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Biomedical subjects

K D Bertakis

Publications and source records attributed to K D Bertakis.

33 records · Page 2Linked to original sources
PubMed1987

Gatekeeping in primary care: a comparison of internal medicine and family practice.

Five hundred twenty new patients were randomly and prospectively assigned to receive their care in the Internal Medicine Clinic or Family Practice Clinic of a large university hospital. The patients were followed by residents in training under the supervision of board-certified internists or family physicians. After a mean length of care of slightly over two years, the charts were reviewed for frequency of visits to primary care providers (internal medicine or family practice), Emergency Room, Acute Care Clinic, and all clinics other than the two primary care clinics. The records were also reviewed for laboratory tests ordered. Frequency of visits to the clinic of primary care, Emergency Room, Acute Care Clinic, and broken appointments were all significantly higher for patients randomized to the Internal Medicine Clinic. In addition, the median total annual cost of laboratory tests for patients followed by internal medicine physicians was significantly higher, largely because of higher laboratory charges generated by the specialist consultants. Over the study period, internal medicine patients had a significantly higher number of visits to all nonprimary care clinics and specifically to the dermatology, obstetrics and gynecology, and general surgery consultant clinics. It can be concluded that in this clinical environment, the practice styles of internal medicine and family practice are different.

Adult↗
PubMed1984

Fetal asphyxia: prevention, detection and intervention.

Fetal asphyxia occurs eight times more frequently in high-risk pregnancies than in normal pregnancies. Primary prevention is possible through exemplary prenatal care, and a variety of techniques are available for early detection of the fetus at risk. Fetal distress demands an urgent search for the cause of hypoxemia. In the absence of any correctable abnormality, persistent hypoxemia requires immediate delivery.

Child, Preschool↗
PubMed1982

Family practice.

Explore the source record for details and available documents.

Family Practice↗
PubMed1981

Does race have an influence on patients' feelings toward physicians?

Much debate has been waged over the use of race as a criterion for admission to medical school. This study reports data relative to this issue, derived from interviews with 66 patients (40 black, 21 white, and 5 Mexican-American) of three family physicians (Asian, black, and white) in a county medical clinic serving welfare and low-income patients. There were no significant differences in responses to each of 18 questions among the different racial groups of patients regardless of physicians seen. There were also no significant differences in responses among the different racial groups for each physicians' patients were compared in the aggregate (not divided into racial groups). Patients strongly agreed that it was important for the physician to be caring and competent and to listen to and understand what they had to say. They disagreed that these qualities were affected by the physician's race and did not seem to have a racial preference in their physician.

Attitude↗
PubMed1977

The communication of information from physician to patient: a method for increasing patient retention and satisfaction.

Patients are more satisfied with their physicians when they are given and retain more information about their illnesses. Whe an experimental group of patients was asked to restate what they had been told, followed by physician feedback, retention of the information was 83.5 percent compared to 60.8 percent in a control group in which this technique was not used. Patient satisfaction was also higher in the experimental group.

Adult↗
PubMedDate not supplied

A comparison of initial and established patient encounters using the Davis Observation Code.

BACKGROUND: Previous research has evaluated how communication during medical visits affects patient outcomes such as compliance, recall, and satisfaction. These prior studies generally did not control for new versus established patient visits. The objective of the present research was to explore differences between new and established patient encounters. METHODS: This research studied 62 new patient and 58 established patient encounters to a university-based family practice clinic. The Davis Observation Code was used to code and evaluate the encounters. RESULTS: Established patient encounters were shorter and involved more chatting, counseling, discussions of treatment effects, compliance checking, and requests for specific patient behavior changes regarding health promotion. On the other hand, established patient encounters involved less structuring of the interaction with the patient, less history taking, and fewer discussions regarding family information, smoking, and substance abuse. CONCLUSIONS: The results indicate that what takes place during the medical interview is highly dependent on physician-patient familiarity. Future research on physician-patient interactions should consider whether the interactions represent new or established visits.

