Página 1 dos resultados de 373 itens digitais encontrados em 0.003 segundos

‣ Sistema de certificação da qualidade de edifícios de escritórios no Brasil. ; Quality certification system of office buildings in Brazil.

Veronezi, Ana Beatriz Poli
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 26/03/2004 Português
Relevância na Pesquisa
384.05004%
A grande diversidade de classificações empregadas no mercado imobiliário para fazer referência a edifícios de escritórios é flagrante. Para suportar qualquer tomada de decisão relacionada ao produto edifício de escritórios é conveniente que a informação sobre a qualidade desses prédios seja única. Este sistema de certificação da qualidade estratifica o mercado de edifícios de escritórios de forma criteriosa, imparcial e única no âmbito nacional. Os prédios submetidos a este sistema de certificação são classificados de acordo com o estado de determinados atributos. Cada edifício analisado obtém duas classificações: nacional e regional, que são representadas por letras, sendo a classificação nacional seguida da extensão “Br”, para distinguir-se da classificação regional. A classificação nacional contempla apenas os atributos físicos da construção, desconsiderando o quesito localização. Na classificação regional, os atributos contemplados são os físicos e a localização do prédio dentro de determinado mercado de escritórios. Em nenhuma delas a gestão do edifício é avaliada. A qualidade do edifício de escritórios analisado é expressa através destas duas classificações em um certificado emitido pelo Núcleo de Real Estate da Escola Politécnica da USP. Os procedimentos e regras para aplicação do sistema em questão foram estabelecidos neste estudo. A perecibilidade de alguns componentes deste sistema de certificação...

‣ Prevalência de consultas médicas e fatores associados : um estudo de base populacional no sul do Brasil; Prevalence of medical visits and associated factors : a population-based study in Southern Brazil

Boing, Antonio Fernando; Matos, Izabella Barison; Arruda, Marina Patrício de; Oliveira, Maria Conceição de; Njaine, Kathie
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
Relevância na Pesquisa
485.5916%
Objetivo. Descrever a prevalência de consultas médicas e os fatores associados na população adulta de um município de médio porte do sul do Brasil. Métodos. Realizou-se estudo transversal de base populacional em Lages, Santa Catarina. A população de referência foram os adultos (20 a 59 anos). O processo de amostragem foi por conglomerados e foram entrevistadas 2.022 pessoas. O desfecho foi a realização de consulta médica nos 12 meses anteriores à pesquisa. Também foram coletadas informações relativas à natureza do serviço utilizado (público/privado) e a avaliação do mesmo. As variáveis independentes foram sexo, raça/cor de pele, estado civil, renda per capita, escolaridade, autopercepção da saúde, estado nutricional, diabetes autorreferido, nível pressórico elevado, tabagismo e problemas com álcool. Foi realizada regressão de Poisson obtendo-se a Razão de Prevalência como medida de efeito. Resultados. A prevalência de consultas médicas nos 12 meses anteriores à entrevista foi de 76% (IC95% 73,6-78,4). As mulheres, os mais ricos, aqueles com diabetes, fumantes, ex-fumantes, com problemas com álcool e que avaliaram negativamente a sua saúde reportaram maior prevalência do desfecho. Também se observou que entre os estratos com menor renda a utilização do Sistema Único de Saúde para a realização das consultas médicas foi mais elevada. Conclusão. A realização de consultas médicas variou entre estratos da população. As políticas de saúde das três esferas de governo devem considerar tal desigualdade para subsidiar suas ações para o setor a fim de propor políticas equânimes.; Objective. describe the prevalence of medical visits and associated factors in an adult population of a midsized town in Southern Brazil. Methods. a population-based cross-sectional study was carried out in a representative random cluster sampling in Lages...

‣ Office Visits with Patients over 65 Years of Age: Do They Take More Time?

