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[The simple, the difficult and the obvious--about the opportunities and pitfalls of the diagnostic warranty].

https://arctichealth.org/en/permalink/ahliterature271888
Source
Ugeskr Laeger. 2013 Sep 23;175(39):2292-3
Publication Type
Article
Date
Sep-23-2013
Author
Frede Olesen
Source
Ugeskr Laeger. 2013 Sep 23;175(39):2292-3
Date
Sep-23-2013
Language
Danish
Publication Type
Article
Keywords
Delivery of Health Care - standards
Denmark
Diagnosis
Humans
Neoplasms - diagnosis
Time Factors
PubMed ID
26495489 View in PubMed
Less detail

Social environment and frequent attendance in Danish general practice.

https://arctichealth.org/en/permalink/ahliterature70650
Source
Br J Gen Pract. 2005 Jul;55(516):510-5
Publication Type
Article
Date
Jul-2005
Author
Peter Vedsted
Frede Olesen
Author Affiliation
University of Aarhus, Denmark. p.vedsted@alm.au.dk
Source
Br J Gen Pract. 2005 Jul;55(516):510-5
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Adult
Cross-Sectional Studies
Denmark
Family Practice - statistics & numerical data
Female
Health Services Misuse - statistics & numerical data
Humans
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Questionnaires
Referral and Consultation - statistics & numerical data
Social Support
Socioeconomic Factors
Abstract
BACKGROUND: A lack of social support is associated with increased morbidity and mortality and a decreased effect of prevention. Frequent attenders to primary care are characterised by poorer social conditions than other patients in general practice, but we do not know whether this is due to social inequalities in health or whether social factors in themselves determine the use of general practice. AIM: To examine if social factors are associated with frequent attendance in general practice after adjusting for physical and psychological health variables. DESIGN OF STUDY: Population-based cross-sectional survey. SETTING: Two hundred and twenty GPs in 132 practices in the county of Aarhus, Denmark, and the listed adult population (aged 20-64 years). METHOD: A sample of frequent attenders and infrequent attenders was drawn. The study included only those resident in the county and who had consulted a GP during the period November 1997-October 1998. A questionnaire about physical, psychological and social factors was sent to the patients. The associations between social factors and frequent attendance were adjusted for physical and psychological health and tendency towards somatisation. RESULTS: A total of 1423 (73.7%) frequent attenders and 1103 (74.9%) infrequent attenders responded. Male frequent attendance was associated, with statistical significance, with living alone and being without work or on a disability pension. Among women, lack of professional education or being without work tended to increase the likelihood of frequent attendance. CONCLUSION: This study shows that for men, social factors may in themselves determine the use of general practice. None of the investigated social factors seemed to restrict the use of general practice.
PubMed ID
16004735 View in PubMed
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[General practitioners' job satisfaction].

https://arctichealth.org/en/permalink/ahliterature161671
Source
Ugeskr Laeger. 2007 Jun 25;169(26):2521-5
Publication Type
Article
Date
Jun-25-2007
Author
Anders Brøndt
Peter Vedsted
Frede Olesen
Author Affiliation
Aarhus Universitet, Forskningsenheden for Almen Praksis i Arhus, Arhus C. a.broendt@alm.au.dk
Source
Ugeskr Laeger. 2007 Jun 25;169(26):2521-5
Date
Jun-25-2007
Language
Danish
Publication Type
Article
Keywords
Adult
Denmark
Family Practice - manpower - statistics & numerical data
Female
Humans
Interprofessional Relations
Job Satisfaction
Male
Middle Aged
Physicians, Family - psychology
Physicians, Women - psychology
Questionnaires
Workload
Abstract
The aim of the study was to assess the level of job satisfaction among Danish general practitioners (GPs).
A questionnaire on job satisfaction and sociodemography was sent to all 458 registered GPs in the County of Aarhus, Denmark.
A total of 379 (83.5%) GPs participated. Danish GPs have a high level of job satisfaction. They were most satisfied with colleagues and fellow workers, amount of responsibility and freedom to choose their own method of working, and they were least satisfied with remuneration and hours of work. Longer working hours were associated with lower job satisfaction. Furthermore, GPs with low job satisfaction wanted to retire earlier. There was no association between job satisfaction and the number of practice staff. One in every twenty (6%) GPs would not repeat the same career choice again. Apart from their remuneration, Danish GPs' job satisfaction was higher than that of their Norwegian and British colleagues.
Overall job satisfaction among Danish GPs was high, also compared with foreign countries. Low job satisfaction was associated with wanting to retire early, implying that a high level of job satisfaction is important for GP retention. Shorter working hour was associated with higher job satisfaction.
PubMed ID
17725898 View in PubMed
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Reasons for encounter and disease patterns in Danish primary care: changes over 16 years.

