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13 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
Less detail

Are general practitioner hospitals cost-saving? Evidence from a rural area of Norway.

https://arctichealth.org/en/permalink/ahliterature72617
Source
Fam Pract. 1997 Oct;14(5):397-402
Publication Type
Article
Date
Oct-1997
Author
I. Aaraas
H. Søråsdekkan
I S Kristiansen
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Fam Pract. 1997 Oct;14(5):397-402
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cost Savings - statistics & numerical data
Costs and Cost Analysis
Cross-Sectional Studies
Family Practice - economics - organization & administration
Female
Health Care Surveys
Hospital Costs - statistics & numerical data
Hospitals, General - economics - organization & administration
Hospitals, Rural - economics
Humans
Male
Middle Aged
Norway
Primary Health Care - economics - organization & administration
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVE: We aimed to determine whether general practitioner GP hospitals, compared with alternative modes of health care, are cost-saving. METHODS: Based on a study of admissions (n = 415) to fifteen GP hospitals in the Finnmark county of Norway during 8 weeks in 1992, a full 1-year patient throughput in GP hospitals was estimated. The alternative modes of care (general hospital, nursing home or home care) were based on assessments by the GPs handling the individual patients. The funds transferred to finance GP hospitals were taken as the cost of GP hospitals, while the cost of alternative care was based on municipality and hospital accounts, and standard charges for patient transport. RESULTS: The estimated total annual operating cost of GP hospitals was 32.2 million NOK (10 NOK = 1 Pound) while the cost of alternative care was in total 35.9 million NOK. Sensitivity analyses, under a range of assumptions, indicate that GP care in hospitals incurs the lowest costs to society. CONCLUSION: GP hospitals are likely to provide health care at lower costs than alternative modes of care.
PubMed ID
9472375 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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The Finnmark general practitioner hospital study. Patient characteristics, patient flow and alternative care level.

https://arctichealth.org/en/permalink/ahliterature35079
Source
Scand J Prim Health Care. 1995 Dec;13(4):250-6
Publication Type
Article
Date
Dec-1995
Author
I. Aaraas
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Scand J Prim Health Care. 1995 Dec;13(4):250-6
Date
Dec-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Family Practice - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Hospitals, Group Practice - utilization
Humans
Infant
Length of Stay
Male
Middle Aged
Norway
Patient transfer
Physician's Practice Patterns
Prospective Studies
Referral and Consultation - statistics & numerical data
Research Support, Non-U.S. Gov't
Rural Health
Utilization Review
Abstract
OBJECTIVES: In a study assessing the role of general practitioner hospitals (GPHs) in the health service two main questions were addressed: 1) Are general practitioner beds used for short-term medical observations, or as a supplement for long-term geriatric care? 2) What are the alternatives to stays in GPHs? DESIGN: In a prospective design GPH stays during 8 weeks were recorded. SETTING: 15 GPH units in Finnmark county in Norway. SUBJECTS: 395 completed stays were recorded. MAIN OUTCOME MEASURES: The patients' sex, age and diagnosis, flow of patients, length of stays, bed occupancy rate, and doctors' assessments of alternative level of care. RESULTS: 60% of the patients were admitted from and discharged to their home after a mean stay of 6.8 days. The 19% who were transferred to higher level hospitals stayed significantly shorter than the rest (3.6 days), while 9% transferred from hospital stayed significantly longer (22.3 days). Of the 395 patients discharged 61% were assessed as candidates for higher level hospitals, if GPHs did not exist. 45% of the GPH stays seem to replace higher level hospital admissions. CONCLUSION: The GPHs have a pre-hospital "buffer" function by preventing patients with acute symptoms from being unnecessarily admitted to general hospitals through short-term observation stays. A post-hospital function was also demonstrated, since GPHs allow for long-term follow up stays for patients transferred from general hospitals.
PubMed ID
8693208 View in PubMed
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GPs' motives for referrals to general hospitals: does access to GP hospital beds make any difference?

