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CONTEXT There is growing pressure to avoid hospitalizing emergency department patients who can be treated safely as outpatients, but this strategy depends on timely access to follow-up care. OBJECTIVE To determine the association between reported insurance status and access to follow-up appointments for serious conditions that are commonly identified(More)
OBJECTIVE The purpose of this study was to assess the impact of baseline A1c, cardiovascular disease, and depression on subsequent health care costs among adults with diabetes. RESEARCH DESIGN AND METHODS A prospective analysis was performed of data from a patient survey and medical record review merged with 3 years of medical claims. Costs were estimated(More)
INTRODUCTION Physical inactivity, overweight, and obesity are associated with increased morbidity and mortality. The objective of this study was to estimate the proportion of total health care charges associated with physical inactivity, overweight, and obesity among U.S. populations aged 40 years and older. METHODS A predictive model of health care(More)
participants in numerous seminars for comments and suggestions. ABSTRACT Although the validity of knowledge is critical to scientific progress, substantial concerns exist regarding the governance of knowledge production. While as or more important to the knowledge economy as defects are in the manufacturing economy, mechanisms to identify and signal "(More)
OBJECTIVE To assess the impact of a quality improvement (QI) intervention on the quality of diabetes care at primary care clinics. RESEARCH DESIGN AND METHODS Twelve primary care medical practices were matched by size and location and randomized to intervention or control conditions. Intervention clinic staff were trained in a seven-step QI change process(More)
INTRODUCTION We studied variance in glycated hemoglobin (HbA1c) values among adults with diabetes to identify variation in quality of diabetes care at the levels of patient, physician, and clinic, and to identify which levels contribute the most to variation and which variables at each level are related to quality of diabetes care. METHODS Study subjects(More)
OBJECTIVE To assess whether providing customized clinical information to patients and physicians improves safety or quality of diabetes care. RESEARCH DESIGN AND METHODS Study subjects included 123 primary care physicians and 3,703 eligible adult diabetic patients with elevated A1C or LDL cholesterol, who were randomly assigned to receive customized(More)
OBJECTIVE To investigate the relationship between binge eating behavior and weight loss maintenance over a two-year period in adults. DESIGN Secondary data analysis using the Keep It Off study, a randomized trial evaluating an intervention to promote weight loss maintenance. PARTICIPANTS 419 men and women (ages: 20 to 70 y; BMI: 20-44 kg/m2) who had(More)
Long-term weight-loss maintenance is notoriously difficult to achieve and promote. As the novelty of weight loss treatment fades, enthusiasm for diet and exercise tends to wane in the maintenance phase. Given the recognition of obesity as a chronic disorder requiring continued engagement in weight-control behaviors, there is a need to identify(More)
Development and targeting efforts by academic organizations to effectively promote research integrity can be enhanced if they are able to collect reliable data to benchmark baseline conditions, to assess areas needing improvement, and to subsequently assess the impact of specific initiatives. To date, no standardized and validated tool has existed to serve(More)