Adult↗
PubMedDate not supplied

Impact of a patient education intervention on appropriate utilization of clinic services.

BACKGROUND: Patient education interventions have been identified as a means of decreasing the utilization of ambulatory services; however, research on the impact of self-care initiatives should also assess changes in the appropriateness of patient visits. METHODS: New patients to the Family Practice Clinic at a university medical center were randomized into control and experimental groups. Experimental patients received the Family Practice Clinic Patient Medical Advisor Booklet and an educational presentation. Controls received the booklet without the educational intervention. RESULTS: Over the subsequent year, there were no significant differences in the total number of visits or telephone calls to the Family Practice Clinic by either group. The total number of visits to other medical center clinics and the emergency department was also similar. The experimental group, however, showed a statistically higher percentage of appropriate Family Practice Clinic visits, and their telephone calls to the clinic for advice tended to be more appropriate. Finally, experimental group patients had a significantly higher percentage of appropriate visits to the emergency department than did control group patients. CONCLUSIONS: Although this educational intervention did not change the total number of patient visits or telephone calls, it did have an impact on the appropriateness of patient utilization of health care services.

Adolescent↗
PubMedDate not supplied

Continuity of care for family practice patients in a university hospital-based residency program.

In the present study, conducted in a university hospital-based family practice residency program, 271 new patients to the family practice clinic were followed for a mean length of 3.4 years. During that time 27 (10 percent) patients were hospitalized at least once. Of a total of 58 hospitalizations, lasting an average of 6.3 days, only eight were made from the family practice clinic and only four family practice patients were actually admitted to the family practice ward service. Furthermore, more than half of the admissions were to the internal medicine or the obstetrics and gynecology services. This would appear to be inappropriate, given the fact that family physicians are trained to care for acutely ill adult patients and many obstetrical and gynecological patients. A review of hospital admissions records revealed a variety of issues in continuity of care. Recommendations are made regarding possible solutions and further research in this area.

Adult↗
PubMedDate not supplied

Educational impact of a Family Practice Clinic Patient Medical Advisor Booklet.

The present study was conducted to test the efficacy of a new "Family Practice Clinic Patient Medical Advisor Booklet" developed by the author for patient education. Experimental group patients were given the booklet with a prepared 25-minute talk describing it. Two to four weeks later they were seen again to answer a health knowledge questionnaire. Control group patients were seen only once. At that time, the questionnaire was given without the preceding presentation. The interviewer then discussed incorrect answers with control group patients and distributed the booklet. Both groups were asked to evaluate the booklet by mail approximately one month after administration of the health knowledge questionnaire. The experimental group showed a statistically significant higher mean score on the health knowledge questionnaire. The experimental group answered 96.8% correctly, compared to 71.6% for the control group. In their responses to the mailed evaluation forms, both experimental and control groups thought the booklet was well written and useful in understanding and treating the illnesses described.

Ambulatory Care Facilities↗
PubMedDate not supplied

An application of the health belief model to patient education and compliance: acute otitis media.

This study made use of concepts from the health belief model to test the influence of educational intervention on patient attitude and subsequent sick-role behavior. The hypothesis tested was as follows: Mothers of pediatric patients in an experimental group (N-29) receiving specially designed education about otitis media, would consequently acquire greater awareness of their children's susceptibility to the disease, the possibility of its serious effects, and the benefits of treatment than a comparable control group (N-30) not receiving the educational intervention. It was further hypothesized that patient compliance would be higher in the experimental group. Experimental group health beliefs changed in a significant, positive direction with respect to illness susceptibility and severity, the benefits of treatment, and patient modifying factors. Control group attitudes did not significantly change. Compliance rates for both groups were very high; 91.8% compliance was noted for experimental subjects and 85.6% for controls. This may reflect the additional time and attention given all those participating in the study.

Acute Disease↗