https://arctichealth.org/en/permalink/ahliterature123966
Source
Scand J Prim Health Care. 2012 Jun;30(2):70-5
Publication Type
Article
Date
Jun-2012
Author
Grete Moth
Frede Olesen
Peter Vedsted
Author Affiliation
Research Unit for General Practice, Aarhus University, Aarhus, Denmark. grete.moth@alm.au.dk
Source
Scand J Prim Health Care. 2012 Jun;30(2):70-5
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Denmark
Family Practice - statistics & numerical data - trends
Female
Humans
Male
Primary Health Care - utilization
Referral and Consultation - statistics & numerical data - trends
Abstract
Approximately 98% of Danish citizens are listed with a general practice which they consult for medical advice. Although 85% of the population contact their general practitioner (GP) every year, little is known about these contacts. The aim of the present paper is to gain updated knowledge about patients' reasons for encounter and the GP activities and to make comparisons with a similar study from 1993.
All GPs in the Central Denmark Region were invited to register all contacts during one randomly chosen day within a year. The registration included questions about patients' reasons for encounter, the types and contents of the contacts, referrals, and distribution between new episodes and follow-up contacts. Aggregated data were compared with the results from 1993.
A total of 404 (46%) GPs participated. The number of contacts per 1000 inhabitants had risen by 19.7%. The reasons for encounter and final diagnoses resembled those in 1993. Musculoskeletal, psychological, and respiratory problems were the most common reasons for encounter, psychological problems being the only type to increase over the period. Interestingly, the proportion of diagnoses within the ICPC 'A' chapter rose from 13.5 to 19.7%. The referral rate rose by 2% (relative: 18.7%) from 10.7% to 12.7% and the share of follow-up contacts rose from 45.9% to 50.4% (relative: 8.7%).
Quite small changes were seen in the patterns of reasons for encounter and diagnoses from 1993 to 2009. However, an increase was found in contacts with general practice and referrals and in the proportion of follow-ups.
Notes
Cites: Dan Med Bull. 2006 Nov;53(4):441-917150149
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Cites: Health Policy. 2002 Feb;59(2):107-1811755993
PubMed ID
22643150 View in PubMed
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[Lack of evidence to support chlamydia infection screening].

https://arctichealth.org/en/permalink/ahliterature142299
Source
Ugeskr Laeger. 2010 Jul 12;172(28):2059-61
Publication Type
Article
Date
Jul-12-2010
Author
Berit Andersen
Lars Østergaard
Frede Olesen
Author Affiliation
Forskningsenheden for Almen Praksis, Vennelyst Boulevard 6, 8000 Arhus C. ba@alm.au.dk
Source
Ugeskr Laeger. 2010 Jul 12;172(28):2059-61
Date
Jul-12-2010
Language
Danish
Publication Type
Article
Keywords
Chlamydia Infections - complications - prevention & control
Chlamydia trachomatis - isolation & purification
Denmark
Evidence-Based Medicine
Female
Humans
Infertility, Female - microbiology - prevention & control
Male
Mass Screening
Young Adult
Abstract
Every year one fourth of the young Danish population is tested for urogenital Chlamydia trachomatis--mostly as part of opportunistic testing. The rationale is that asymptomatic infections may reduce reproductive capacity in women and that screening may reduce the burden of disease in the population. Systematic reviews documented lack of conclusive evidence for reproductive complications after asymptomatic infections and lack of evidence concerning the effect of screening on long-term sequelae. Routine opportunistic testing should be replaced by research protocols aiming to evaluate the effect of such interventions.
PubMed ID
20615375 View in PubMed
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[Palliation in the primary care sector--shared care].

