Journal of general internal medicine
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Managed care organizations should be expected to provide equivalent access to preventive and screening services to all members. We studied mammography in 1,667 women members of one HMO who had an overall utilization rate of 84.9%. ⋯ Each $10,000 increment of income increased mammography rates by 2.5 percentage points (95% confidence interval [CI], 1.4% to 3.6%), independent of age and division. Our findings suggest that coverage for mammography services is not sufficient to ensure equivalent use of screening across income groups.
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Because of growing concern that constituents of drinking water may have adverse health effects, consumption of tap water in North America has decreased and consumption of bottled water has increased. Our objectives were to 1) determine whether North American tap water contains clinically important levels of calcium (Ca2+), magnesium (Mg2+), and sodium (Na+) and 2) determine whether differences in mineral content of tap water and commercially available bottled waters are clinically important. ⋯ Drinking water sources available to North Americans may contain high levels of Ca2+, Mg2+, and Na+ and may provide clinically important portions of the recommended dietary intake of these minerals. Physicians should encourage patients to check the mineral content of their drinking water, whether tap or bottled, and choose water most appropriate for their needs.
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We surveyed 241 board-certified internists affiliated with a large teaching hospital (Boston, Mass) before implementing a hospitalist service to determine attitudes towards providing inpatient care and the hospitalist model. Of physicians surveyed, 66% responded. ⋯ Multivariable analyses suggest that physicians physically furthest from their inpatient site were had more favorable attitudes toward the hospitalist model; more experienced and busier physicians were more negative. Future investigations should determine strategies for implementing the hospitalist model which address physicians' concerns.