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Hepatitis B is a disease of public health importance in Singapore. A study was conducted in 1999 to estimate the overall and gender-, age- and ethnic-specific prevalence of hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and antibody to hepatitis B surface antigen in the Singapore population. A cross-sectional sample of the Singapore(More)
INTRODUCTION AND OBJECTIVE This paper provides an overview of the DUQuE (Deepening our Understanding of Quality Improvement in Europe) project, the first study across multiple countries of the European Union (EU) to assess relationships between quality management and patient outcomes at EU level. The paper describes the conceptual framework and methods(More)
BACKGROUND To characterize the association of antiretroviral drug combinations on risk of cardiovascular events. METHODS Certain antiretroviral medications for human immunodeficiency virus (HIV) have been implicated in increasing risk of cardiovascular disease. However, antiretroviral drugs are typically prescribed in combination. We characterized the(More)
BACKGROUND The effect of antiretroviral therapy (ART) interruption or intensification on health-related quality of life (HRQoL) in advanced HIV patients is unknown. OBJECTIVE To assess the impact of temporary treatment interruption and intensification of ART on HRQoL. DESIGN A 2 x 2 factorial open label randomized controlled trial. SETTING Hospitals(More)
BACKGROUND New patient-centered models of ambulatory care aim to substitute better primary care for preventable acute care within existing primary care practices. This study aims to identify whether mental illness and other characteristics of primary care patients are related to risk for an acute event for an ambulatory care-sensitive condition (ACSC). (More)
OBJECTIVE The aim of this study was to develop and validate an index to assess the implementation of quality management systems (QMSs) in European countries. DESIGN Questionnaire development was facilitated through expert opinion, literature review and earlier empirical research. A cross-sectional online survey utilizing the questionnaire was undertaken(More)
BACKGROUND The effect of adherence, treatment failure, and comorbidities on the cost of HIV care is not well understood. OBJECTIVE To characterize the cost of HIV care including combination antiretroviral treatment (ART). RESEARCH DESIGN Observational study of administrative data. SUBJECTS Total 1896 randomly selected HIV-infected patients and 288(More)
BACKGROUND Evidence-based quality improvement (EBQI) methods may facilitate practice redesign for more effective implementation of the patient-centered medical home (PCMH). OBJECTIVE We assessed changes in health care utilization and costs for patients receiving care from practices using an EBQI approach to implement PCMH and comparison practices over a(More)
OBJECTIVE This study estimated the loss in outpatient copayment revenue for the U.S. Department of Veterans Affairs (VA) health care system from a mandate for free care related to military sexual trauma. s METHODS A retrospective database analysis located all VA enrollees who screened positive for military sexual trauma and received related care in fiscal(More)
OBJECTIVE To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. DESIGN A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management systems, illustrated by four clinical pathways. SETTING(More)