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Biomedical subjects

N D Kohatsu

Publications and source records attributed to N D Kohatsu.

9 recordsLinked to original sources
PubMed2000

Case management: a controlled evaluation of persons with diabetes.

Case management has been widely used with the intent of improving clinical outcomes while reducing medical costs. Studies of case management, however, have shown variable effectiveness. This study assessed the impact of a state health department case management program on hospitalizations, emergency department (ED) visits, and preventive services among persons with diabetes receiving Medicaid fee-for-service health care. The patients enrolled in the non-disease-specific case management program were low-income, chronically ill and medically complex. Nurse case managers authorized and coordinated services in the home for these patients and established links to health-care professionals and community resources. A retrospective, non-randomized, controlled time series design using paid claims files was employed. Case management reduced admissions and hospital days but did not significantly impact ED visits or use of preventive services.

California↗
PubMed2000

Put prevention into practice: a controlled evaluation.

OBJECTIVES: The purpose of this study was to evaluate whether Put Prevention Into Practice (PPIP) materials affected the delivery of 8 clinical preventive services. METHODS: Program materials were provided to a family medicine practice serving a diverse, low-income population. Appropriate use of clinical preventive services was assessed via medical record reviews at baseline, 6 months, 18 months, and 30 months at both intervention and control sites. RESULTS: The delivery rates of 7 clinical preventive services were higher in the intervention site at 6 months. These rates had flattened or decreased by 30 months. CONCLUSIONS: Use of PPIP materials modestly improved delivery of certain clinical preventive services. Sustained improvement will require substantial system changes and ongoing support.

Adult↗
PubMed1994

Correlates of Mini-Mental Status Examination scores among elderly demented patients: the influence of race-ethnicity.

Data on 1888 patients seen at Alzheimer's Disease Diagnostic and Treatment Centers in California were used to examine possible differences in Mini-Mental State Examination (MMSE) results for different racial-ethnic groups. White patients had scores less indicative of dementia than Black and Hispanic patients using the standard 23 cutting point on the MMSE. However, there were no differences among these groups in the percentages clinically diagnosed as demented. The difference in the percentage of Whites vs Blacks and Hispanics categorized as demented by the MMSE was not accounted for by education, occupation, age, sex, or other variables tested, even though these variables were correlated with MMSE scores. Our data suggest that clinicians should consider MMSE scores for Black and Hispanic patients an underestimate of their cognitive capabilities relative to that of White patients.

Black or African American↗
PubMed1990

Risk factors for the development of osteoarthrosis of the knee.

The roles of physical activity (both work and leisure time), obesity, and history of significant knee injury on the development of severe osteoarthrosis (OA) of the knee were evaluated. A case-control design compared 46 cases with a history of severe OA of the knee with 46 community controls matched for age and gender. Data were gathered with a self-administered questionnaire. The OA cases were 3.5 times more likely than controls to have been obese at 20 years of age, two to three times more likely than controls to have performed heavy work, and almost five times more likely than controls to have had a significant knee injury. In contrast, leisure-time physical activity was not significantly different in cases compared with controls. Obesity, significant knee injury, and long-term heavy physical activity are important risk factors for the development of OA of the knee.

Female↗
PubMedDate not supplied

Use of a clinician reminder system for screening mammography in a public health clinic.

Physician reminder systems have been used to increase the appropriate use of clinical preventive services. These systems, though, have been typically tested in resident clinics. We conducted this study, using a time-series design, to determine if a manual clinician reminder system could increase the use of screening mammography in an urban public health clinic. In the one-year baseline period, 47% of women who were due for a mammogram received the procedure; the corresponding percentage in the one-year intervention period was 72% (P < .0000001). The improvement reflected a large increase in appropriate ordering behavior by primary care providers rather than an increase in patient adherence. This study demonstrates that a noncomputerized reminder system can greatly improve the delivery of screening mammography in a public health clinic setting.

Adult↗