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Effect Of A Physician Uncertainty Reduction Intervention On Blood Pressure In Uncontrolled Hypertensives-A Cluster Randomized Trial, David J. Hyman, Valory N. Pavik, Anthony J. Greisinger, Wenyaw Chan, Jose Bayona, Carol Mansyur, Victor Simjms, James Pool

Community & Environmental Health Faculty Publications

BACKGROUND: Clinical inertia, provider failure to appropriately intensify treatment, is a major contributor to uncontrolled blood pressure (BP). Some clinical inertia may result from physician uncertainty over the patient’s usual BP, adherence, or value of continuing efforts to control BP through lifestyle changes.

OBJECTIVE: To test the hypothesis that providing physicians with uncertainty reduction tools, including 24-h ambulatory BP monitoring, electronic bottle cap monitoring, and lifestyle assessment and counseling, will lead to improved BP control.

DESIGN: Cluster randomized trial with five intervention clinics (IC) and five usual care clinics (UCC).

SETTING: Six public and 4 private primary care clinics.

PARTICIPANTS: …

Physician Review Of Workers' Compensation Case Files: Can It Affect Decision Outcomes?, Mark E. Hammett, Christopher Jankosky, John Muller, Elizabeth Hughes, Francesca Litow

Community & Environmental Health Faculty Publications

Objective: To identify common attributes of Federal workers compensation cases referred to Navy physicians for medical opinions and to determine the impact of the review on the final case decision. Methods: Retrospective case study and descriptive analysis of 258 opinion letters written by physicians on referred cases from 2006 to 2010. Results: Navy physician opinions were considered in the outcome in some of the cases, and there was a statistically significant difference between the claim acceptance rate in the study population and the total population. Worker age was correlated with certain claim types. Conclusions: There is preliminary evidence that the …

Socioeconomic Disparity In Healthcare-Seeking Behavior Among Chinese Women With Genitourinary Symptoms, Qi Zhang, Diane Lauderdale, Shanshan Mou, William I. Parish, Edward O. Laumann, John Schneider

Community & Environmental Health Faculty Publications

Background: Sexually transmitted infections (STIs) are of growing concern in China. Understanding the relationship between socioeconomic status (SES) and healthcare-seeking (HCS) behavior will help design effective policies to contain the epidemic of STIs across SES.

Methods: We used the Chinese Health and Family Life Survey, a nationally representative survey of 3813 adults from 48 Chinese cities and counties during 1999-2000. We studied the 730 women with at least one genito-urinary (GU) symptom. HCS was measured by whether respondents visited a hospital or an unrecognized clinic, self-treatment, or doing nothing. Formal treatment was defined as visiting a hospital. SES was measured …

The Increasing Number Of Clinical Items Addressed During The Time Of Adult Primary Care Visits, Elmer D. Abbo, Qi Zhang, Martin Zelder, Elbert S. Huang

Community & Environmental Health Faculty Publications

BACKGROUND: Primary care physicians report that there is insufficient time to meet patients' needs during clinical visits, but visit time has increased over the past decade.

OBJECTIVE: To determine whether the number of clinical items addressed during the primary care visit has increased, and if so, whether this has been associated with changes in visit length and the pace of clinical work.

DESIGN: Analysis of non-hospital-based adult primary care visits from 1997 to 2005, as reported in the National Ambulatory Medical Care Survey.

PARTICIPANTS: A total of 46,431 adult primary care visits.

MEASUREMENTS: We assessed changes over time for …