A repeated measures design was used to evaluate methadone maintenance (MM) treatment effects for 720 heroin addicts who entered MM in Southern California in 1971-1978. Compared to pretreatment measures, results show significant improvement for methadone users. Level of improvement was affected by sex, ethnicity, and treatment duration. (TJH)

Studied variation in physicians' practice styles and policies through a survey of 46 family physicians and internists. Overall, the results indicate that a brief open-ended survey can assess practice variations quickly, providing a basis to guide interventions. (SLD)

Two articles consider areas of rehabilitation measurement. The first, "Health Care Outcome Measurement," by William P. Fisher, explores the usefulness of the Rasch model in measuring results of health care programs. The second, "Instantaneous Measurement and Diagnosis," by John M. Linacre, discusses use of the Functional…

A Medicaid retrospective therapeutic intervention was designed to notify physicians about their patients' long-term use of sedatives and suggest to them that they reevaluate the patient's need for sedative hypnotic medication. Physicians' responses and follow-up actions are reported. Practice implications and the need for physician education are…

The political and social development of the Medicare Hospice Benefit combines humanitarian and cost-saving strategies. Although it mainstreamed care of the terminally ill and provided multiple services, four major constraints of the benefit package are identified and explored. It is important that we analyze this policy before we devise new ways…

Describes the nature of outcomes research. Provides a historical sketch, and discusses its use in medicine and nursing, such as in developing measurement instruments, in measuring quality of life, and in sampling. Looks at outcomes research's role in psychotherapy and provides implications for its use in art therapy. (MKA)

The purpose of this study was to identify barriers to the management of pain in long-term care institutions. Formal caregivers practising in four long-term care institutions in Hamilton, Ontario participated in eight focus groups. Participants included 6 physicians, 19 registered nurses, 8 registered practical nurses, 13 health care aides and 8…

Measurement of clinically significant change is critical for rehabilitation research because it can enhance the credibility of rehabilitation efforts and guide evidence-based practices. The practical appeal of clinically significant change is that it can bridge research and clinical practice by focusing on individual rather than group differences.…

Previous studies suggest that complementary and alternative medical (CAM) therapy use in children with chronic illnesses is higher than in children in the general population. In this study, we investigated patterns of CAM therapy use in children diagnosed with autism spectrum disorders (ASD, n = 50) as compared to a control population of children…

This report concerns the Health Care Financing Administration's (HCFA) contracting with Utilization and Quality Control Peer Review Organizations (PROs) as a means of monitoring the medical necessity and quality of in-hospital care provided to Medicare beneficiaries. Findings from a HCFA survey of PROs in California, Florida, and Georgia are used…

Precise and accurate cholesterol measurements are required to identify and treat individuals with high blood cholesterol levels. However, the current state of reliability of blood cholesterol measurements suggests that considerable inaccuracy in cholesterol testing exists. This report describes the Laboratory Standardization Panel findings on the…

This monograph examines the effectiveness of adjuvant chemotherapy in premenopausal women with breast cancer that has spread to the lymph nodes under the arm. The review focuses on the issue of how the survival of node-positive breast cancer patients has changed over time. It concludes that the survivability benefits from this treatment need…

Defensive medicine (the use of diagnostic and end-treatment measures explicitly for the purposes of averting malpractice suits) is frequently cited as one of the least desirable effects of the current rise in medical litigation. It is claimed that defensive medicine is responsible for the rising cost of health care and the exposure of patients to…

Preparation for quality assurance in nursing care must begin in basic nursing education, continue through the graduate and doctoral levels, and be provided for practicing nurses through continuing education activities, according to the author. She discusses the meaning of quality assurance and its integration into the nursing curriculum. (MF)

Evaluation model guidelines for hospital departments of nursing to use in their nursing quality assurance programs are presented as developed in Wisconsin. Four essential components of the Wisconsin outcome evaluation system are criteria, assessment, standards, and improvement of care. Sample tests and charts are included in the article. (MF)