American Journal of Medical Quality 

About: American Journal of Medical Quality is an academic journal published by SAGE Publishing. The journal publishes majorly in the area(s): Health care & Medicine. It has an ISSN identifier of 1062-8606. Over the lifetime, 1987 publications have been published receiving 31081 citations.

Identifying persons with diabetes using Medicare claims data.

Abstract: The objective of this study was to develop and validate a method for identifying Medicare beneficiaries with diabetes by using Medicare claims data. We used self-reports of diabetes status from participants in the Medicare Current Beneficiary Survey to determine disease status, and then we examined these participants' Medicare claims. Using self-reported diabetes status as the "gold standard," we determined the sensitivity, specificity, and reliability of claims data in identifying beneficiaries with diabetes. We found that to construct a method that is adequately sensitive (> or = 70%), highly specific (> or = 97.5%), and reliable (kappa > or = 0.80), researchers must combine information from different types of Medicare claims files, use 2 years of data to identify cases, and require at least 2 diagnoses of diabetes among claims involving ambulatory care. Since these criteria are met by more than one method, the choice of method should be governed by the goals of the research as well as more practical concerns.

Systematic Review of Handoff Mnemonics Literature

Abstract: A systematic review of published English-language articles on handoffs is conducted (1987 to June 4, 2008). Forty-six articles describing 24 handoff mnemonics are identified by trained reviewers. The majority (82.6%) have been published in the last 3 years (2006-2008), and SBAR (Situation, Background, Assessment, Recommendation) is the most frequently cited mnemonic (69.6%). Of 7 handoff research articles, only 4 study mnemonics. All 4 of these studies have relatively small sample sizes (10-100) and lack validated instruments. Only 1 study has obtained IRB approval. Scientifically rigorous research studies are needed to assess the effectiveness of handoff mnemonics. These should be published in the peer-reviewed literature using the Standards for QUality Improvement Reporting Excellence (SQUIRE) guidelines.

Clinical Vignette-Based Surveys: A Tool for Assessing Physician Practice Variation

Abstract: Clinical vignette-based surveys have been used for more than 30 years to measure variation in physicians' approaches to the diagnosis and treatment of patients with similar health problems Vignettes offer advantages over medical record reviews, analysis of claims data, and standardized patients A vignette-based survey can be completed more quickly than a record review or standardized patient program Research has shown that vignette-based surveys produce better measures of quality of care than medical record reviews when used to measure differential diagnosis, selection of tests, and treatment decisions Although standardized patients are preferred when measuring communication and physical examination skills, vignettes are more cost-effective than standardized patients when assessing clinical physicians' decision making Vignettes offer better opportunities to isolate physicians' decision making and to control case-mix variation than do analyses of claims data sets Clinical vignette-based surveys are simple and economical tools that can be used to characterize physicians' practice variation

Health status in VA patients: results from the Veterans Health Study.

Abstract: Recently, the Veterans Administration (VA) Under Secretary for Health has designated functional status as one of the domains of value for the system, given its increasing importance for clinical care. The Veterans Health Study (VHS) was designed to assist the VA in monitoring outcomes and measuring the case mix of patients who use the VA. The Veterans SF-36 (short form functional status assessment for veterans) was administered to 2425 veterans receiving ambulatory care. Measures of the Veterans SF-36 were strongly correlated with sociodemographics and morbidities of the veterans. Young veterans had poorer mental health status than older veterans. Veterans who used ambulatory care in the VHS reported lower levels of health status, reflecting more disease than a non-VA civilian population. These measures of health are important indicators of the disease burden or case mix of the patients and are pertinent to health systems such as the VA for resource allocation decisions and as outcomes of care.

Spirituality, religion, and health.

Abstract: tant aspect of patient care, particularly at the end of life. Research has shown that spirituality may assist patients as they are coping with illness, be related to better health and quality of life, and influence medical decision-making. There are relationships between health, spirituality, and religion in biological, psychological, and social domains. Spiritual and religious practices have benefited those with mental illness, as well as those with physical conditions such as kidney disease, cancer, cardiovascular disease, HIV, and diabetes mellitus. In particular, addressing spiritual issues is important to maintaining quality of life for the terminally ill. Family caregivers, often burdened by the day-to-day stress of tending to a loved one, also derive spiritual and emotional support from spiritual practices and communities. Biological research has demonstrated a physiological link between brain chemistry and mystical experience. Deep inner peace, closely related with meditation and prayer, has been associated with parasympathetic relaxation. Through brain imaging, researchers have correlated spiritual states with brain physiology. Psychological coping mechanisms may be supported by religion and spirituality, addressing sickness and the declining health, fear, helplessness, uncertainty, and physical discomfort that accompany illness. Spiritual and religious practices are protective of emotional and physical well-being in times of crisis. Those with strong religious faith appear to be happier and more satisfied and to have less depression. Social support from members of a spiritual community or congregation may reduce stresses. Spiritual communities support healthy lifestyles, discouraging unhealthy behaviors such as alcohol and substance abuse. In addition, the social connectedness provided by a community helps to address depression and support coping mechanisms. Those with social ties have reduced mortality as well as emotional and instrumental supports, engendering better compliance with health care regimens and better response to crises.