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Analysis of after-hours calls and visits in a family practice.

https://arctichealth.org/en/permalink/ahliterature247987
Source
J Fam Pract. 1978 Dec;7(6):1185-90
Publication Type
Article
Date
Dec-1978
Author
B D Koffman
K. Merritt
Source
J Fam Pract. 1978 Dec;7(6):1185-90
Date
Dec-1978
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Ambulatory Care Facilities - utilization
Child
Child, Preschool
Family Practice
Female
Health Services Accessibility
Humans
Infant
Infant, Newborn
Male
Middle Aged
Ontario
Physicians, Family
Telephone
Time Factors
Abstract
The after-hours encounter is an important aspect of primary care. This study examined the pattern of patient behavior after hours in a rural Ontario setting serving a mixed white and native population. Of the 83 telephone calls and 59 visits over a six-week period, approximately 60 percent were from females (52 percent of the clinic population), and 70 percnet were for new problems, with acute infection accounting for nearly one third of the contacts. Forty-seven percent of the calls were rated as highly necessary; 56 percent of the calls received visits. The following factors related to the preceding call increased the likelihood of a visit: (1) an early evening call; (2) a high necessity rating; (3) a classification of trauma: (4) caller at the limit of tolerance of symptoms: (5) white caller. The significance of the results and their implications are discussed.
PubMed ID
748492 View in PubMed
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Are there sex-related differences in specialized, multidisciplinary congestive heart failure clinics?

https://arctichealth.org/en/permalink/ahliterature163686
Source
Can J Cardiol. 2007 May 1;23(6):451-5
Publication Type
Article
Date
May-1-2007
Author
Stefanie Houde
Debbie Ehrmann Feldman
Louise Pilote
Eduard J Beck
Nadia Giannetti
Marc Frenette
Anique Ducharme
Author Affiliation
Université de Montréal, Montréal, Canada.
Source
Can J Cardiol. 2007 May 1;23(6):451-5
Date
May-1-2007
Language
English
Publication Type
Article
Keywords
Aged
Ambulatory Care Facilities - utilization
Cardiology
Female
Heart Failure - epidemiology - etiology - physiopathology - prevention & control
Humans
Male
Middle Aged
Patient Admission - statistics & numerical data
Patient care team
Quebec - epidemiology
Risk factors
Severity of Illness Index
Sex Factors
Ventricular Dysfunction, Left - physiopathology
Abstract
Specialized, multidisciplinary clinics improve service provision and reduce morbidity for patients with congestive heart failure (CHF). Although sex-related differences in access to cardiac health services have been reported, it remains unclear whether there are sex-related differences in the use of these specialized services.
To evaluate possible sex-related differences in severity at entry into specialized, multidisciplinary clinics, and compare prescription patterns between male and female patients at these clinics.
Data were obtained from the electronic clinical files of 765 CHF patients newly admitted to any of three main CHF clinics in Montreal, Quebec. Univariate and multivariate models were used to compare differences between sexes.
Only 27.1% of patients were female. The mean age (+/- SD) of the women in the present study was similar to that of the men (64+/-16 years versus 65+/-13 years, respectively). Left ventricular ejection fraction at entry for patients with reduced systolic function was comparable between sexes. The New York Heart Association functional class at entry was similar among men and women with systolic dysfunction. However, among patients with preserved systolic function, women were more symptomatic, with a higher functional class at entry (adjusted OR 2.52, 95% CI 1.18 to 5.38). Prescription profiles were similar for men and women.
Entry into a clinic may be delayed for women with preserved systolic function CHF. However, clinic referral patterns and disease management appeared to be similar among both men and women with systolic dysfunction CHF.
Notes
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PubMed ID
17487289 View in PubMed
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Camp health center usage at a Scout jamboree.

https://arctichealth.org/en/permalink/ahliterature119761
Source
Nursing. 2012 Nov;42(11):17-22
Publication Type
Article
Date
Nov-2012
Author
Christopher R Stephens
Author Affiliation
Sheldon M. Chumir Health Centre, Alberta Health Services, in Calgary, Alberta, Canada.
Source
Nursing. 2012 Nov;42(11):17-22
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Ambulatory Care Facilities - utilization
Camping
Canada - epidemiology
Child
Female
Humans
Incidence
Male
Middle Aged
Office visits - statistics & numerical data
Retrospective Studies
Therapeutics - statistics & numerical data
Wounds and Injuries - epidemiology - therapy
Abstract
To describe the incidence, reasons for, and characteristics of health center visits by campers at a Canadian provincial Scout jamboree.
A retrospective observational design utilized a medical record review process. The study sample was 804 campers present for 4,816 camper days (CDs).
There were 172 visits to the camp health center for an incidence rate of 36 per 1,000 CDs. The median length of stay was 30 minutes. Patients with illnesses were seen 1.7 times more frequently than those with injuries. One in five visits was for follow-up. More than 97% of visits occurred during the scheduled health center hours of operation. The rate of adverse events (AEs) was 3.32 per 1,000 CDs, accounting for 9.3% of all visits.
The incidence of health center visits and AEs are consistent with studies conducted with other resident camps. Camp administrators, organizers, and healthcare personnel must be prepared to provide care for a wide range of illnesses and injuries at camp. Understanding the trends associated with camp health center usage allows adequate personnel and physical resources to be prepared and identifies increased usage levels. Nurses can use this information to advocate for nurses to be employed at camps to aid in health prevention services as well as to manage illnesses and injuries.
PubMed ID
23076313 View in PubMed
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A Canadian urban early pregnancy assessment clinic: a review of the first year of operation.