Divett, Andrew Graeme
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /04/1983 Português
Relevância na Pesquisa
484.7701%
Office visits were timed for 952 patients seen in a family practice, comparing time required for patients aged 65 and over with time required for patients aged two to 65. Diagnoses were similar in both groups. No significant difference was found in time required. This may be due to familiarity with the patients and appropriate office design, or may mean that not enough time was spent with geriatric patients. However, since family medicine is inherently patient-centred and not disease-centred, good geriatric care should take no more time than care to other age groups.

‣ Utilization of the office, hospital and emergency department for adult sickle cell patients: a five-year study.

Epstein, Kenneth; Yuen, Elaine; Riggio, Jeff M.; Ballas, Samir K.; Moleski, Stephanie M.
Fonte: National Medical Association Publicador: National Medical Association
Tipo: Artigo de Revista Científica
Publicado em /07/2006 Português
Relevância na Pesquisa
397.7401%
Sickle cell disease (SCD) is a hematological disorder that is manifested primarily by severe pain and chronic organ damage. Little normative data exists on what the usual healthcare utilization is of a population of SCD patients, especially adults. Our study analyzed the office, emergency department (ED) and hospital use data for 142 patients who received care for three consecutive years. Relationships between health service use, patient age, gender and sickle cell phenotype were described. Multivariate analyses studied relationships between demographic and clinical characteristics and levels of office, independent ED and inpatient encounters over a five-year period (1997-2001). We found female patients were older and had less ED and hospital admissions. The 20% highest inpatient utilizers accounted for 54% of the ED total visits, 52% of the ED independent visits, 54% of hospital bed days and 24% of office visits. The ED was a common place for utilization, with a mean of 7.4 visits per patient year, a third of which resulted in a hospital admission. The healthcare utilization of our adult sickle cell population is very complex, with a subset of our patients accounting for a majority of the resources used and female patients living longer but with less ED and hospital admissions.

‣ Characteristics of Patients Who Seek Care via eVisits Instead of Office Visits

Mehrotra, Ateev; Paone, Suzanne; Martich, G. Daniel; Albert, Steven M.; Shevchik, Grant J.
Fonte: Mary Ann Liebert, Inc. Publicador: Mary Ann Liebert, Inc.
Tipo: Artigo de Revista Científica
Publicado em /07/2013 Português
Relevância na Pesquisa
496.9404%
Purpose: There is growing recognition that many physician–patient encounters do not require face-to-face contact. The availability of secure Internet portals creates the opportunity for online eVisits. Increasing numbers of health systems provide eVisits, and many health plans reimburse for eVisits. However, little is known on who chooses to seek care via an eVisit. Materials and Methods: At four primary care practices, we used the electronic medical record to identify all eVisits and office visits for sinusitis and urinary tract infections (UTIs) between January 2010 and May 2011. From the electronic medical record we abstracted the necessary information on patient demographics. The population studied included 5,165 sinusitis visits (9% of which were eVisits) and 2,954 UTI visits (3% eVisits). Results: In multivariate models controlling for other patient factors, the variables most strongly associated with a patient initiating an eVisit versus an office visit were age (18–44 years of age versus 65 years of age and older: sinusitis, odds ratio 1.65 [0.97–2.81]; UTI, 2.97 [1.03–8.62]) and longer travel distance to clinic (>10 miles from patient home to clinic versus 0–5 miles: sinusitis, odds ratio 6.54 [4.68–9.16]; UTI...

