Annals of family medicine
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Annals of family medicine · Mar 2006
Postpartum health of employed mothers 5 weeks after childbirth.
Most new mothers return to work soon after childbirth. A need exists to reexamine the definition of postpartum health and evaluate employed women's recovery from childbirth in association with such factors as delivery type and breastfeeding. ⋯ These mothers experienced several childbirth-related symptoms at 5 weeks postpartum, indicating a need for ongoing rest and recovery. Health concerns were greater for women who were breastfeeding and for those whose babies were delivered by cesarean section, suggesting a need for greater support for these women and a reassessment by the medical community of the progressively growing practice of cesarean deliveries.
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Annals of family medicine · Mar 2006
Transforming medical care: case study of an exemplary, small medical group.
Most published descriptions of organizations providing or improving quality of care concern large medical groups or systems; however, 90% of the medical care in the United States is provided by groups of no more than 20 physicians. We studied one such group to determine the organizational and cultural attributes that seem related to its achievements in care quality. ⋯ The identified 12 attributes of this medical group seem to be associated with its superior care quality, and most of them might be replicable by other small groups if they choose to work toward that end.
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Annals of family medicine · Mar 2006
Effect of primary health care orientation on chronic care management.
It has been suggested that the best way to improve chronic illness care is through a redesign of primary care emphasizing comprehensive, coordinated care as espoused by the Chronic Care Model (CCM). This study examined the relationship between primary care orientation and the implementation of the CCM in physician organizations. ⋯ Organizations that have adopted 6 core attributes of primary care, representing comprehensive health service delivery and a commitment to overall patient health, appear to use more chronic care management practices. Policy makers and other stakeholders may wish to focus on creating an improved primary care home in their quest to close the "quality chasm" in chronic illness care.
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Annals of family medicine · Jan 2006
Management of type 2 diabetes in the primary care setting: a practice-based research network study.
We wanted to describe how primary care clinicians care for patients with type 2 diabetes. ⋯ Only modest numbers of patients achieve established targets of diabetes control. Reengineering primary care practice may be necessary to substantially improve care.
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Annals of family medicine · Jan 2006
Comparative StudyEffect of improved primary care access on quality of depression care.
We wanted to determine whether a major improvement in access to primary care during 2000 was associated with changes in the quality of care for patients with depression. ⋯ Marked improvement in access to primary care for 1 year was associated with some improvement in primary care for patients with depression, but the mechanism appeared to be improved continuity. Those planning to implement advanced access to care need to do so in such a way that continuity of care is enhanced rather than harmed by the change.