Biomedical subjects

Judith Hibbard

Publications and source records attributed to Judith Hibbard.

4 recordsLinked to original sources

PubMed2006

Neuropsychological performance in normal pregnancy and preeclampsia.

OBJECTIVE: The objective of the study was to evaluate neurocognitive function in preeclampsia and normal pregnancy. STUDY DESIGN: Three groups (each n = 15) were studied before and after delivery using standard neurocognitive test techniques. Group A consisted of normal laboring patients; group B, preeclamptics receiving magnesium; and group C, women in preterm labor receiving MgSO4 tocolysis (Mg control). The tests, examining attention, working memory, explicit memory, auditory comprehension, and measures for emotional distress, pain, and fatigue were analyzed via 4-way multivariate analysis of variance and multiple t tests. RESULTS: Preeclamptics receiving MgSO4 had better attention and working memory (P = .05), compared with normal laboring women and the preterm patients. Explicit memory was impaired in all groups, and this could not be accounted for by pain or emotional distress. CONCLUSION: We could detect no cognitive defects in preeclamptics, compared with normotensive gravidas, at least while the cerebral vasodilator MgSO4 is being infused.

Adolescent↗

PubMed2004

Why not give consumers a framework for understanding quality?

BACKGROUND: Consumers care about the quality of medical care but do not pay attention to currently available quality information or use it to make more informed health care choices. According to the theory of constructed preferences, when people are in a situation that is both complex and unfamiliar, they likely do not have fixed ideas about what is important to them. This theory seems to describe the situation of consumers and comparative quality information. The alternative would be to help consumers understand the overall concept of quality and the different elements that make up quality of care. The Institute of Medicine (IOM) report Crossing the Quality Chasm provides a framework for understanding, measuring, and evaluating the quality of medical care. IMPACT OF PROVIDING A FRAMEWORK FOR UNDERSTANDING QUALITY: Focus groups were conducted in 2001 to determine what performance information they would like to see to help them select a physician. The findings indicated that consumers' understanding of health care quality information was expanded to include a broader array of factors when a cogent framework was used to present quality information. USING THE IOM FRAMEWORK FOR ALL PUBLIC REPORTING ON QUALITY: The IOM framework or a modified version should be used for all public reporting on health care quality. The consistent use of some or all of the six IOM categories of performance reporting will reinforce the message that this is what constitutes high-quality care and it is what the public should expect to know when they make health care choices.

Consumer Advocacy↗

PubMed2002

Similarities and differences in choosing health plans.

BACKGROUND: Increasingly, consumers have multiple health insurance options. New information is being developed to help consumers with these choices. OBJECTIVES: To study similarities and differences in how the publicly and privately insured choose health plans. To explore the effect of traditional enrollment materials and reports developed by the Consumer Assessment of Health Plans Study (CAHPS) on consumers' perceptions and decision-making. RESEARCH DESIGN: Using data from eight CAHPS demonstrations, we tested for significant differences across consumers with employer-sponsored insurance, Medicaid, and Medicare. SUBJECTS: Approximately 10,000 consumers with employer-sponsored, Medicaid, and Medicare health plans. MEASURES: Perceptions of the health plan selection process, use of information sources, and reactions to and use of traditional enrollment materials and CAHPS reports. RESULTS: Most consumers with all types of insurance thought that choosing a health plan was important and obtained information from multiple sources. Choosing a plan was more difficult for Medicare and Medicaid recipients than for the privately insured. When choosing a plan, Medicaid recipients cared most about convenience and access, whereas the privately insured emphasized providers and costs. The percentage of consumers who looked at and remembered the CAHPS report varied widely from 24% to 77%. In all but one of the demonstration sites, most consumers spent less than 30 minutes looking at the CAHPS report. CONCLUSIONS: Group sponsors and the developers of information interventions such as CAHPS may need to invest in developing and testing different reporting approaches for Medicare, Medicaid, and privately insured consumers.

Consumer Advocacy↗

PubMedDate not supplied

Is patient activation associated with outcomes of care for adults with chronic conditions?

We examined the patient activation measure's (PAM's) association with process and health outcomes among adults with chronic conditions. Patients with high PAM scores were significantly more likely to perform self-management behaviors, use self-management services, and report high medication adherence, compared to patients with the lowest PAM scores. This population was 10 times more likely to report high patient-satisfaction scores, 5 times more likely to report high quality-of-life scores, and reported significantly higher physical and mental functional status scores, compared to those with the lowest scores. These results suggest that PAM scores are associated with key process and health outcome measures.

Aged↗