‣ Missed Office Visits and Risk of Mortality Among HIV-Infected Subjects in a Large Healthcare System in the United States

Horberg, Michael A.; Hurley, Leo B.; Silverberg, Michael J.; Klein, Daniel B.; Quesenberry, Charles P.; Mugavero, Michael J.
Fonte: Mary Ann Liebert, Inc. Publicador: Mary Ann Liebert, Inc.
Tipo: Artigo de Revista Científica
Publicado em /08/2013 Português
Relevância na Pesquisa
384.5247%
Linkage and retention in care soon after HIV diagnosis improves clinical outcomes. Conversely, missed visits after diagnosis are associated with increased mortality in the public care setting. We analyzed mortality among newly diagnosed HIV patients ≥18 years old in a large private care setting between 01/01/1997 and 12/31/2009, comparing patients who missed visits in their first year following diagnosis (index period) with those who did not. Patients who died during the index period were excluded. Hazard ratios (HR) for association of missed visits and mortality were obtained by Cox proportional hazards regression, adjusting for patient demographics, CD4+ counts, and AIDS-defining conditions (CDC, 1993) at diagnosis. We also evaluated risk factors of missed visits by multivariable logistic regression. 2811 patients were included, of whom 65% had ≥1 missed visit, and 226 patients died during follow-up. Patients with ≥1 missed visit had a 71% increased mortality risk (HR=1.71, p=0.001) with 12% increased rate per missed visit (HR=1.12, p<0.001). Factors associated with missed visits were younger age (OR=1.69 compared to 60+ years), Black and Latino race/ethnicity (OR=1.54, 1.48 respectively, compared to Caucasians), injection drug use (OR=2.50 compared to men who have sex with men)...

‣ Frequent office visits of patients with chronic kidney disease: Is a prelude to prevention of dialysis

Mandal, Anil K
Fonte: Baishideng Publishing Group Co., Limited Publicador: Baishideng Publishing Group Co., Limited
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
496.28773%
This study is an excerpt of broad-based office practice which is designed to treat patients with diabetes and hypertension, the two most common causes of chronic kidney disease (CKD), as well as CKD of unknown etiology. This model of office practice is dedicated to evaluating patients with CKD for their complete well-being; blood pressure control, fluid control and maintenance of acid-base status and hemoglobin. Frequent office visits, every four to six weeks, confer a healthy life style year after year associated with a feeling of good well-being and a positive outlook. Having gained that, such patients remain compliant to their medication and diet, and scheduled laboratory and office visits which are determinant of a dialysis-free life.

‣ Impact of Patient Portal Secure Messages and Electronic Visits on Adult Primary Care Office Visits

North, Frederick; Crane, Sarah J.; Chaudhry, Rajeev; Ebbert, Jon O.; Ytterberg, Karen; Tulledge-Scheitel, Sidna M.; Stroebel, Robert J.
Fonte: Mary Ann Liebert, Inc. Publicador: Mary Ann Liebert, Inc.
Tipo: Artigo de Revista Científica
Publicado em 01/03/2014 Português
Relevância na Pesquisa
388.67203%
Introduction: Secure messages and electronic visits (“e-visits”) through patient portals provide patients with alternatives to face-to-face appointments, telephone contact, letters, and e-mails. Limited information exists on how portal messaging impacts face-to-face visits in primary care. Materials and Methods: We conducted a retrospective cohort study of 2,357 primary care patients who used electronic messaging (both secure messages and e-visits) on a patient portal. Face-to-face appointment frequencies (visits/year) of each patient were calculated before and after the first message in a matched-pairs analysis. We analyzed visit frequencies with and without adjustments for a first message surge in visits, and we examined subgroups of high message utilizers and long-term users. Results: Primary care patients who sent at least one message (secure message or e-visit) had a mean of 2.43 (standard deviation [SD] 2.3) annual face-to-face visits before the first message and 2.47 (SD 2.8) after, a nonsignificant difference (p=0.45). After adjustment for a first message surge in visits, no significant visit frequency differences were observed (mean, 2.35 annual visits per patient both before and after first message; p=0.93). Subgroup analysis also showed no significant change in visit frequency for patients with higher message utilization or for those who had used the messaging feature longer. Conclusions: No significant change in face-to-face visit frequency was observed following implementation of portal messaging. Secure messaging and e-visits through a patient portal may not result in a change of adult primary care face-to-face visits.

