The final sample included 740 surgical and 416 medical discharges. Rates of process of care problems were high, ranging from 24.4 percent to 82.5 percent across CSP screens for surgical cases. Problems were lower for medical cases, ranging from 2 percent to 69.1 percent across CSP screens. However, the CSP did not flag discharges with significantly higher rates of explicit process problems than unflagged discharges, indicating that such an approach to identifying complications of care should be evaluated cautiously. A new system for understanding clinical negotiation in office practice.
Requests are the primary means of patient-initiated action in office practice.
But these requests can be problematic because they consume time and resources. In particular, patients' requests for diagnostic tests, medications, and referrals can be costly to capitated practices and may cause physician-patient discord if not handled appropriately. They used input from researchers, clinicians, and patient focus groups and assessed its reliability and validity in audiotaped encounters between 139 patients and 6 northern California internists. The 139 patients made 772 requests. Patients with better health status made fewer requests.