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[Collaboration between family physicians and home care professionals. Is it possible?].

https://arctichealth.org/en/permalink/ahliterature194751
Source
Can Fam Physician. 2001 Apr;47:751-8
Publication Type
Article
Date
Apr-2001
Author
M. Aubin
L. Vézina
R. Bergeron
A. Laberge
Author Affiliation
Unité de médecine familiale de l'Hôpital Laval.
Source
Can Fam Physician. 2001 Apr;47:751-8
Date
Apr-2001
Language
French
Publication Type
Article
Keywords
Canada
Case Management
Family Practice
Home Care Services - manpower
Humans
Interprofessional Relations
Abstract
To describe perceptions of physicians and home care professionals working in local community service centres (CLSCs) with respect to collaboration on home care follow up, and to identify conditions likely to help or hinder cooperation.
Descriptive study using individual and group interviews.
Areas served by three CLSCs in the Quebec city region.
Forty-five general practitioners with large home care practices and coordinators and representatives of CLSC home care teams.
Perceptions of physicians and home care professionals with respect to interprofessional cooperation on and barriers to home care follow up.
Most participants thought that cooperation would be beneficial to complex case management and continuity of follow-up care. In practice, however, cooperation is hindered by differences in medical practice and home care team service delivery and in methods of remuneration, and lack of knowledge of the other field of practice.
All participants recognized the importance of cooperation. This study did not reveal any real integration of medical and CLSC home care services. Efforts must be made to identify the strategies most conducive to improving interprofessional cooperation.
Notes
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Cites: Home Care Provid. 1998 Apr;3(2):100-3, 1109611523
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Cites: J Fam Pract. 1999 Jan;48(1):62-59934386
Cites: CMAJ. 1999 Aug 24;161(4):369-7310478159
Cites: Arch Intern Med. 1992 Oct;152(10):2025-321417375
PubMed ID
11340756 View in PubMed
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[Delivery of home health care. Survey of the Quebec region].

https://arctichealth.org/en/permalink/ahliterature196685
Source
Can Fam Physician. 2000 Oct;46:2022-9
Publication Type
Article
Date
Oct-2000
Author
A. Laberge
M. Aubin
L. Vézina
R. Bergeron
Author Affiliation
Centre de santé publique de la région de Québec.
Source
Can Fam Physician. 2000 Oct;46:2022-9
Date
Oct-2000
Language
French
Publication Type
Article
Keywords
Delivery of Health Care - statistics & numerical data
Family Practice - statistics & numerical data
Health Care Surveys
Home Care Services - statistics & numerical data
Humans
Physician's Practice Patterns
Quebec
Abstract
To describe the characteristics of home health care delivered by general practitioners and to identify the conditions that facilitate or hinder development of this practice.
Mailed survey.
Quebec city region.
General practitioners in private practice, family practice units, community health centres, or hospitals.
A self-administered questionnaire was used to gather information on volume of home care provided, characteristics of clients and visits, methods of follow up, and factors that promoted or hindered home care.
Of the 487 physicians surveyed, 58.1% (283) made housecalls to a clientele consisting mainly of elderly patients (87.6%): 42% saw fewer than five patients per week, and 31% spent 2 hours or less per week on housecalls. Close to two thirds (64%) devoted 15 to 30 minutes to these visits, and 90.2% said they used community health centres for assessment or home follow up of their patients. Difficulties with scheduling and methods of remuneration reportedly hampered development of this practice.
Home care practice is widespread around Quebec city, but represents only a small portion of the clinical work of many GPs.
Notes
Cites: Am Fam Physician. 1999 Oct 1;60(5):1481-810524492
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Cites: Med Care. 1992 Jan;30(1):43-571729586
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Cites: J Epidemiol Community Health. 1993 Dec;47(6):481-48120504
Cites: Soc Sci Med. 1995 Feb;40(3):349-587899947
Cites: N Engl J Med. 1997 Dec 18;337(25):1815-209400040
Cites: Can Fam Physician. 1998 Oct;44:2143-99805169
PubMed ID
11072582 View in PubMed
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[Variations in the incidence of fractures of the upper part of the femur in aged persons in the Quebec region].

