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Access to and continuity of primary medical care of different providers as perceived by the Finnish population.

https://arctichealth.org/en/permalink/ahliterature164689
Source
Scand J Prim Health Care. 2007 Mar;25(1):27-32
Publication Type
Article
Date
Mar-2007
Author
Pekka Mäntyselkä
Pirjo Halonen
Arto Vehviläinen
Jorma Takala
Esko Kumpusalo
Author Affiliation
Department of Public Health and Clinical Nutrition, Unit of Family Practice, University of Kuopio, Kuopio, Finland. pekka.mantyselka@uku.fi
Source
Scand J Prim Health Care. 2007 Mar;25(1):27-32
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Chronic Disease - therapy
Community Health Centers - standards - statistics & numerical data
Continuity of Patient Care
Family Practice - standards - statistics & numerical data
Finland
Health Services Accessibility
Humans
Middle Aged
Occupational Health Services - standards - statistics & numerical data
Patient satisfaction
Primary Health Care - standards - statistics & numerical data
Private Sector
Public Sector
Questionnaires
Abstract
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.
Finland.
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.
Notes
Cites: Fam Pract. 2000 Jun;17(3):236-4210846142
Cites: Br J Gen Pract. 2000 Nov;50(460):882-711141874
Cites: Scand J Prim Health Care. 2001 Jun;19(2):131-4411482415
Cites: Br J Gen Pract. 2002 Jun;52(479):459-6212051209
Cites: Health Serv Res. 2002 Oct;37(5):1403-1712479503
Cites: Scand J Prim Health Care. 2006 Sep;24(3):140-416923622
Cites: Scand J Prim Health Care. 1992 Dec;10(4):290-41480869
Cites: J Fam Pract. 2004 Dec;53(12):974-8015581440
Cites: CMAJ. 2006 Jan 17;174(2):177-8316415462
Cites: Scand J Prim Health Care. 2006 Mar;24(1):1-216464807
Cites: Ann Fam Med. 2003 Sep-Oct;1(3):149-5515043376
PubMed ID
17354156 View in PubMed
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Compliance with Baby-Friendly policies and practices in hospitals and community health centers in Quebec.

https://arctichealth.org/en/permalink/ahliterature122146
Source
J Hum Lact. 2012 Aug;28(3):343-58
Publication Type
Article
Date
Aug-2012
Author
Laura N Haiek
Author Affiliation
Ministère de la Santé et des Services sociaux, Montreal, QC, Canada. laura.haiek@msss.gouv.qc.ca
Source
J Hum Lact. 2012 Aug;28(3):343-58
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Adult
Birthing Centers - standards - statistics & numerical data
Breast Feeding - statistics & numerical data
Community Health Centers - standards - statistics & numerical data
Cross-Sectional Studies
Delivery Rooms - standards - statistics & numerical data
Female
Guideline Adherence - statistics & numerical data
Health Policy
Humans
Infant Care - methods - standards
Infant Formula
Infant, Newborn
Male
Marketing
Maternal Health Services - methods - standards
Practice Guidelines as Topic
Pregnancy
Program Evaluation
Quebec
United Nations
World Health Organization
Abstract
Since 2001, Quebec's ministry of health and social services has prioritized implementation of the Baby-Friendly Initiative (BFI), which includes the original hospital initiative and its expansion to community services.
The objective was to document across the province compliance with the BFI's Ten Steps to Successful Breastfeeding in hospitals, Seven Point Plan in community health centers (CHCs), and International Code of Marketing of Breast-Milk Substitutes (Code).
Using managers/staff, mothers, and observers, the author measured the extent of implementation of indicators formulated for each step/point and the Code, based on the revised WHO/UNICEF recommendations.
Mean compliance scores in Quebec were 3.13 for 140 CHCs (range, 0 to 7) and 4.54 for 60 hospitals/birthing centers (range, 0 to 10). The mean compliance score for the Code was 0.69 for both CHCs and hospitals/birthing centers. The evaluation documented marked variations in implementation level for each of the steps/points and the Code. Also, managers/staff, mothers, and observers differed in their report of BFI compliance for most steps/points and the Code. Facilities that had applied for or obtained BFI designation demonstrated higher compliance with the BFI than those that had not.
Results disseminated to participating organizations allowed comparisons on a regional/provincial perspective and in relation to BFI-designated facilities. Furthermore, this first portrait of BFI compliance in Quebec provided provincial, regional, and local health authorities with valuable information that can be used to bring about policy and organizational changes to achieve the international standards required for Baby-Friendly certification.
PubMed ID
22843803 View in PubMed
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Drug utilization 90%--a simple method for assessing the quality of drug prescribing.