https://arctichealth.org/en/permalink/ahliterature204901
Source
Fam Pract. 1998 Jun;15(3):252-8
Publication Type
Article
Date
Jun-1998
Author
I. Aaraas
K. Fylkesnes
O H Førde
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Fam Pract. 1998 Jun;15(3):252-8
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Decision Making
Family Practice
Female
Hospitals, General - statistics & numerical data
Humans
Logistic Models
Male
Middle Aged
Motivation
Norway
Odds Ratio
Patient Admission - statistics & numerical data
Referral and Consultation - statistics & numerical data
Abstract
We aimed to explore the relative impact of medical and other situational motives on GP's decisions to refer patients to specialist care in a general hospital, and to assess whether having access to a GP hospital influences the decisions.
We carried out a prospective study of consecutive doctor-patient contacts during one week. The effects of main motives, medical, social/nursing, general hospital advice, distance from the nearest general hospital and access to GP hospitals on referral decisions were explored by logistic regression. The motives for different referral decisions were also explored through frequency analyses. The study was set in general practices in the county of Finnmark in North Norway, which included 40 GPs from rural practices with access to a GP hospital and eight GPs working closer to a general hospital without access to GP hospital. We studied 2496 doctor-patient contacts, which resulted in 411 patients being considered for any kind of referral, of which 205 were referred to the general hospital.
Medical needs were recorded as the only referral motive of major importance in about half of the cases considered for referral, while additional motives were recorded in the other half. The rationale for admissions to general hospitals and GP hospitals (in-patient care) was compatible in terms of the relative importance of the medical arguments. The GP hospital option was mainly chosen because of the long distance from the general hospital, nursing needs and the preferences of the patient and the family, and resulted in a lower proportion of patients being referred to general hospitals from GPs with access to a GP hospital.
Medical motives dominate the decision to refer patients to general hospitals, but access to a GP hospital, in cases where nursing needs and long distances to the general hospital are supplementary considerations, reduces the proportion of patients being referred to general hospitals.
PubMed ID
9694183 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
Less detail

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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[Organization of general practice in an integrated health and social service center. Evaluation of an appointment system].

https://arctichealth.org/en/permalink/ahliterature245532
Source
Tidsskr Nor Laegeforen. 1980 Aug 20;100(23):1362-5
Publication Type
Article
Date
Aug-20-1980

[The cottage hospital model, a key to better cooperation in health care--let the cottage hospital survive!]

https://arctichealth.org/en/permalink/ahliterature20464
Source
Tidsskr Nor Laegeforen. 2000 Feb 28;120(6):702-5
Publication Type
Article
Date
Feb-28-2000
Author
I. Aaraas
E. Langfeldt
G. Ersdal
D. Haga
Author Affiliation
Institutt for samfunnsmedisin, Universitetet i Tromsø.
Source
Tidsskr Nor Laegeforen. 2000 Feb 28;120(6):702-5
Date
Feb-28-2000
Language
Norwegian
Publication Type
Article
Keywords
Community Health Services - economics - statistics & numerical data - trends
English Abstract
Family Practice - economics - statistics & numerical data - trends
Hospitals, Rural - economics - statistics & numerical data - trends
Humans
Length of Stay
Models, organizational
Norway
Nursing Homes - economics - statistics & numerical data - trends
Patient Admission
Primary Health Care - economics - statistics & numerical data - trends
Abstract
The cottage hospital model may be defined as an intermediary service between primary care and the general hospital. On the basis of experience and studies from Finnmark county, the northern-most county in Norway, this article makes a case for a revival of the cottage hospitals. They may improve comprehensive patient care and cooperation between care levels, to the benefit of groups of patients who often are in a squeeze between care levels: the elderly, the chronically ill, and the severely ill and dying patients. The cottage hospitals may also contribute to strengthening the chain of service in acute medicine. The professional challenges of work in a cottage hospital may attract practitioners to primary health care. We suggest that 1% of the funds set aside for ongoing national programmes for the elderly, in cancer care and mental illnesses are used for cottage hospital beds, as this may contribute to increasing the viability of these programmes. The extra cost upgrading 1,000 of a total of 27,000 nursing home beds in Norway to cottage hospital standard is estimated to be modest.
PubMed ID
10806884 View in PubMed
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13 records – page 1 of 2.