Journal of general internal medicine
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Comparative Study
Coronary artery bypass grafting in Native Americans: a higher risk of death compared to other ethnic groups?
While the efficacy and safety of coronary artery bypass grafting (CABG) has been established in several clinical trials, little is known about its outcomes in Native Americans. ⋯ The risk of in-hospital death following CABG may be higher in Native Americans than in other ethnic groups. Given the small number of Native Americans in the database (n = 155), however, further research will be needed to confirm these findings.
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To establish rates of and risk factors for cardiac complications after noncardiac surgery in veterans. ⋯ Five patient-specific risk factors are associated with high risk for cardiac complications in the perioperative period of noncardiac surgery in veterans. Inclusion of the operative procedure significantly improves the predictive ability of the risk model. Overall cardiac complication rates (pretest probabilities) are established for these patients. A simple nomogram is presented for calculation of post-test probabilities by incorporating the operative procedure.
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Comparative Study
Impact of interpreter services on delivery of health care to limited-English-proficient patients.
To determine whether professional interpreter services increase the delivery of health care to limited-English-proficient patients. ⋯ Professional interpreter services can increase delivery of health care to limited-English-speaking patients.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effectiveness of a focused educational intervention on resident evaluations from faculty a randomized controlled trial.
To improve the quality and specificity of written evaluations by faculty attendings of internal medicine residents during inpatient rotations. ⋯ A brief, focused educational intervention delivered to faculty prior to the start of a ward rotation appears to have a modest effect on faculty behavior for written evaluations and promoted higher quality feedback given to house staff.
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Comparative Study
Doctor discontent. A comparison of physician satisfaction in different delivery system settings, 1986 and 1997.
To examine the differences in physician satisfaction associated with open- versus closed-model practice settings and to evaluate changes in physician satisfaction between 1986 and 1997. Open-model practices refer to those in which physicians accept patients from multiple health plans and insurers (i.e., do not have an exclusive arrangement with any single health plan). Closed-model practices refer to those wherein physicians have an exclusive relationship with a single health plan (i.e., staff- or group-model HMO). ⋯ This study finds that the state of physician satisfaction in Massachusetts is extremely low, with the majority of physicians dissatisfied with the amount of time they have with individual patients, their leisure time, and their incentives for high quality. Satisfaction with most areas of practice declined significantly between 1986 and 1997. Open-model physicians were less satisfied than closed-model physicians in most aspects of practices.