https://arctichealth.org/en/permalink/ahliterature126484
Source
J Obstet Gynaecol Can. 2012 Mar;34(3):243-9
Publication Type
Article
Date
Mar-2012
Author
Stephanie A Rhone
Zoë G Hodgson
Arezu Moshrefzadeh
Catherine Maurer
Author Affiliation
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
Source
J Obstet Gynaecol Can. 2012 Mar;34(3):243-9
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Ambulatory Care Facilities - utilization
British Columbia
Female
Humans
Middle Aged
Patient satisfaction
Pregnancy
Pregnancy Complications - diagnosis - therapy
Retrospective Studies
Young Adult
Abstract
To review the services provided by an early pregnancy assessment clinic (EPAC) in Vancouver, British Columbia, and to assess the characteristics of the women accessing their services and their satisfaction with the care provided.
The EPAC at BC Women's Hospital and Health Centre was opened in September 2007 to offer assessment of early pregnancy complications and management of early pregnancy loss. We conducted a review of the records of all patients who accessed the clinic in its first year of operation to review the origin of referrals, patient assessments, diagnoses, treatment, complications, and follow-up. Additionally, we distributed satisfaction surveys to patients.
A total of 411 patients were referred to the EPAC in its first year of operation. Most referrals were from family physicians (38%), and the primary reason for referral was most commonly cramping and/or spotting (57%). The mean wait time for patients to be seen was 2.02 working days, and the majority of women (91%) were given a diagnosis at their first clinic visit. After assessment, 48% of women had manual vacuum aspiration or dilatation and curettage arranged, 21% had expectant management, and 17% required no treatment, because of complete miscarriage. While 94% of patients with non-viable pregnancies were treated at EPAC, 6% were referred to other health care agencies. In the satisfaction surveys completed, comments about the EPAC were largely positive and primarily focused on the emotional support and level of care received.
In its first year of operation, the EPAC was well used and provided efficient and compassionate care. Patients reported high satisfaction with the quality of care received from staff, and showed particular appreciation for the emotional care received.
PubMed ID
22385667 View in PubMed
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Complementary and alternative medicine use among patients presenting to a pediatric otolaryngology clinic.

https://arctichealth.org/en/permalink/ahliterature116106
Source
Int J Pediatr Otorhinolaryngol. 2013 May;77(5):721-5
Publication Type
Article
Date
May-2013
Author
M Elise Graham
Maria K Brake
S Mark Taylor
Gordon Flowerdew
Paul Hong
Author Affiliation
IWK Health Centre, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Source
Int J Pediatr Otorhinolaryngol. 2013 May;77(5):721-5
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Ambulatory Care Facilities - utilization
Canada
Caregivers - statistics & numerical data
Child
Child, Preschool
Complementary Therapies - statistics & numerical data - utilization
Data Collection
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Otolaryngology - statistics & numerical data
Pediatrics - statistics & numerical data
Questionnaires
Young Adult
Abstract
This study sought to quantify and characterize complementary and alternative medicine (CAM) use among patients presenting to a pediatric otolaryngology clinic with the aim of increasing CAM use awareness for the practicing pediatric otolaryngologist.
Four hundred thirty-four caregivers of patients presenting to a pediatric otolaryngology clinic were surveyed regarding their child's use of CAMs. Demographic information, perceived benefits, and sources of information regarding CAM was collected. Spearman correlation coefficient was used to assess strength of associations.
Three-hundred and sixty-four caregivers completed the survey (83.9% response rate). The children of 69% of respondents had utilized CAM, and 46% were using CAM at the time of the survey. Higher income and chronic illness in the child were significant predictors of CAM use. The children of older and married parents were more likely to have utilized CAM (non-significant). The most common agents were multivitamins (43%) and vitamin D (32%). Parents whose children used more CAMs were more likely to perceive a benefit.
A significant proportion of pediatric otolaryngology patients utilized CAM in our study population. The most commonly used agents are mostly benign, but others may have more unknown consequences. It is crucial that otolaryngologists ask specifically about these agents, as they potentially interact with prescription medications and some may lead to surgical complications.
PubMed ID
23433921 View in PubMed
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Correlates of a "do not hospitalize" designation: in a sample of frail nursing home residents in Vancouver.