https://arctichealth.org/en/permalink/ahliterature160226
Source
Ugeskr Laeger. 2007 Oct 29;169(44):3745-7
Publication Type
Article
Date
Oct-29-2007
Author
Mette Asbjørn Neergaard
Birgit Abom
Frede Olesen
Author Affiliation
Aarhus Universitet, Forskningsenheden for Almen Praksis,Arhus C. man@alm.au.dk
Source
Ugeskr Laeger. 2007 Oct 29;169(44):3745-7
Date
Oct-29-2007
Language
Danish
Publication Type
Article
Keywords
Delivery of Health Care - manpower - organization & administration
Denmark
Family Practice - manpower - organization & administration
Home Care Services - manpower - organization & administration
Hospitalists
Humans
Palliative Care - manpower - organization & administration
Patient Care Team - organization & administration
Primary Health Care - manpower - organization & administration
Abstract
Palliative homecare has been a primary care task for a long time. The introduction of palliative specialist teams has given patients with severe symptoms the possibility of getting qualified help, but has also resulted in a general tendency to exclude primary care from palliative care. Barriers to providing shared care are the organization of palliative care and the working culture of health professionals. Increased focus on shared care research is needed in order to optimise palliative home care.
PubMed ID
18028839 View in PubMed
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General practitioners' experience and benefits from patient evaluations.

https://arctichealth.org/en/permalink/ahliterature130040
Source
BMC Fam Pract. 2011;12:116
Publication Type
Article
Date
2011
Author
Hanne N Heje
Peter Vedsted
Frede Olesen
Author Affiliation
The Research Unit, Department of General Practice, University of Aarhus, Denmark. hh@alm.au.dk
Source
BMC Fam Pract. 2011;12:116
Date
2011
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Chi-Square Distribution
Denmark
Feedback, Psychological
General Practitioners - psychology
Humans
Job Satisfaction
Patient satisfaction
Physician-Patient Relations
Quality Assurance, Health Care - methods
Questionnaires
Abstract
It has now for many years been recognised that patient evaluations should be undertaken as an integral part of the complex task of improving the quality of general practice care. Yet little is known about the general practitioners' (GPs') benefit from patient evaluations. Aim 1 was to study the impact on the GPs of a patient evaluation and subsequent feedback of results presented at a plenary session comprising a study guide for the results and group discussions. Aim 2 was to study possible facilitators and barriers to the implementations of the results raised by the patient evaluation process.
A patient evaluation survey of 597 voluntarily participating GPs was performed by means of the EUROPEP questionnaire. Evaluation results were fed back to the GPs as written reports at a single feedback meeting with group discussions of the results. Between 3 and 17 months after the feedback, the 597 GPs received a questionnaire with items addressing their experience with and perceived benefit from the evaluations.
79.4% of the GPs responded. 33% of the responding GPs reported that the patient evaluation had raised their attention to the patient perspective on the quality of general practice care. Job satisfaction had improved among 26%, and 21% had developed a more positive attitude to patient evaluations. 77% of the GPs reported having learnt from the evaluation. 54% had made changes to improve practice, 82% would recommend a patient evaluation to a colleague and 75% would do another patient evaluation if invited. 14% of the GPs had become less positive towards patient evaluations, and job satisfaction had decreased among 3%.
We found a significant impact on the GPs regarding satisfaction with the process and attitude towards patient evaluations, GPs' attention to the patients' perspective on care quality and their job satisfaction. Being benchmarked against the average seemed to raise barriers to the concept of patient evaluations and difficulties interpreting the results may have formed a barrier to their implementation which was partly overcome by adding qualitative data to the quantitative results. The GPs' significant willingness to share and discuss the results with others may have served as a facilitator.
Notes
Cites: Fam Pract. 2000 Jun;17(3):236-4210846142
Cites: JAMA. 2010 Dec 8;304(22):2532-321139116
Cites: Med Educ. 2001 Aug;35(8):748-5611489102
Cites: Qual Health Care. 2001 Dec;10(4):224-811743151
Cites: Patient Educ Couns. 2003 Oct;51(2):149-5314572944
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Cites: N Engl J Med. 1989 Jan 5;320(1):53-62909878
Cites: Qual Assur Health Care. 1991;3(3):183-91782386
Cites: Ann N Y Acad Sci. 1993 Dec 31;703:226-35; discussion 235-78192299
Cites: BMJ. 1995 Jan 21;310(6973):1707833759
Cites: Qual Manag Health Care. 1996 Winter;4(2):55-6710154537
Cites: Soc Sci Med. 1998 Nov;47(10):1573-889823053
Cites: Qual Saf Health Care. 2005 Dec;14(6):428-3216326789
Cites: Int J Qual Health Care. 2006 Jun;18(3):232-716766604
Cites: Fam Pract. 2007 Apr;24(2):117-2717264071
Cites: Health Expect. 2008 Jun;11(2):160-7618494960
Cites: Scand J Prim Health Care. 2008;26(3):174-8018759161
Cites: Scand J Prim Health Care. 2008;26(4):228-3418792855
Cites: Qual Saf Health Care. 2008 Dec;17(6):437-4119064659
Cites: Br J Gen Pract. 2000 Nov;50(460):882-711141874
PubMed ID
22040039 View in PubMed
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[Patients' assessment of general practitioners. Association with type of practice].