‣ Patient-Reported Geriatric Symptoms as Risk Factors for Hospitalization and Emergency Department Visits

Chandra, Anupam; Crane, Sarah J; Tung, Ericka E; Hanson, Gregory J; North, Frederick; Cha, Stephen S; Takahashi, Paul Y
Fonte: JKL International LLC Publicador: JKL International LLC
Tipo: Artigo de Revista Científica
Publicado em 01/06/2015 Português
Relevância na Pesquisa
381.35848%
There is an urgent need to identify predictors of adverse outcomes and increased health care utilization in the elderly. The Mayo Ambulatory Geriatric Evaluation (MAGE) is a symptom questionnaire that was completed by patients aged 65 years and older during office visits to Primary Care Internal Medicine at Mayo Clinic in Rochester, MN. It was introduced to improve screening for geriatric conditions. We conducted this study to explore the relationship between self-reported geriatric symptoms and hospitalization and emergency department (ED) visits within 1 year of completing the survey. This was a retrospective cohort study of patients who completed the MAGE from April 2008 to December 2010. The primary outcome was an ED visit or hospitalization within 1 year. Predictors included responses to individual questions in the MAGE. Data were obtained from the electronic medical record and administrative records. Logistic regression analyses were performed from significant univariate factors to determine predictors in a multivariable setting. A weighted scoring system was created based upon the odds ratios derived from a bootstrap process. The sensitivity, specificity, and AUC were calculated using this scoring system. The MAGE survey was completed by 7738 patients. The average age was 76.2 ± 7.68 years and 57% were women. Advanced age...

‣ The Effect of Systematic Clinical Interventions with Cigarette Smokers on Quit Status and the Rates of Smoking-Related Primary Care Office Visits

Land, Thomas G.; Warner, Donna; Li, Wenjun; Rigotti, Nancy Ann; Levy, Douglas Edward; Schilling, Thad Ferguson
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
496.28773%
Background: The United States Public Health Service (USPHS) Guideline for Treating Tobacco Use and Dependence includes ten key recommendations regarding the identification and the treatment of tobacco users seen in all health care settings. To our knowledge, the impact of system-wide brief interventions with cigarette smokers on smoking prevalence and health care utilization has not been examined using patient population-based data. Methods and Findings Data on clinical interventions with cigarette smokers were examined for primary care office visits of 104,639 patients at 17 Harvard Vanguard Medical Associates (HVMA) sites. An operational definition of “systems change” was developed. It included thresholds for intervention frequency and sustainability. Twelve sites met the criteria. Five did not. Decreases in self-reported smoking prevalence were 40% greater at sites that achieved systems change (13.6% vs. 9.7%, p<.01). On average, the likelihood of quitting increased by 2.6% (p<0.05, 95% CI: 0.1%–4.6%) per occurrence of brief intervention. For patients with a recent history of current smoking whose home site experienced systems change, the likelihood of an office visit for smoking-related diagnoses decreased by 4.3% on an annualized basis after systems change occurred (p<0.05...

‣ Necessity of Office Visits for Acute Respiratory Infections in Primary Care

Renati, Sruthi
Fonte: Harvard University Publicador: Harvard University
Tipo: Thesis or Dissertation; text Formato: application/pdf
Português
Relevância na Pesquisa
406.03195%
Background: Acute respiratory infections (ARIs) are the most common symptomatic reason to seek ambulatory care in the United States, but many ARI visits may not be necessary. Methods: We identified ARI visits to 14 primary care practices between May 2011 and May 2012 and randomly selected 500 visits, 439 of which were new ARI visits. We separated non- visit-required information (e.g., history of present illness [HPI], past medical history, etc.) from information that required an office visit (e.g., physical exam, testing, etc.). Reviewing non-visit- required information, we identified the diagnosis and whether an office visit appeared necessary. Independently, we reviewed the visit-required information and determined if the visit changed management. Results: The 439 ARI patients had an average age of 45 years and symptoms for 8 days. Based on non-visit-required information, 72% (316/439) of visits did not appear to require an office visit. The most common diagnoses were non-specific upper respiratory infection (39%), sinusitis (24%), and bronchitis (22%). The HPI diagnosis was an exact match for clinicians’ diagnosis in 67% (213/316) of visits. After reviewing the visit-required information, management did not change for 87% (276/316) of visits. Conclusions: About 2/3 of primary care ARI visits are not necessary for appropriate management. Improved...

