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  • 1
    Electronic Resource
    Electronic Resource
    Palo Alto, Calif. : Annual Reviews
    Annual Review of Public Health 22 (2001), S. 49-61 
    ISSN: 0163-7525
    Source: Annual Reviews Electronic Back Volume Collection 1932-2001ff
    Topics: Medicine
    Notes: Abstract The lack of an outpatient prescription drug benefit under Medicare has become a conspicuous omission in the face of accelerated growth in prescription drug expenditures and increased availability of highly effective medications. This article provides a critical review of the empirical evidence on the effect of drug coverage on the use of prescription drugs, health care outcomes, and health care costs among Medicare beneficiaries. The existing literature provides considerable evidence that drug coverage is associated with greater use of all drugs and clinically essential medications and that not all forms of coverage provide the same protection. Longitudinal evidence from elderly and disabled persons in Medicaid indicates that restricting coverage has serious adverse health outcomes for sick and low-income beneficiaries that actually lead to increased health care costs.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of medical systems 6 (1982), S. 377-386 
    ISSN: 1573-689X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In an experimental controlled trial, prescribing records were obtained from the Medicaid Management Information Systems (MMIS) of four states for all physicians participating in the Medicaid programs of those states. Three categories of drugs that are commonly misprescribed were identified, and moderate to high prescribers of these drugs were identified from the MMIS data set. These physicians were then randomly divided into three groups. One group received no intervention, the second group received an innovative series of print materials urging appropriate drug use, and a third group received the print materials and was visited by consultant pharmacists to discuss the drugs in question. Our experience suggests that use of Medicaid prescribing data can be an efficient and accurate way of conducting large-scale surveillance of misprescribing, and of targeting interventions that can improve such suboptimal drug utilization. Use of the same data set in a follow-up period can monitor the effectiveness of each mode of intervention and will measure the degree of behavior change for each physician.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-7217
    Keywords: breast cancer ; breast conserving surgery ; hospital practices ; mastectomy ; physician behavior
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied whether a hospital intervention utilizing medical opinion leaders and performance feedback reduced the proportion of women who reported that surgeons did not discuss options prior to surgery for early stage breast cancer. Opinion leaders provided clinical education to their peers using a variety of strategies and were selected for their ability to influence their peers. Performance feedback involved distributing performance reports that contained data on the outcomes of interest as well as on other treatment patterns. Twenty-eight hospitals in Minnesota were randomized to the intervention or to a control group that received performance feedback only. The proportion of patients at intervention hospitals who said that their surgeon did not discuss options decreased significantly (p〈0.001) from 33% to 17%, but a similar decrease was observed among control hospitals. Using medical opinion leaders to intervene in hospitals appeared as effective as performance feedback.
    Type of Medium: Electronic Resource
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