https://arctichealth.org/en/permalink/ahliterature233128
Source
CMAJ. 1988 May 1;138(9):824-6
Publication Type
Article
Date
May-1-1988
Author
A. Laberge
P M Bernard
L. Bernard
Author Affiliation
Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Ste-Foy.
Source
CMAJ. 1988 May 1;138(9):824-6
Date
May-1-1988
Language
French
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Animals
Female
Femoral Fractures - epidemiology
Humans
Male
Middle Aged
Quebec
Sex Factors
Abstract
To estimate the incidence of fracture of the proximal end of the femur in people aged 50 years or older living in the Quebec area in 1971, 1976 and 1981 we determined the number of admissions for such fractures to the 15 acute care hospitals in the region. From 1971 to 1981 the number of fractures increased by 71%; the increases for those aged 75 to 84 years and 85 years or over were 98% and 118% respectively. The variation is only partly explained by changes in sex and age distribution of the population; the incidence rates also increased. Among men aged 75 to 84 years the incidence rate per 1000 person-years rose from 2.63 in 1971 to 5.22 in 1981, an increase of 98%; the corresponding figures for men aged 85 years or more were 9.76 and 16.91, an increase of 73%. Among women aged 75 to 84 years the rate rose from 7.28 to 8.81, an increase of 21%; the corresponding figures for women aged 85 years or more were 20.40 and 24.27, an increase of 21% and 19% respectively.
Notes
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Cites: Age Ageing. 1979 Feb;8(1):16-24443106
PubMed ID
3359376 View in PubMed
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Which physicians make home visits and why? A survey.

https://arctichealth.org/en/permalink/ahliterature200938
Source
CMAJ. 1999 Aug 24;161(4):369-73
Publication Type
Article
Date
Aug-24-1999
Author
R. Bergeron
A. Laberge
L. Vézina
M. Aubin
Author Affiliation
Family Medicine Unit, Hôpital Laval, Sainte-Foy, Que.
Source
CMAJ. 1999 Aug 24;161(4):369-73
Date
Aug-24-1999
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Chi-Square Distribution
Female
Home Care Services - economics - statistics & numerical data
Humans
Male
Physician's Practice Patterns - economics - statistics & numerical data
Physicians, Family
Quebec
Questionnaires
Reimbursement Mechanisms
Workload
Abstract
Recent changes in the North American health care system and certain demographic factors have led to increases in home care services. Little information is available to identify the strategies that could facilitate this transformation in medical practice and ensure that such changes respond adequately to patients' needs. As a first step, the authors attempted to identify the major factors influencing physicians' home care practices in the Quebec City area.
A self-administered questionnaire was sent by mail to all 696 general practitioners working in the Quebec City area. The questionnaire was intended to gather information on physicians' personal and professional characteristics, as well as their home care practice (practice volume, characteristics of both clients and home visits, and methods of patient assessment and follow-up).
A total of 487 physicians (70.0%) responded to the questionnaire, 283 (58.1%) of whom reported making home visits. Of these, 119 (42.0%) made fewer than 5 home visits per week, and 88 (31.1%) dedicated 3 hours or less each week to this activity. Physicians in private practice made more home visits than their counterparts in family medicine units and CLSCs (centres locaux des services communautaires [community centres for social and health services]) (mean 11.5 v. 5.8 visits per week), although the 2 groups reported spending about the same amount of time on this type of work (mean 5.6 v. 5.0 hours per week). The proportion of visits to patients in residential facilities or other private residences was greater for private practitioners than for physicians from family medicine units and CLSCs (29.7% v. 18.9% of visits), as were the proportions of visits made at the patient's request (28.0% v. 14.2% of visits) and resulting from an acute condition (21.4% v. 16.0% of visits). The proportion of physicians making home visits at the request of a CLSC was greater for those in family medicine units and CLSCs than for those in private practice (44.0% v. 11.3% of physicians), as was the proportion of physicians making home visits at the request of a colleague (18.0% v. 4.5%) or at the request of hospitals (30.0% v. 6.8%). Physicians in family medicine units and CLSCs did more follow-ups at a frequency of less than once per month than private practitioners (50.9% v. 37.1% of patients), and they treated a greater proportion of patients with cognitive disorders (17.2% v. 12.6% of patients) and palliative care needs (13.7% v. 8.6% of patients). Private practitioners made less use of CLSC resources to assess home patients or follow them. Male private practitioners made more home visits than their female counterparts (mean 12.8 v. 8.3 per week), although they spent an almost equal amount of time on this activity (mean 5.7 v. 5.2 hours per week).
These results suggest that practice patterns for home care vary according to the physician's practice setting and sex. Because of foreseeable increases in the numbers of patients needing home care, further research is required to evaluate how physicians' practices can be adapted to patients' needs in this area.
Notes
Cites: J Med Educ. 1983 Jun;58(6):447-566854606
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Cites: Union Med Can. 1987 Apr;116(4):243-5, 248-93603886
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Cites: Can J Public Health. 1990 Jan-Feb;81(1):27-312311046
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Cites: J Am Med Womens Assoc. 1991 Mar-Apr;46(2):49-542033207
Cites: J Am Geriatr Soc. 1991 Nov;39(11):1100-41753049
Cites: Med Care. 1992 Jan;30(1):43-571729586
Cites: Arch Intern Med. 1992 Oct;152(10):2025-321417375
Cites: J Epidemiol Community Health. 1993 Dec;47(6):481-48120504
Cites: Inquiry. 1983 Fall;20(3):248-576226610
PubMed ID
10478159 View in PubMed
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