Journal of general internal medicine
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To describe the prevalence of hepatitis C virus (HCV) infection in a sample of homeless and impoverished adults and examine risk factors for HCV infection in the overall sample and as a function of injection drug use. ⋯ Targeted outreach for homeless women and their partners, including HCV testing coupled with referrals to HCV and substance abuse treatments, may be helpful.
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Comparative Study
Use of cholesterol-lowering therapy and related beliefs among middle-aged adults after myocardial infarction.
To assess use of cholesterol-lowering therapy and related beliefs among middle-aged adults after myocardial infarction. ⋯ Although most patients recognized the importance of lowering cholesterol after myocardial infarction, several clinical and demographic subgroups were less likely to receive cholesterol-lowering therapy, and many patients were unaware of their cholesterol level. Health-care providers and managed-care plans can use these findings to promote cholesterol testing and treatment for patients with coronary heart disease who are most likely to benefit from these efforts.
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Comparative Study
Adherence of low-income women to cancer screening recommendations.
African-American and low-income women have lower rates of cancer screening and higher rates of late-stage disease than do their counterparts. ⋯ Organizing healthcare services to promote continuity with a specific primary care clinician, a comprehensive array of services available at the primary care delivery site, coordination among providers, and better patient-practitioner relationships are likely to improve inner-city, low-income women's adherence to cancer screening recommendations.
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To assess whether primary care performance of low-income women's primary care delivery sites is associated with the strength of their relationships with their physicians. ⋯ Primary care delivery sites organized to be more accessible, to link patients with the same clinician for their visits, to provide for all of a woman's health care needs, and to coordinate specialty care services are associated with stronger relationships between low-income women and their physicians. Primary care systems that fail to emphasize these features of primary care may jeopardize the clinician-patient relationship and indirectly the quality of care and health outcomes.