https://arctichealth.org/en/permalink/ahliterature139319
Source
Can Fam Physician. 2010 Nov;56(11):1158-64
Publication Type
Article
Date
Nov-2010
Author
Margaret McGregor
Dan Pare
Areta Wong
Michelle B Cox
Penny Brasher
Author Affiliation
Centre for Clinical Epidemiology & Evaluation, Department of Family Practice, Room 713, 828 West 10th, Vancouver, BC V5Z 1L8. mrgret@interchange.ubc.ca
Source
Can Fam Physician. 2010 Nov;56(11):1158-64
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Ambulatory Care Facilities - utilization
British Columbia
Cohort Studies
Comorbidity
Continuity of Patient Care
Female
Frail Elderly - statistics & numerical data
Health Services - utilization
Hospitalization - statistics & numerical data
Humans
Male
Nursing Homes - utilization
Outcome Assessment (Health Care)
Patient Admission
Patient transfer
Physician-Patient Relations
Proportional Hazards Models
Utilization Review
Abstract
To explore what nursing home resident demographic, clinical, functional, and health services utilization characteristics influence a "do not hospitalize" designation.
Historical cohort study.
Vancouver, BC.
Extended care residents in 2 hospital-based and 4 free-standing nursing homes who died between 2001 and 2007.
The designation of "do not hospitalize" on a resident's chart.
Continuity of family physician care from admission to death (adjusted hazard ratio [AHR] 2.16, 95% confidence interval [CI] 1.33 to 3.49), a sudden and unexpected death (AHR 0.43, 95% CI 0.25 to 0.73), and age (AHR 1.02, 95% CI 1.01 to 1.02) were independently associated with a "do not hospitalize" designation.
The greater than 2-fold positive association of continuity of family physician care with a "do not hospitalize" designation is an interesting addition to the literature on how continuity of physician care matters.
Notes
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PubMed ID
21075999 View in PubMed
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A descriptive study of continuity of care as an element in the process of ambulatory medical care utilization.

https://arctichealth.org/en/permalink/ahliterature230510
Source
Can J Public Health. 1989 Jul-Aug;80(4):249-54
Publication Type
Article
Author
F. Béland
Source
Can J Public Health. 1989 Jul-Aug;80(4):249-54
Language
English
Publication Type
Article
Keywords
Aged
Ambulatory Care Facilities - utilization
Continuity of Patient Care
Female
Humans
Male
Middle Aged
Office visits - statistics & numerical data
Primary Health Care
Quebec
Abstract
Continuity of care is one of the components of the medical care utilization process. This process includes a number of components. Here two of these other components are considered so that variations in the continuity of care may be studied: the volume of utilization and the regularity of utilization. Volume of utilization is the number of visits to physicians in a period of time, while regularity of utilization is the extent to which an individual visits physicians at regular intervals. When data on utilization from an administrative data file were used, analysis showed that continuity varied with the volume and regularity of use. Sex, a diagnosis of chronic illness, visits to specialists and age were introduced as predictors of continuity, given the levels of both volume and regularity of utilization. Sex did not have any effect on continuity. Age had an effect only for individuals with a low volume of utilization. Continuity scores varied for chronic illness only if use of medical care was regular, while it varied for physician specialty only for those with few visits. An interaction effect of chronic illness with the specialty of the physician was also identified.
PubMed ID
2790631 View in PubMed
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Differences between women who begin pill use before and after first intercourse: Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature245314
Source
Fam Plann Perspect. 1980 Nov-Dec;12(6):304-5
Publication Type
Article

Effects of obtaining a blood culture on subsequent management of young febrile children without an evident focus of infection.

https://arctichealth.org/en/permalink/ahliterature236292
Source
CMAJ. 1986 Nov 15;135(10):1125-9
Publication Type
Article
Date
Nov-15-1986
Author
M S Kramer
E L Mills
A M MacLellan
P J Coates
Source
CMAJ. 1986 Nov 15;135(10):1125-9
Date
Nov-15-1986
Language
English
Publication Type
Article
Keywords
Ambulatory Care Facilities - utilization
Anti-Bacterial Agents - therapeutic use
Blood - microbiology
Child Health Services - utilization
Child, Preschool
Clinical Laboratory Techniques - utilization
Clinical Trials as Topic
Costs and Cost Analysis
Diagnostic Tests, Routine - economics
Emergency Service, Hospital
Female
Fever - etiology
Follow-Up Studies
Hematologic Tests - utilization
Hospitalization - utilization
Humans
Infant
Male
Physician's Practice Patterns
Quebec
Random Allocation
Sepsis - diagnosis
Abstract
To assess the effects of obtaining a blood culture on the subsequent diagnostic and therapeutic management of young febrile children without an evident focus of bacterial infection, we carried out a randomized controlled clinical trial of this procedure in 146 children 3 to 24 months of age who presented to our emergency department with an unexplained temperature of 39.0 degrees C or higher. Random assignment to either have (67 children) or not have (79) a blood sample taken for culture resulted in groups equivalent in age, sex, weight, socioeconomic status, temperature at enrolment and laboratory test results. No differences were detected in the rates of subsequent hospital admission, outpatient visits, determination of complete blood count or other blood tests, urinalysis or urine culture, chest or other roentgenography, or administration of antibiotics or other medications. Knowledge of the absence of such differences should be helpful in evaluating the relative benefits and costs of blood culture for young febrile children.
Notes
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PubMed ID
3533243 View in PubMed
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49 records – page 1 of 5.