https://arctichealth.org/en/permalink/ahliterature143937
Source
Ugeskr Laeger. 2010 Apr 12;172(15):1119-26
Publication Type
Article
Date
Apr-12-2010
Author
Hanne N Heje
Frede Olesen
Peter Vedsted
Author Affiliation
Forskningsenheden for Almen Praksis i Arhus, Aarhus Universitet, DK-8000 Arhus C, Denmark. hh@alm.au.dk
Source
Ugeskr Laeger. 2010 Apr 12;172(15):1119-26
Date
Apr-12-2010
Language
Danish
Publication Type
Article
Keywords
Denmark
Family Practice - manpower - organization & administration - standards
Group Practice
Health Services Accessibility
Humans
Patient satisfaction
Patients - statistics & numerical data
Physician-Patient Relations
Physicians, Family - standards
Private Practice
Quality Assurance, Health Care
Questionnaires
Abstract
This study aimed to examine if and how the patients' assessment of their general practitioner (GP) was associated with the organization of the practice, the number of listed patients and the number of staff members.
A survey among patients registered with the participating GPs assessing 23 aspects of the GP-patient relationship, medical care, information and support, organisation of care and accessibility. Analysis of the associations between the assessments and practice characteristics was performed.
A total of 703 GPs partook in the study. Assessments from 56,652 patients were included in the analyses (response rate 67.6%). Solo practicing GPs, GPs with a short list of patients and GPs with a large staff were assessed more positively than their colleagues in other types of practices, GPs with many listed patients and GPs with a small staff.
The study showed a complex association between the patient-experienced accessibility of general practice care and the number of listed patients and practice staff. Patients experienced the best accessibility in practices with few listed patients and in practices with a large staff. GPs in single-handed practices had far more positive assessments of accessibility than did GPs in partnership practices, especially availability by phone and waiting time prior to an appointment. Differences in patient list and staff between practices could not explain this finding.
PubMed ID
20427003 View in PubMed
Less detail

