Looking for improved clinical quality, reduced costs, streamlined operations? Advocates of business process reengineering say it can help achieve all those things. But what is reengineering in a health care context? Experts look at the conceptual, operational and information management challenges.

Hospital Information Systems↗

PubMed1994

Laws sought to guard health data from falling into the wrong hands.

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Civil Rights↗

PubMed1994

Making the grade. Report cards will be used to measure the performance of health plans: how might they work?

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Annual Reports as Topic↗

PubMed1994

Integrated information paves the way to better decision making on patient care.

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Clinical Medicine↗

PubMed1994

Is there a sex difference in the association of plasma insulin level and insulin sensitivity with serum lipids and lipoproteins?

Previous studies on the relationship between the plasma insulin level, insulin sensitivity (SI), serum lipids, and lipoproteins have been performed predominantly in men. Therefore, we investigated whether there is a sex difference in the association of insulin level during an oral glucose tolerance test and SI with lipids and lipoproteins among normoglycemic men and women aged 53 to 61 years. SI was determined by the minimal model from the frequently sampled intravenous glucose tolerance test (IVGTT). There were no correlations between total cholesterol or low-density lipoprotein (LDL) cholesterol and insulin level or SI. High-density lipoprotein (HDL) cholesterol correlated inversely with fasting insulin (r = -.26, P < .05 in men; r = -.29, P < .01 in women) and 2-hour insulin (r = -.31, P < .01 in men; r = -.39, P < .001 in women) and positively with SI (r = .28, P = .05 in men; r = .43, P < .001 in women). Total and very-low-density lipoprotein (VLDL) triglycerides correlated positively with fasting insulin (r = .43, P < .001 in men; r = .42, P < .001 in women) and 2-hour insulin (r = .50, P < .001 in men; r = .31, P < .01 in women) and inversely with (r = -.49, P < .001 in men; r = -.40, P < .001 in women). In multiple regression analyses including age, body mass index (BMI), waist to hip ratio, 2-hour glucose, fasting or 2-hour insulin, and SI, only BMI was associated with HDL cholesterol level in men.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

PubMed1994

The pathogenesis and clinical significance of xanthelasma palpebrarum.

Xanthelasma palpebrarum is the most common type of xanthoma. On average, only half the patients with xanthelasma palpebrarum are hyperlipidemic. This review is an attempt to elucidate the pathogenesis and clinical significance of xanthelasma palpebrarum, especially its suggested role as a marker for increased risk for atherosclerosis. In hyperlipidemic patients with xanthelasma, the risk for atherosclerosis may be inferred from the associated lipoprotein and apolipoprotein abnormalities. The possible risk for atherosclerosis in normolipidemic patients with xanthelasma is more obscure because of the relative paucity of epidemiologic data and the conflicting results in some of the lipid studies. Several studies, however, showed decreased high-density lipoprotein cholesterol levels and other lipoprotein and apolipoprotein abnormalities that are associated with atherosclerosis. Therefore, on the basis of the present data, determining the plasma lipoprotein and apolipoprotein levels (especially those associated with increased risk for atherosclerosis) in each normolipidemic patient with xanthelasma appears to be justified.

Adult↗