This study documents features of clinical departments in teaching hospitals that are using physician assistants (PAs) and nurse practitioners (NPs) to perform some tasks previously done by medical or surgical residents. More than 60 percent of teaching hospital medical directors surveyed reported experience with substitution in their hospitals. The experience overall appears to be positive; one...

BACKGROUND Consumer directed health care proposes that patients will engage as informed consumers of health care services by sharing in more of their medical costs, often through deductibles. We examined knowledge of deductible plan details among new enrollees, as well as anticipated care-seeking changes in response to the deductible. METHODS In a large integrated delivery system with a range...

INTRODUCTION Despite the availability of preventive screening for colorectal cancer, compliance with screening recommendations in Appalachian Kentucky is low. Although there are various cancer education materials available, none focus on Appalachian populations and few on low-literacy populations. The purpose of this study was to assess the type of information needed in written educational mate...

BACKGROUND Although trust in health care providers (physicians, nurses, and others) may be lower among African Americans compared with whites, limited information is available on factors that are associated with low trust in these populations. This study evaluated the association between trust in health care providers and prior health care experiences, structural characteristics of health care,...

STUDY OBJECTIVE The rise in emergency department (ED) use in the United States is frequently attributed to increased visits by the uninsured. We determine whether insurance status is associated with the increase in ED visits. METHODS Using the national Community Tracking Study Household Surveys from 1996 to 1997, 1998 to 1999, 2000 to 2001, and 2003 to 2004, we determined for each period the ...

Denmark and Alberta are both advanced in the application of the Western scientific model of healthcare and both currently enjoy similar levels of economic prosperity. This article evaluates the current state, driving forces and general health system factors that have impacted two culturally and historically different medical jurisdictions--Denmark and Alberta, Canada.

With the rise in availability and increasing use of oral anticancer agents, concerns about adherence to prescribed regimens will become an increasingly important issue in oncology. Few published studies have focused on adherence to oral antineoplastic therapy, in part because the vast majority of chemotherapy is delivered intravenously in physicians' offices or hospitals. In this article, we re...

The problem of providing unsafe medical care in health care systems now is a widespread issue throughout the world. It can cause many side effects such as high rate of morbidity and mortality and can affect hospital efficiency in a bad way (1, 2). In this regard, governments in both developed and developing countries try to reach an acceptable level of safety in hospitals (3,4) In 2007, the WHO...

Hello! We are pleased to present our third issue of The Cana-dian Geriatrics Journal for 2013. This issue examines some of the current work being done in Canada on caring for frail older adults. Dr. Robert Lam has examined retrospectively what medical issues arise in a Care of the Elderly physician's office, in an attempt to provide evidence to better match future Continuing Medical Education a...

BACKGROUND Few population studies have examined the psychiatric outcomes of children and adolescents in the child welfare system, and no studies have compared outcomes before and after entry into care. Our objective was to assess the relative rate (RR) of suicide, attempted suicide, admission to hospital and visits to physicians' offices among children and adolescents in care compared with thos...