Pilot study of a preliminary criterion standard for prescription opioid misuse.

Multidisciplinary experts created a behaviorally defined preliminary criterion standard definition of probable prescription opioid misuse (PPOM) that could be rated from material found in administrative, pharmacy, and electronic health record databases. They then derived a scoring system to identify PPOM patients requiring referral to a specialist. Experts next rated cases of misuse and nonmisuse.

The association between depressive symptoms and acute exacerbations of COPD.

Background: Depression is an important comorbidity for patients with chronic obstructive pulmonary disease (COPD). The association between depression and acute exacerbations of COPD is unknown. This study was designed to determine the frequency of COPD exacerbations in outpatients with and without depressive symptoms.

The clinical history and costs associated with delayed diagnosis of bipolar disorder.

The purpose of this reported study was to determine healthcare utilization and costs associated with delayed diagnosis of bipolar disorder. With use of automated data from a large integrated health system in the Midwest, all patients with newly diagnosed bipolar disorder recorded in any inpatient or outpatient encounter from January 1, 2000 to August 31, 2002 were identified. The date of initial diagnosis was the index date.

Bipolar disorder detection, ascertainment, and treatment: primary care physician knowledge, attitudes, and awareness.

Objective: To describe knowledge, attitudes, and awareness of bipolar disorder detection, ascertainment, and treatment among primary care physicians in a managed care setting.

Method: Quota sampling was used to obtain 102 completed surveys assessing knowledge, attitudes, and awareness of bipolar disorder from a pool of 350 primary care physicians in a large, vertically integrated Midwestern health system from June 2004 through August 2004. Descriptive statistics were used to characterize the distribution of the study results at the physician level.

The Michigan leadership model: developing a management infrastructure.

University of Michigan Health System underwent a number of reduction strategies in the early 1990s to address the rising costs of healthcare. By 2001, an analysis revealed that these strategies negatively impacted employee satisfaction and patient care. A team of nurse managers was charged with redesigning the current support structure for nurse managers.