https://arctichealth.org/en/permalink/ahliterature205410
Source
Eur J Clin Pharmacol. 1998 Apr;54(2):113-8
Publication Type
Article
Date
Apr-1998
Author
U. Bergman
C. Popa
Y. Tomson
B. Wettermark
T R Einarson
H. Aberg
F. Sjöqvist
Author Affiliation
Karolinska Institute, Department of Medical Laboratory Sciences & Technology, WHO Collaborating Centre for Drug Utilization Research, Huddinge University Hospital, Sweden. ulf.bergman@pharmlab.hs.sll.se
Source
Eur J Clin Pharmacol. 1998 Apr;54(2):113-8
Date
Apr-1998
Language
English
Publication Type
Article
Keywords
Catchment Area (Health)
Community Health Centers - standards - statistics & numerical data
Drug Costs - statistics & numerical data
Drug Prescriptions - standards - statistics & numerical data
Drug Utilization Review - economics - standards - statistics & numerical data
European Union
Family Practice - economics - standards - statistics & numerical data
Guideline Adherence - statistics & numerical data
Humans
Quality Assurance, Health Care - methods
Reference Standards
Sweden
Abstract
To describe a simple method for assessing the quality of drug prescribing.
We tested the idea that the number of drugs accounting for 90% of drug use--drug utilization 90% (DU90%)--may serve as an indicator of the quality of drug prescribing. We ranked the drugs by volume of defined daily doses (DDD) and determined how many drugs accounted for the DU90% segment. We also compared this segment with the pharmacotherapeutic guidelines issued by the Regional (local) Drug Committee to determine the adherence to its recommendations (index of adherence). The cost per DDD within the DU90% segment and for the remaining 10% was also calculated. The utilization of drugs based on prescriptions purchased during April 1995 was determined for 24 primary health care (PHC) centres in southwestern Stockholm.
The number of different products, defined as all products marketed under a single brand name within an ATC (anatomic therapeutic chemical) category, in the DU90% segment varied twofold (81-164) between the 24 PHC centres. Differences in the number of GPs per PHC centre accounted for a third of this variation. The compliance with the Drug Committee recommendations varied between 54% and 78%. There was no relationship between the number of products accounting for the DU90% segment and the adherence to local prescription guidelines, i.e. prescribing more products did not increase the adherence. The costs for the DU90% drugs varied from 2.26 SEK/DDD in one PHC centre to 3.75 in another one, with an average cost of 2.87 SEK/DDD, while for the remaining 10% it was the double (6:54 SEK/DDD). In all, the DU90% drugs made up 80.8% of the total cost as compared with 19.2% for the remaining 10%. In the DU90% segment, there was no clear relationship between adherence to the guidelines and the cost/DDD, i.e. following the evidence-based guidelines appeared to provide a higher quality of prescribing rather than cheaper prescribing.
The DU90% is an inexpensive, flexible, and simple method for assessing the quality of drug prescribing in routine health care. The number of products in the DU90% segment and adherence to prescription guidelines may serve as general quality indicators. The method may be adapted to provide comparative data between PHC centres, hospitals, regions etc. that may be cross-sectional and longitudinal. Other quality criteria, specific for each class of drugs, should complement these general indicators.
PubMed ID
9626914 View in PubMed
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