[Patients' assessment of their general practitioners--the significance of physician gender and age]

https://arctichealth.org/en/permalink/ahliterature97177
Source
Ugeskr Laeger. 2010 Apr 12;172(15):1112-8
Publication Type
Article
Date
Apr-12-2010
Author
Hanne N Heje
Frede Olesen
Peter Vedsted
Author Affiliation
Forskningsenheden for Almen Praksis i Arhus, Aarhus Universitet, DK-8000 Arhus C, Denmark. hh@alm.au.dk
Source
Ugeskr Laeger. 2010 Apr 12;172(15):1112-8
Date
Apr-12-2010
Language
Danish
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Denmark
Female
Health Services Accessibility
Humans
Male
Middle Aged
Patient Education as Topic
Patient satisfaction
Physician-Patient Relations
Physicians, Family - standards
Physicians, Women - standards
Quality Assurance, Health Care
Questionnaires
Sex Factors
Abstract
INTRODUCTION: The aim of the present study was to examine to which extent the patients' assessment of their general practitioner was associated which the gender and age of the physician. MATERIAL AND METHODS: A survey among patients registered with the GPs assessing 23 aspects of the GP-patient relationship, medical care, information and support, organisation of care and accessibility. Analyses of associations between the assessments and the gender and age of the physicians. RESULTS: A total of 703 doctors participated in the study. Assessments from 56,652 patients were included in the analyses (response rate 73.1%). We found that patients perceived male physicians as more accessible than their female colleagues. The younger doctors were assessed more positively than their older colleagues on certain aspects, but the numeric differences between the groups were minor. CONCLUSION: Female general practitioners may benefit from paying more attention to the accessibility aspect. Older physicians may benefit from emphasizing their patients' need for participation, information and a sense of continuity.
PubMed ID
20427002 View in PubMed
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[Patients' assessment of their general practitioners--the significance of patient characteristics. General results from the DanPEP--part I]

https://arctichealth.org/en/permalink/ahliterature97178
Source
Ugeskr Laeger. 2010 Apr 12;172(15):1105-12
Publication Type
Article
Date
Apr-12-2010
Author
Hanne N Heje
Frede Olesen
Peter Vedsted
Author Affiliation
Aarhus Universitet, Forskningsenheden for Almen Praksis i Arhus, DK-8000 Arhus C, Denmark. hh@alm.au.dk
Source
Ugeskr Laeger. 2010 Apr 12;172(15):1105-12
Date
Apr-12-2010
Language
Danish
Publication Type
Article
Keywords
Age Factors
Denmark
Educational Status
Family Practice - organization & administration - standards - statistics & numerical data
Female
Health Services Accessibility
Humans
Male
Patient satisfaction
Patients - classification
Physician-Patient Relations
Physicians, Family - standards
Quality Assurance, Health Care
Questionnaires
Sex Factors
Abstract
INTRODUCTION: Patients' experiences constitute a significant part of the quality assessment of general practice care. The aim of the present study was to examine the patients' assessment of their general practitioners (GPs) and to determine to which extent the assessments were associated with patient characteristics. MATERIAL AND METHODS: A survey among patients registered with the participating GPs assessing 23 aspects of the GP-patient relationship, medical care, information and support, organisation of care and accessibility. Analyses of associations between the assessments and patient characteristics. RESULTS: The most positively assessed aspect was confidentiality in the GPs' record keeping followed by aspects of empathy and precision, while the poorest evaluations were given to GP and practice availability by phone and amount of waiting time in the waiting room. Elderly patients, frequent attenders, patients who had a long history with the GP and patients with a good self-rated health were those who were most satisfied in general. The significance of patient gender and educational level was more complex. Patients suffering from chronic heart, endocrine or cancer diseases were more satisfied than patients without a chronic condition. CONCLUSION: Our results may be used for ongoing adjustment of care to the needs of groups of patients - while keeping in mind the individual patient's needs.
Notes
RefSource: Ugeskr Laeger. 2010 May 17;172(20):1548; author reply 1548
PubMed ID
20427001 View in PubMed
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77 records – page 1 of 8.