Learn More
BACKGROUND Use of the emergency department for nonemergency care is frequent and costly. We studied the effect of a copayment on emergency department use in a group-model health maintenance organization (HMO). METHODS We examined the use of the emergency department in 1992 and 1993 by 30,276 subjects who ranged in age from 1 to 63 years at the start of(More)
OBJECTIVE Some preclinical in vivo studies and limited human data suggest a possible increased risk of bladder cancer with pioglitazone therapy. This is an interim report of an ongoing cohort study examining the association between pioglitazone therapy and the risk of bladder cancer in patients with diabetes. RESEARCH DESIGN AND METHODS This study(More)
A synthesis of findings from the TRIAD Study THE TRIAD STUDY GROUP* H ealth care systems have played a central role in the public health response to the growing problem of diabetes (1–2) and its complications. During the 1990s, managed care organizations (MCOs) began seeking system-level approaches to improve diabetes outcomes and control costs in covered(More)
Although commonly thought to be an effective method of screening for prostatic cancer, digital rectal examinations have yet to be shown by controlled study to help prevent advanced forms of this disease. 139 men with metastatic (stage D) prostatic cancer (cases) were compared with an equal number of matched men free of this condition (controls), with(More)
PURPOSE We sought to evaluate the effectiveness of self-monitoring blood glucose levels to improve glycemic control. SUBJECTS AND METHODS A cohort design was used to assess the relation between self-monitoring frequency (1996 average daily glucometer strip utilization) and the first glycosylated hemoglobin (HbA1c) level measured in 1997. The study sample(More)
OBJECTIVE To evaluate the patterns of e-Health use over a four-year period and the characteristics of users. DESIGN Longitudinal, population-based study (1999-2002) of members of a prepaid integrated delivery system. Available e-Health services included ordering prescription drug refills, scheduling appointments, and asking medical questions. (More)
BACKGROUND Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. METHODS A descriptive study was conducted among persons at least 13 years of(More)
Maximal grip strength was measured in kilograms using a hand dynamometer on 344 unrelated males between the ages of 59 and 70 participating in the third examination of the NHLBI Twin Study. There was a significant linear decline in mean grip strength over this age range. Mean grip strength and grip strength per kilogram weight are presented for age 59, ages(More)
OBJECTIVE To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN Longitudinal analysis. SETTING 35 medical facilities of Kaiser Permanente Northern California, 1997-2007. PARTICIPANTS 2 523 659 adult members of Kaiser(More)
OBJECTIVE To examine the association between breastfeeding intensity in relation to maternal blood glucose and insulin and glucose intolerance based on the postpartum 2-h 75-g oral glucose tolerance test (OGTT) results at 6-9 weeks after a pregnancy with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS We selected 522 participants enrolled(More)