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17 records – page 1 of 2.

[A personal physician, wishes and realities in Northern Norway. A patient study in Northern Norway in 1987].

https://arctichealth.org/en/permalink/ahliterature228020
Source
Tidsskr Nor Laegeforen. 1990 Nov 10;110(27):3482-4
Publication Type
Article
Date
Nov-10-1990
Author
H. Melbye
I. Aaraas
Author Affiliation
Institutt for samfunnsmedisin, Universitetet i Tromsø.
Source
Tidsskr Nor Laegeforen. 1990 Nov 10;110(27):3482-4
Date
Nov-10-1990
Language
Norwegian
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Consumer Satisfaction
Continuity of Patient Care
Female
Humans
Male
Middle Aged
Norway
Physician-Patient Relations
Physicians, Family
Questionnaires
Abstract
Among patients consulting general practitioners in northern Norway, 57% had a stable relationship with one doctor, according to answers to a questionnaire. Rather than having a free choice between several doctors, 85% preferred to have a personal doctor. About half the patients wanted the same doctor for the whole family. Even if they had to wait longer for the consultation, 63% would prefer to meet their own doctor. A personal doctor was much less common in northern Norway than in the rest of the country, which could be put down to lower stability in the practices.
PubMed ID
2256075 View in PubMed
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[Are we able to reduce the use of antibiotics in acute bronchitis?].

https://arctichealth.org/en/permalink/ahliterature214928
Source
Tidsskr Nor Laegeforen. 1995 Jun 20;115(16):1930-1
Publication Type
Article
Date
Jun-20-1995
Author
H. Melbye
Author Affiliation
Institutt for samfunnsmedisin, Universitetet i Tromsø.
Source
Tidsskr Nor Laegeforen. 1995 Jun 20;115(16):1930-1
Date
Jun-20-1995
Language
Norwegian
Publication Type
Article
Keywords
Acute Disease
Anti-Bacterial Agents - administration & dosage
Bronchitis - diagnosis - drug therapy - microbiology
Drug Resistance, Microbial
Drug Utilization
Humans
Norway
PubMed ID
7638842 View in PubMed
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Bronchial airflow limitation and chest findings in adults with respiratory infection.

https://arctichealth.org/en/permalink/ahliterature213750
Source
Scand J Prim Health Care. 1995 Dec;13(4):261-7
Publication Type
Article
Date
Dec-1995
Author
H. Melbye
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Scand J Prim Health Care. 1995 Dec;13(4):261-7
Date
Dec-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Airway Obstruction - diagnosis - etiology - physiopathology
Female
Forced expiratory volume
Humans
Male
Middle Aged
Norway
Predictive value of tests
Pulmonary Ventilation
Respiratory Sounds
Respiratory Tract Infections - complications - physiopathology
Spirometry
Abstract
To study the predictive value of clinical chest findings for bronchial airflow limitation in patients with respiratory tract infection.
Associations were analysed between FEV1 (forced expiratory volume in one second) in % of predicted and physical chest findings.
The Municipal Emergency Clinic in Tromsø, Norway.
398 adult patients with respiratory tract infection and 40 general practitioners.
Mean FEV1% predicted and frequency of FEV1
PubMed ID
8693210 View in PubMed
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[Diabetic care in Norwegian general practice. A report of current status from Salten and some regions in Rogaland]

https://arctichealth.org/en/permalink/ahliterature48143
Source
Tidsskr Nor Laegeforen. 1997 Oct 20;117(25):3661-4
Publication Type
Article
Date
Oct-20-1997
Author
T. Claudi
J. Cooper
K. Skogøy
M F Hausken
H. Melbye
Author Affiliation
Rønvik Legesenter, Bodø.
Source
Tidsskr Nor Laegeforen. 1997 Oct 20;117(25):3661-4
Date
Oct-20-1997
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 1 - blood - diagnosis - therapy
Diabetes Mellitus, Type 2 - blood - diagnosis - therapy
English Abstract
Family Practice - standards - statistics & numerical data
Female
Humans
Male
Middle Aged
Norway
Patient satisfaction
Quality of Health Care
Abstract
Few published data are available on the quality of diabetic care in Norway. This applies both to general practice and to hospital clinics. We reviewed the notes of 1,876 diabetic patients who were registered with general practitioners in Salten and Rogaland to assess the quality of care with reference to the Norwegian College of General Practitioners' guidelines for diabetic care. 89% of patients were classified as having type-2 diabetes. Hospital clinics were responsible for the care of 93 patients. Analysis of the results showed that during the last 12 months Hb A1c and blood pressure had been measured in 84 and in 86% of those patients under the care of their general practitioner. Some inspection of the foot had been carried out in 45% of the patients, and 37% of the patients had been referred to an ophthalmologist. Guideline targets for glycaemic control had been achieved in 46% of patients younger than 70 years of age (Hb A1c
Notes
Comment In: Tidsskr Nor Laegeforen. 1998 Jan 20;118(2):2789485629
PubMed ID
9417661 View in PubMed
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The diagnosis of adult pneumonia in general practice. The diagnostic value of history, physical examination and some blood tests.

