To study people's views on the accessibility and continuity of primary medical care provided by different providers: a public primary healthcare centre (PPHC), occupational healthcare (OHC), and a private practice (PP).
A nationwide population-based questionnaire study.
A total of 6437 (from a sample of 10,000) Finns aged 15-74 years.
Period of time (in days) to get an appointment with any physician was assessed via a single structured question. Accessibility and continuity were evaluated with a five-category Likert scale. Values 4-5 were regarded as good.
Altogether 72% had found that they could obtain an appointment with a physician within three days, while 6% had to wait more than two weeks. Older subjects and subjects with chronic diseases perceived waiting times as longer more often than younger subjects and those without chronic diseases. The proportion of subjects who perceived access to care to be good was 35% in a PPHC, 68% in OHC, and 78% in a PP. The proportion of subjects who were able to get successive appointments with the same doctor was 45% in a PPHC, 68% in OHC, and 81% in a PP. A personal doctor system was related to good continuity and access in a PPHC.
Access to and continuity of care in Finland are suboptimal for people suffering from chronic diseases. The core features of good primary healthcare are still not available within the medical care provided by public health centres.
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To study the associations of patient-related and perceived healthcare-related factors with the control of blood pressure.
Physicians identified all of the hypertensive patients they saw during I week in 26 health centres. Out of 2,219 patients, 80% agreed to participate, 88% of which took antihypertensive medication.
In this cross-sectional questionnaire study, based on 82 opinion statements, 14 problem indices were formed using factor analysis. Logistic regression models were used to study the associations with blood pressure control.
Eighty per cent of the men and 79% of the women had poor blood pressure control (BP > or = 140/90 mmHg). High levels of hopelessness towards hypertension (adjusted OR 2.16; 95% confidence interval (CI) 1.20-3.88) as well as medium and high levels of frustration with treatment (adjusted OR 1.50; 95% CI 1.04-2.18 and OR 1.83; 95% CI 0.98-3.44) were associated with poor control. The perceived tension with blood pressure measurement (adjusted OR 1.60; 95% CI 1.08-2.36) was similarly associated with poor control. Non-compliance in men, old age and monotherapy were also associated with poor blood pressure control.
Hopelessness, frustration with treatment, and perceived tension with blood pressure measurement are associated with poor blood pressure control.