‣ Multiple vs. single visit root canal therapy

Liset, Beltran
Fonte: Universidade de Rochester Publicador: Universidade de Rochester
Tipo: Essay
Português
Relevância na Pesquisa
378.862%
In patients undergoing RCT who are experiencing flare ups will multiple visits, as compared to single visits, result in less flare ups?

‣ Office of the University President Sous fonds: Dr. James A. Gibson; Dr. James A. Gibson fonds

Williams, Edie
Fonte: Brock University Publicador: Brock University
Tipo: Outros
Português
Relevância na Pesquisa
388.06633%
Dr. James A. Gibson was born in Ottawa on January 29, 1912 to John W. and Belle Gibson. At an early age the family moved to Victoria, B.C. where John W. Gibson was a director of the Elementary Agricultural Education Branch, Department of Education. Gibson received his early education in Victoria, receiving a B.A. (honours) at UBC in 1931. In 1931 he was awarded the Rhodes scholarship and received his B.A., M.A., B.Litt and D. Phil at New College, Oxford. This was to be the beginning of a long and dedicated relationship with the Rhodes Scholar Association. Upon his return to Canada, Dr. Gibson lectured in Economics and Government at the University of British Columbia. In 1938 he was married to Caroline Stein in Philadelphia, and the same year joined the staff of the Department of External Affairs as a Foreign Service officer. Within twenty minutes of his arrival he was seconded to the Office of the Prime Minister and Secretary of State for External Affairs, W. L. Mackenzie King in charge of War Records and Liaison Officer. This was a critical time in the history of Canada, and Dr. Gibson experienced firsthand several milestones, including the Royal Visit of King George VI and Queen Elizabeth in 1939. Dr. Gibson was present at the formation of the United Nations in San Francisco in 1945...

‣ Practice activity trends among oral and maxillofacial surgeons in Australia

Brennan, D.; Spencer, A.; Singh, K.; Teusner, D.; Goss, A.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2004 Português
Relevância na Pesquisa
381.35848%
BACKGROUND: The aim of this study was to describe practice activity trends among oral and maxillofacial surgeons in Australia over time. METHODS: All registered oral and maxillofacial surgeons in Australia were surveyed in 1990 and 2000 using mailed self-complete questionnaires. RESULTS: Data were available from 79 surgeons from 1990 (response rate = 73.8%) and 116 surgeons from 2000 (response rate = 65.1%). The rate of provision of services per visit changed over time with increased rates observed overall (from 1.43 ± 0.05 services per visit in 1990 to 1.66 ± 0.06 services per visit in 2000), reflecting increases in pathology and reconstructive surgery. No change over time was observed in the provision of services per year (4,521 ± 286 services per year in 1990 and 4,503 ± 367 services per year in 2000). Time devoted to work showed no significant change over time (1,682 ± 75 hours per year in 1990 and 1,681 ± 94 hours per year in 2000), while the number of visits per week declined (70 ± 4 visits per week in 1990 to 58 ± 4 visits per week in 2000). CONCLUSIONS: The apparent stability in the volume of services provided per year reflected a counterbalancing of increased services provided per visit and a decrease in the number of visits supplied.; David S Brennan...

