PubMed Health⌕ Search

Biomedical subjects

Roger T Anderson

Publications and source records attributed to Roger T Anderson.

24 records · Page 2Linked to original sources
PubMedDate not supplied

Evaluation of the quality of care in the clinical care centers of the National Centers of Excellence in Women's Health.

This study evaluated the quality of primary care services provided in 15 National Centers of Excellence in Women's Health (CoE) clinical sites in operation in 2001 using self-reported clinical preventive services and patient satisfaction as indicators of quality of care. A sample of 3,111 women served by the CoE program was surveyed and compared with quality of care benchmarks from national and local community surveys. The benchmark surveys were: a nationally representative sample of 2,075 women from the 1998 Commonwealth Fund Survey of Women's Health; a community sample of women who lived within a geographical catchment area for three CoEs; and a sample of 71,438 women in the 1999 Consumer Assessment of Health Plans Study (CAHPS) of commercial managed care plans. Adjusting for region, age, education, perceived health status, and managed care enrollment, women in the CoEs were more satisfied with their care and had received significantly more screening tests and counseling services than women in the benchmark samples. The largest effects among primary care services were for physical breast examination, mammogram (ages 50+), and counseling for smoking, domestic violence, and sexually transmitted diseases.

Benchmarking↗
PubMedDate not supplied

Patient-centered outcomes of diabetes self-care. Associations with satisfaction and general health in a community clinic setting.

BACKGROUND: Despite the recognition of strategies for diabetes care management, information systems that screen patient diabetes self-care problems are not commonplace, especially among low-income patients. This study examined correlates of three patient-centered outcomes of diabetes self-care (awareness of self-care components, difficulties in diabetes self-care, and adherence to self-care) among low-income diabetic patients. METHODS: Clinical and patient survey data were obtained on 249 participants from 11 primary care community health clinics serving low-income populations in North Carolina in Project IDEAL (Improving Diabetes Education, Access to Care and Living). Measures of patient-centered outcomes of self-care were obtained from the Diabetes Quality Improvement Project (DQIP) Patient-Reported Measures set. RESULTS: A substantial proportion of patients reported difficulty achieving standard self-care treatment goals. The study identified distinct patient characteristics associated with poor self-care outcomes. Increased understanding of self-care components and adherence to them were associated with increased perception of quality of care and, in turn, better general health perceptions in these patients (p < 0.01). CONCLUSIONS: This study identified an unmet need for diabetes self-care knowledge and skills associated with patient outcomes in low-income patients. Routine monitoring of patient-centered self-care outcomes could help improve long-term outcomes of diabetes care in this population.

Community Health Services↗
PubMedDate not supplied

Demand for continuing medical education programs on cancer care among primary care physicians in North Carolina.

BACKGROUND: Primary care physicians have a central role in cancer prevention and control services, yet relatively little attention has been given to their needs for continuing medical education (CME) that clarify or update screening guidelines, enhance recognition of signs or symptoms of cancer, and address ongoing health issues in patients treated for cancer (e.g., pain control lymphedema, tertiary prevention). METHODS: A random sample of 600 primary care physicians practicing in urban and rural locations in North Carolina was selected to assess past cancer-related CME sessions, and demand for current cancer education topics. RESULTS: Of 539 eligible, 231 surveys were returned (43%). Approximately 37% of respondents had attended no cancer-related CME in the last two years. Highest interest for cancer CME topics was found for screening for breast and skin cancers, general update diagnostic skills, pain management and patient/family support, side effects from treatment, lymphedema management and lymphedema diagnosis, genetic susceptibility diet and smoking cessation. Interest levels by CME topic did not vary by urban/rural practice settings. CONCLUSION: There is low access but high demand for cancer-related CME topics among primary care physicians. Strategies are needed to fill this need and to assess impact.

Attitude of Health Personnel↗
PubMedDate not supplied

Medication and health care service utilization related to depressive symptoms in older adults with psoriasis.

OBJECTIVE: This study examined the relationship between depressive symptoms and related medication adherence and health care costs in older adults (age > or = 65 years) with psoriasis. DESIGN: Prospective longitudinal cohort study over a 2-year post enrollment period in a population of older adults with psoriasis enrolled in managed care. SETTING: A Medicare Health Maintenance Organization (HMO) in southeastern United States with prescription benefits. PARTICIPANTS: Sixty-three older adults with psoriasis using topical corticosteroids therapy and enrolled in a Medicare HMO for a 2-year continuous period. MEASUREMENT: Upon enrollment, each enrollee was mailed a comprehensive health status assessment battery, which included the Center for Epidemiologic Studies Depression (CES-D) scale. Information on medication adherence (using medication possession ratio) and total health care utilization/costs following enrollment were retrieved from the Medicare HMO database. RESULTS: Nearly one-fifth of the patient population had depressive symptoms. Patients with psoriasis who had depressive symptoms at the time of enrollment were less likely to be adherent to topical corticosteroid medication (r= -0.29, p<0.01) and less likely to utilize health care resources as evidenced by lower health care costs (r= -0.27, p<0.05), after confounder adjustment. CONCLUSIONS: The prevalence of depressive symptoms in older adults with psoriasis is commonplace, with strong, yet unexplained correlations between presence of depressive symptoms and lower rates of medication and health care service use among these patients.

Aged↗
PubMedDate not supplied

Improving diabetes care among low-income North Carolinians: Project IDEAL.

OBJECTIVES: Many barriers exist in implementing evidence-based guidelines for diabetes care, particularlyfor low-income patients. To address this, the North Carolina Project IDEAL (Improving Diabetes Education, Access to Care, and Living) Diabetes Initiative was created STUDY DESIGN/SETTING: Fourteen programs representing different types of agencies and intervention strategies across the state participated in the initiative. DATA COLLECTION: Separate random samples of medical charts of participating patients were reviewed at baseline (n=429) and three-year follow-up (n=656) to assess changes in six process (assessment of hemoglobin A1c, cholesterol blood pressure, and urinary protein; conduction of foot and retina examination) and three outcome (glycemia, blood pressure, and lipid control) measures. Four national guidelines (DQIP, HEDIS, NCEP and ADA) were used as benchmarks. RESULTS: Large increases were observed for some measures (hemoglobin A1c control and testing, LDL-cholesterol testing), while modest increases were observed for others (dilated eye exam, blood pressure testing, and control). CONCLUSIONS/RELEVANCE: Project IDEAL was successful in improving access to high-quality diabetes care for low-income patients. Additional effort is needed to address specific areas of concern, particularly retinopathy screening.

Adult↗