ACP American College of Physicians - Internal Medicine - Doctors for Adults

May/June 2000

ORIGINAL ARTICLES

Failure of a Continuous Quality Improvement Intervention To Increase the Delivery of Preventive Services
A Randomized Trial

Leif I. Solberg, Thomas E. Kottke, Milo L. Brekke, Sanne Magnan, Gestur Davidson, Carolyn A. Calomeni, Shirley A. Conn, Gail M. Amundson, and Andrew F. Nelson

Despite the enthusiasm for continuous quality improvement (CQI) spurred by its reported success in other industries, in this study CQI methods did not result in important increases in preventive service delivery rates. This disappointing outcome may have resulted from use of atypical clinics in the study, inadequate evaluation or implementation of the intervention, or inadequacy of CQI.
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Breast-Feeding Education and Support: Association with the Decision To Breast-Feed
Anjali D. Deshpande and Julie A. Gazmararian

Breast-feeding education, access to a lactation consultant, and other postpartum support may improve a woman's chances of starting and continuing to breast-feed her newborn. With an increasing number of women enrolled in managed care organizations, there may be potential for increasing breast-feeding rates.
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Telephone Care as an Adjunct to Routine Medical Follow-up
A Negative Randomized Trial
H. Gilbert Welch, Deborah J. Johnson, and Robert Edson

A previous randomized trial showed that making telephone appointments part of routine care can save money and reduce hospitalizations. However, in this study, telephone care showed minimal benefit and merely became an additional service.
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PATTERNS OF PRACTICE

The Burdens of Uninsured Hospitalizations in an Urban County
Patrick L. F. Zuber, Timothy A Dignam, M. Blake Caldwell, and Paul J. Weisner

In DeKalb County, Georgia, a disproportionate share of uninsured hospitalizations falls on the public sector. Policy initiatives are needed for more even distribution of these hospitalizations between public and for-profit hospitals.
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EDITORIALS

Linking Experimental Research Methods and Health Services Research: Everything is Possible
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Should All Mothers Breast-Feed?
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Endnote
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Primer on Probability and Odds and Interpreting Their Ratios
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POLICY MATTERS

Does Risk Adjustment for Medicare Patients Reward Caring for Sick Patients or Liberal Admission Practices?
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INVITED COMMENTARY

Improving Prevention Is Difficult
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LETTER TO THE EDITOR

Do Report Cards Make the Grade?
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