‣ Practice activity trends among Australian private general dental practitioners: 1983-84 to 1998-99

Brennan, D.; Spencer, A.
Fonte: F D I World Dental Press Ltd Publicador: F D I World Dental Press Ltd
Tipo: Artigo de Revista Científica
Publicado em //2002 Português
Relevância na Pesquisa
385.5916%
Aim: To investigate time trends in practice activity. Design: Four cross-sectional surveys across a 15 year period. Setting: Australian private general practice. Participants: A random sample of dentists. Methods: Dentists were surveyed by mailed questionnaire in 1983, 1988, 1993 and 1998 (response rates 71%-75%). Data were weighted to provide representative estimates for the age by sex distribution of private general practitioners in 1983, 1988, 1993 and 1998. Main Outcome Measures: Hours per year worked, patient visits per hour and patient visits per year. Results: The number of patient visits per year declined across the period, related to parallel decreases in the number of patient visits per hour (ANOVA; P<0.05), while there was no significant difference during the period in the number of hours per year devoted to work. The interaction of dentist sex by time of survey indicated that while numbers of patient visits per year had remained stable for female dentists, there was a trend for the higher number of patient visits per year among male dentists at the beginning of the survey period to decline over time. Conclusions: Male dentists had higher levels of practice activity compared with female dentists, but a decline in the number of patient visits per year reflected a convergence of male practice patterns towards that of female dentists.; http://lib.bioinfo.pl/pmid:12013251; Copyright © 2002 F D I World Dental Press

‣ Impact of the physician's participatory style in asthma outcomes and patient satisfaction

Adams, R.; Smith, B.; Ruffin, R.
Fonte: Amer Coll Allergy Asthma Immunology Publicador: Amer Coll Allergy Asthma Immunology
Tipo: Artigo de Revista Científica
Publicado em //2001 Português
Relevância na Pesquisa
391.5841%
OBJECTIVES: To identify factors associated with asthma patients' perceptions of the propensity of pulmonologists to involve them in treatment decision-making, and its association with asthma outcomes. DESIGN: Cross-sectional observational study performed from June 1995 to December 1997. SETTING: Pulmonary unit of a university teaching hospital. PATIENTS: Adult patients with asthma (n = 128). MEASUREMENTS AND RESULTS: By patient self-report, mean physician's participatory decision-making (PDM) style score was 72 (maximum 100, 95% CI 65, 79). PDM scores were significantly correlated (P < .0001) with the duration of clinic visits (r = .63), patient satisfaction (r = .53), duration of tenure of doctor-patient relationship (r = .37), and formal education (r = .22, P = .023). Significantly higher PDM style scores were reported when visits lasted longer than 20 minutes and when a patient had a >6-month relationship with a particular doctor. PDM scores were also significantly correlated with possession of a written asthma action plan (r = .54, P < .0001), days affected by asthma (r = .36, P = .0001), asthma symptoms (r = .23, P = .017), and preferences for autonomy in asthma management decisions (r = .28, P = .0035). Those with PDM scores <50 reported significantly lower quality of life for all domains of a disease-specific instrument and the Short-Form 36 health survey version 1.0. In multiple regression analysis...

‣ Influence of patient, visit, and oral health factors on dental service provision

Brennan, D.; Spencer, A.
Fonte: AAPHD National Office Publicador: AAPHD National Office
Tipo: Artigo de Revista Científica
Publicado em //2002 Português
Relevância na Pesquisa
479.41383%
Objectives: Service provision should reflect the oral health of the patient. However, patient and visit factors may influence service patterns and the appropriateness of care delivered. The aim of this study was to examine factors associated with variation in dental services and to assess whether variation by patient and visit characteristics persisted after controlling for oral health status. Methods: A random sample of Australian dentists was surveyed during 1997–98 (response rate=60.3%). Private general practitioners (n=345) provided data on service provision, as well as patient, visit and oral health variables from a log of a typical clinical day (n=4,115 patients). Multivariate Poisson regression models were run for eight service areas (e.g., diagnostic, preventive, and restorative). Results: Significant effects (P<.05) were observed for oral health factors in all eight models, visit factors in all eight models, patient demographics in four models, dental knowledge/behavior in one model, and area-based socioeconomic status in one model. Conclusions: After controlling for oral health, visit characteristics persisted as significant predictors of services, with nonemergency visits, insurance, and capital city location associated with more favorable service mix patterns. Higher socioeconomic status areas and payment scale ratings also were associated with a better service pattern in particular service areas. These findings show that a wide range of factors...