https://arctichealth.org/en/permalink/ahliterature233098
Source
Scand J Prim Health Care. 1988 May;6(2):111-7
Publication Type
Article
Date
May-1988
Author
H. Melbye
B. Straume
U. Aasebø
J. Brox
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Scand J Prim Health Care. 1988 May;6(2):111-7
Date
May-1988
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Blood Sedimentation
C-Reactive Protein - analysis
Family Practice
Female
Humans
Leukocyte Count
Male
Medical History Taking
Middle Aged
Norway
Physical Examination
Pneumonia - blood - diagnosis - radiography
Time Factors
Abstract
Because of lower respiratory infection that was treated with antibiotics on the suspicion of pneumonia, 71 patients aged 15 years or more were referred to the study by general practitioners. Using a positive chest X-ray as a "gold standard", 15% had pneumonia. The diagnostic value of variables from history, physical examination and blood tests was evaluated by calculating the likelihood ratio (LR). A duration of illness less than 24 hours before consulting the general practitioner was the variable from the history with the highest LR, 13.5. The white blood cell count and particularly the C-reactive protein analysis had a high diagnostic value, CRP greater than 50 mg/l had an LR of 37. In this selected material pulmonary symptoms and lung findings were of minor value in differentiating patients with and without pneumonia, with no LR exceeding 2.3. This can be explained to some extent by selection bias.
PubMed ID
3387706 View in PubMed
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Do general practitioner hospitals reduce the utilisation of general hospital beds? Evidence from Finnmark county in north Norway.

https://arctichealth.org/en/permalink/ahliterature21612
Source
J Epidemiol Community Health. 1998 Apr;52(4):243-6
Publication Type
Article
Date
Apr-1998
Author
I. Aaraas
O H Førde
I S Kristiansen
H. Melbye
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
J Epidemiol Community Health. 1998 Apr;52(4):243-6
Date
Apr-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Bed Occupancy - statistics & numerical data
Child
Child, Preschool
Female
Health Services Accessibility
Hospitals, County - utilization
Hospitals, General - utilization
Hospitals, Group Practice - utilization
Humans
Infant
Infant, Newborn
Length of Stay - statistics & numerical data
Male
Middle Aged
Norway
Patient Admission - statistics & numerical data
Research Support, Non-U.S. Gov't
Retrospective Studies
Abstract
STUDY OBJECTIVE: To assess whether populations with access to general practitioner hospitals (GP hospitals) utilise general hospitals less than populations without such access. DESIGN: Observational study comparing the total rates of admissions and of occupied bed days in general hospitals between populations with and without access to GP hospitals. Comparisons were also made separately for diagnoses commonly encountered in GP hospitals. SETTING: Two general hospitals serving the population of Finnmark county in north Norway. PATIENTS: 35,435 admissions based on five years' routine recordings from the two hospitals. MAIN RESULTS: The total rate of admission to general hospitals was lower in peripheral municipalities with a GP hospital than in central municipalities without this kind of institution, 26% and 28% lower for men and women respectively. The corresponding differences were 38% and 52%, when analysed for occupied bed days. The differences were most pronounced for patients with respiratory diseases, cardiac failure, and cancer who are primarily or intermediately treated or cared for in GP hospitals, and for patients with stroke and fractures, who are regularly transferred from general hospitals to GP hospitals for longer term follow up care. CONCLUSION: GP hospitals seem to reduce the utilisation of general hospitals with respect to admissions as well as occupied bed days.
PubMed ID
9616411 View in PubMed
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["Hello, doctor's office? May I talk to the doctor?" An analysis of telephone accessibility in offices of general practitioners. A survey of patients in northern Norway 1987].

