-03-01
K Bedeian, J M Hively, B B Gerstman, D Dhanoa
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引用次数: 0
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