A Pilot Test of the Effect of Guided Care on the Quality of Primary Care Experiences for Multimorbid Older Adults
Journal of General Internal MedicinePublished 11 February 2008Open access
Cynthia M. Boyd, Efrat Shadmi, Leslie Jackson Conwell, Michael Griswold, Bruce Leff, Rosemarie Brager
Citations95
SJR quartileQ1
SJR score1.99
SNIP1.71
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TL;DR
In this pilot study, Guided Care appeared to improve the quality of primary care experiences for high-risk, chronically ill older adults.
Abstract
In this pilot study, Guided Care appeared to improve the quality of primary care experiences for high-risk, chronically ill older adults. A larger cluster-randomized controlled trial of Guided Care is underway.
Keywords
MedicineHealth Professions
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