https://arctichealth.org/en/permalink/ahliterature225675
Source
Tidsskr Nor Laegeforen. 1991 Sep 20;111(22):2755-8
Publication Type
Article
Date
Sep-20-1991
Author
I. Aaraas
H. Melbye
S. Lundevall
Author Affiliation
Institutt for samfunnsmedisin, Universitetet i Tromsø.
Source
Tidsskr Nor Laegeforen. 1991 Sep 20;111(22):2755-8
Date
Sep-20-1991
Language
Norwegian
Publication Type
Article
Keywords
Family Practice - standards
Health Services Accessibility - standards
Humans
Norway
Physician-Patient Relations
Questionnaires
Telephone
Abstract
In a survey among 3,739 patients belonging to 36 general practices in northern Norway, 33% reported difficult access to their local surgery by telephone. 43% reported difficulty in obtaining access to the doctor once they had obtained contact with the reception. The proportion of patients reporting problems of accessibility by telephone varied greatly, from 5 to 75%. Patients belonging to practices located in towns, with long waiting lists and many doctors, were most dissatisfied with the telephone service. Stable doctor/patient-relationships made direct contact with the doctor easier, while a scheduled time when patients could call the office made direct contact more difficult. We discuss ways to improve accessibility by telephone.
PubMed ID
1948869 View in PubMed
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Improving pulmonary auscultation as a tool in the diagnosis of bronchial obstruction--results of an educational intervention.

https://arctichealth.org/en/permalink/ahliterature72474
Source
Scand J Prim Health Care. 1998 Sep;16(3):160-4
Publication Type
Article
Date
Sep-1998
Author
H. Melbye
I. Aaraas
J. Hana
A. Hensrud
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Scand J Prim Health Care. 1998 Sep;16(3):160-4
Date
Sep-1998
Language
English
Publication Type
Article
Keywords
Adult
Aged
Auscultation - methods
Clinical Competence - standards
Education, Medical, Continuing - methods
Female
Follow-Up Studies
Forced expiratory volume
Humans
Lung Diseases, Obstructive - diagnosis - physiopathology
Male
Middle Aged
Physicians, Family - education
Predictive value of tests
Research Support, Non-U.S. Gov't
Respiratory Sounds - physiopathology
Spirometry
Abstract
OBJECTIVE: To study the effect of an educational intervention on general practitioners' (GPs') ability to diagnose bronchial obstruction after clinical examination. DESIGN: Based on physical chest examination 11 GPs assessed the degree of bronchial obstruction by estimating the patient's predicted forced expiratory volume in one second (FEV1%). Half way in the study the GPs were taught new knowledge on associations between lung sounds and bronchial airflow. The agreements between estimated and measured FEV1% predicted before and after this educational intervention were compared. SETTING: 11 GPs in five health centres in northern Norway took part. PATIENTS: 351 adult patients were included in phase 1, and 341 in phase 2. MAIN OUTCOME MEASURES: Estimated and measured FEV1% predicted were compared in subgroups of patients according to clinical findings in phase 1 and 2. The effect of the intervention on the doctors' weighting of various chest signs could thus be evaluated. Kappa agreement and correlation between estimated and measured FEV1% predicted in both phases were determined. RESULTS: The agreement between estimated and measured FEV1% predicted increased from Kw (weighted Kappa) = 0.33 in phase 1 to Kw = 0.43 in phase 2 (95% confidence interval 0.35-0.52). The GPs laid more relevant emphasis on rhonchi in their estimates after the educational intervention, while too much weight was laid on uncertain chest findings in phase 2. CONCLUSION: The study shows a potential for better use of physical chest examination in the diagnosis of bronchial obstruction.
PubMed ID
9800229 View in PubMed
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Is the general practitioner hospital a potential "patient trap"? A panel study of emergency cases transferred to higher level hospitals.