‣ Office visits to ophthalmologists and other physicians for eye care among the U.S. population, 1990.

Chiang, Y P; Wang, F; Javitt, J C
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //1995 Português
Relevância na Pesquisa
491.5841%
Despite growth in the use of ophthalmologic care in the last decade, little is known about the use of eye care services and patterns of physician contact across population subgroups. As the U.S. population grows older, such information is crucial in planning strategies for treatment and prevention of eye disorders as well as in identifying potential problems in access and use of eye care. Using the 1990 National Ambulatory Medical Care Survey data, a descriptive statistical analysis was employed to profile the possible variations in eye care-related office visits to ophthalmologists and other physicians across demographic groups. In 1990, a total of 49.3 million visits that were related primarily to an ocular disorder were made to physicians' offices; 43.8 million (89 percent) of these were visits to ophthalmologists and 5.4 million (11 percent) to other physicians. Use of ambulatory eye care varied across demographic subgroups. Those ages 65 or older had a substantially higher rate of eye care related outpatient visits per 1,000 persons per year compared with the rest of the population (743.6 per 1,000 versus 118.5 per 1,000, P < 0.001). Women had a higher rate than men (216.0 per 1,000 versus 177.0 per 1,000, 0.01; P < 0.05). Blacks had a substantially lower rate than whites (143.2 per 1...

‣ The changing nature of physicians' office visits.

Mitchell, J B; Schurman, R; Cromwell, J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1988 Português
Relevância na Pesquisa
490.2992%
Although there is a general feeling that, into the early 1980s, overall improvement was occurring in the content and quality of physicians' services, no time-series documentation to date has appeared to support this assumption. This article provides empirical evidence that physicians' office visits were in fact changing over time, though not in ways that one might expect. Rather than involving more diagnostic services, such as laboratory tests and x-rays, the typical office visit had come to include more therapeutic services, especially counseling. This is consistent with the observed increase in time spent with patients: between 1974 and 1981, the average office visit increased in length by nearly one full minute. Multivariate analysis indicates that the typical office visit was changing largely because physicians themselves were changing. Not only were physicians becoming increasingly specialized, but they were also more likely to be female, in group practice, and board-certified.

‣ Does patient educational level affect office visits to family physicians?

Fiscella, Kevin; Goodwin, Meredith A.; Stange, Kurt C.
Fonte: National Medical Association Publicador: National Medical Association
Tipo: Artigo de Revista Científica
Publicado em /03/2002 Português
Relevância na Pesquisa
485.4024%
Significant disparities in health care based on patient socioeconomic status have been documented. The extent to which physician behavior accounts for these differences is not known. We examined the impact of patient socioeconomic status, measured by years of education, on physician behavior assessed by direct observation of office visits, chart audits, and patient reports among 138 family physicians in 84 practices. Outcomes included time use measured with the Davis Observation Code, delivery of preventive services recommended by the US Preventive Services Task Force, satisfaction assessed with the MOS 9-item Visit Rating Scale, and delivery of attributes of primary care measured by the Components of Primary Care Index. After controlling for patient characteristics among 2538 visits by adult patients who returned questionnaires, a high school education or less was associated with slightly greater proportion of time spent on physical examination and providing nutrition counseling, and less time on patient questions, assessing patient health knowledge, negotiation, and exercise counseling. This indicates that physicians adopt a more directive style with less educated patients. Screening tests were provided at lower rates among less educated patients...