https://arctichealth.org/en/permalink/ahliterature33770
Source
Scand J Prim Health Care. 1998 Jun;16(2):76-80
Publication Type
Article
Date
Jun-1998
Author
I. Aaraas
H. Melbye
B O Eriksen
O. Irtun
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Scand J Prim Health Care. 1998 Jun;16(2):76-80
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Emergency Service, Hospital - statistics & numerical data
Female
Hospitals, General - statistics & numerical data
Humans
Iatrogenic Disease
Infant
Male
Middle Aged
Norway
Outcome and Process Assessment (Health Care)
Patient Transfer - statistics & numerical data
Research Support, Non-U.S. Gov't
Risk
Abstract
OBJECTIVES: 1. To find out whether a stay in local general practitioner hospitals (GP hospitals) prior to an emergency admission to higher level hospitals aggravated or prolonged the course of the disease, or contributed to permanent health loss for some patients. 2. To detect cases where a transitory stay in a GP hospital might have been favourable. DESIGN: A retrospective expert panel study based on records from GP hospitals and general hospitals. The included patients had participated in a previous prospective study of consecutive admissions to GP hospitals during 8 weeks. SETTING: Fifteen out of 16 GP hospitals in Finnmark county, Norway. SUBJECTS: Seventy-three patients transferred to higher level hospitals from a total of 395 admitted to GP hospitals. MAIN OUTCOME MEASURES: Three outcome categories were considered for each patient: "possible permanent health loss", "possible significantly prolonged or aggravated disease course", and "possible favourable effect on the disease course". RESULTS: There was agreement about the possibility of negative effects in two patients (2.7%), while a possible favourable influence was ascribed to six cases (8.2%). CONCLUSION: Negative health effects due to transitory stays in GP hospitals are uncommon and moderate, and balanced by benefits, particularly with regard to early access to life saving treatment for critically ill patients.
PubMed ID
9689683 View in PubMed
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Prevalence and clinical associations of wheezes and crackles in the general population: the Tromsø study.

https://arctichealth.org/en/permalink/ahliterature309052
Source
BMC Pulm Med. 2019 Sep 11; 19(1):173
Publication Type
Journal Article
Date
Sep-11-2019
Author
J C Aviles-Solis
C Jácome
A Davidsen
R Einarsen
S Vanbelle
H Pasterkamp
H Melbye
Author Affiliation
General Practice Research Unit, Department of Community Medicine, UIT the Arctic University of Norway, Tromsø, Norway. juan.c.solis@uit.no.
Source
BMC Pulm Med. 2019 Sep 11; 19(1):173
Date
Sep-11-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Auscultation
Cardiovascular Diseases - physiopathology
Cross-Sectional Studies
Exhalation
Female
Humans
Inhalation
Logistic Models
Lung Diseases - physiopathology
Male
Middle Aged
Multivariate Analysis
Norway - epidemiology
Prevalence
Respiratory Sounds
Sex Distribution
Smoking - physiopathology
Abstract
Wheezes and crackles are well-known signs of lung diseases, but can also be heard in apparently healthy adults. However, their prevalence in a general population has been sparsely described. The objective of this study was to determine the prevalence of wheezes and crackles in a large general adult population and explore associations with self-reported disease, smoking status and lung function.
We recorded lung sounds in 4033 individuals 40?years or older and collected information on self-reported disease. Pulse oximetry and spirometry were carried out. We estimated age-standardized prevalence of wheezes and crackles and associations between wheezes and crackles and variables of interest were analyzed with univariable and multivariable logistic regressions.
Twenty-eight percent of individuals had wheezes or crackles. The age-standardized prevalence of wheezes was 18.6% in women and 15.3% in men, and of crackles, 10.8 and 9.4%, respectively. Wheezes were mostly found during expiration and crackles during inspiration. Significant predictors of expiratory wheezes in multivariable analyses were age (10?years increase - OR 1.18, 95%CI 1.09-1.30), female gender (1.45, 1.2-1.8), self-reported asthma (1.36, 1.00-1.83), and current smoking (1.70, 1.28-2.23). The most important predictors of inspiratory crackles were age (1.76, 1.57-1.99), current smoking, (1.94, 1.40-2.69), mMRC =2 (1.79, 1.18-2.65), SpO2 (0.88, 0.81-0.96), and FEV1 Z-score (0.86, 0.77-0.95).
Nearly over a quarter of adults present adventitious lung sounds on auscultation. Age was the most important predictor of adventitious sounds, particularly crackles. The adventitious sounds were also associated with self-reported disease, current smoking and measures of lung function. The presence of findings in two or more auscultation sites was associated with a higher risk of decreased lung function than solitary findings.
PubMed ID
31511003 View in PubMed
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17 records – page 1 of 2.