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Accuracy of syndrome definitions based on diagnoses in physician claims.

https://arctichealth.org/en/permalink/ahliterature138094
Source
BMC Public Health. 2011;11:17
Publication Type
Article
Date
2011
Author
Geneviève Cadieux
David L Buckeridge
André Jacques
Michael Libman
Nandini Dendukuri
Robyn Tamblyn
Author Affiliation
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. genevieve.cadieux@mail.mcgill.ca
Source
BMC Public Health. 2011;11:17
Date
2011
Language
English
Publication Type
Article
Keywords
Clinical Coding - methods
Community Health Services - utilization
Data Collection
Diagnostic Techniques and Procedures - standards
Exanthema - classification - diagnosis
Female
Fever - classification - diagnosis
Humans
International Classification of Diseases
Male
Nervous System Diseases - classification - diagnosis
Office Visits - utilization
Population Surveillance - methods
Quebec
Registries
Respiratory Tract Infections - classification - diagnosis
Sensitivity and specificity
Abstract
Community clinics offer potential for timelier outbreak detection and monitoring than emergency departments. However, the accuracy of syndrome definitions used in surveillance has never been evaluated in community settings. This study's objective was to assess the accuracy of syndrome definitions based on diagnostic codes in physician claims for identifying 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory including influenza-like illness) in community clinics.
We selected a random sample of 3,600 community-based primary care physicians who practiced in the fee-for-service system in the province of Quebec, Canada in 2005-2007. We randomly selected 10 visits per physician from their claims, stratifying on syndrome type and presence, diagnosis, and month. Double-blinded chart reviews were conducted by telephone with consenting physicians to obtain information on patient diagnoses for each sampled visit. The sensitivity, specificity, and positive predictive value (PPV) of physician claims were estimated by comparison to chart review.
1,098 (30.5%) physicians completed the chart review. A chart entry on the date of the corresponding claim was found for 10,529 (95.9%) visits. The sensitivity of syndrome definitions based on diagnostic codes in physician claims was low, ranging from 0.11 (fever) to 0.44 (respiratory), the specificity was high, and the PPV was moderate to high, ranging from 0.59 (fever) to 0.85 (respiratory). We found that rarely used diagnostic codes had a higher probability of being false-positives, and that more commonly used diagnostic codes had a higher PPV.
Future research should identify physician, patient, and encounter characteristics associated with the accuracy of diagnostic codes in physician claims. This would enable public health to improve syndromic surveillance, either by focusing on physician claims whose diagnostic code is more likely to be accurate, or by using all physician claims and weighing each according to the likelihood that its diagnostic code is accurate.
Notes
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PubMed ID
21211054 View in PubMed
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Acupuncture for substance abuse treatment in the Downtown Eastside of Vancouver.

https://arctichealth.org/en/permalink/ahliterature174951
Source
J Urban Health. 2005 Jun;82(2):285-95
Publication Type
Article
Date
Jun-2005
Author
Patricia A Janssen
Louise C Demorest
Elizabeth M Whynot
Author Affiliation
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada V62-1Y6. pjanssen@interchange.ubc.ca
Source
J Urban Health. 2005 Jun;82(2):285-95
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Acupuncture Therapy - utilization
Adolescent
Adult
Aged
Aged, 80 and over
British Columbia
Charities
Community Health Services - utilization
Humans
Middle Aged
Poverty Areas
Questionnaires
Substance Abuse Treatment Centers
Substance-Related Disorders - ethnology - prevention & control - therapy
Transients and Migrants - statistics & numerical data
Urban health
Urban Health Services - utilization
Abstract
In British Columbia, Canada, the City of Vancouver's notorious Downtown Eastside (DES) represents the poorest urban population in Canada. A prevalence rate of 30% for HIV and 90% for hepatitis C makes this a priority area for public-health interventions aimed at reducing the use of injected drugs. This study examined the utility of acupuncture treatment in reducing substance use in the marginalized, transient population. Acupuncture was offered on a voluntary, drop-in basis 5 days per week at two community agencies. During a 3-month period, the program generated 2,755 client visits. A reduction in overall use of substances (P=.01) was reported by subjects in addition to a decrease in intensity of withdrawal symptoms including "shakes," stomach cramps, hallucinations, "muddle-headedness," insomnia, muscle aches, nausea, sweating, heart palpitations, and feeling suicidal, P
Notes
Cites: J Subst Abuse Treat. 1994 May-Jun;11(3):205-158072048
Cites: J Subst Abuse Treat. 1994 Jul-Aug;11(4):289-3077966500
Cites: J Addict Dis. 1994;13(3):71-997734461
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Cites: J Affect Disord. 2000 Jan-Mar;57(1-3):73-8110708818
Cites: J Subst Abuse Treat. 1993 Jul-Aug;10(4):345-518411294
Cites: JAMA. 2002 Jan 2;287(1):55-6311754709
Cites: CMAJ. 2003 Jan 7;168(1):19-2412515780
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Cites: Bull Narc. 1988;40(1):35-413219455
Cites: J Subst Abuse Treat. 1995 Nov-Dec;12(6):401-138749724
Cites: Arch Intern Med. 2000 Aug 14-28;160(15):2305-1210927727
PubMed ID
15872191 View in PubMed
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[Analysis of a health-deputizing service]

https://arctichealth.org/en/permalink/ahliterature41019
Source
Tidsskr Nor Laegeforen. 1980 May 20;100(14):967-70
Publication Type
Article
Date
May-20-1980
Author
N. Johnsen
D. Bruusgaard
Source
Tidsskr Nor Laegeforen. 1980 May 20;100(14):967-70
Date
May-20-1980
Language
Norwegian
Publication Type
Article
Keywords
Aged
Child
Community Health Services - utilization
English Abstract
Humans
Norway
Physicians, Family
PubMed ID
7404548 View in PubMed
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[Are gallstone diseases decreasing in the community?]

https://arctichealth.org/en/permalink/ahliterature74262
Source
Nord Med. 1984;99(6-7):170-3
Publication Type
Article
Date
1984

Aspects of healthcare utilisation in self-reported obstructive lung disease.

https://arctichealth.org/en/permalink/ahliterature99066
Source
Clin Respir J. 2009 Jan;3(1):34-41
Publication Type
Article
Date
Jan-2009
Author
Rune Nielsen
Ane Johannessen
Per Sigvald Bakke
Jan Erik Askildsen
Ernst Reidar Omenaas
Amund Gulsvik
Author Affiliation
Institute of Medicine, University of Bergen, Haukeland University Hospital, Bergen, Norway. rune.nielsen@med.uib.no
Source
Clin Respir J. 2009 Jan;3(1):34-41
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Analysis of Variance
Chi-Square Distribution
Community Health Services - utilization
Female
Follow-Up Studies
Health Care Surveys
Health Knowledge, Attitudes, Practice
Health Services - utilization
Health Services Accessibility - statistics & numerical data
Humans
Logistic Models
Male
Middle Aged
Norway
Patient Acceptance of Health Care - statistics & numerical data
Probability
Pulmonary Disease, Chronic Obstructive - diagnosis - therapy
Questionnaires
Risk factors
Self Disclosure
Severity of Illness Index
Social Work - statistics & numerical data
Socioeconomic Factors
Spirometry
Statistics, nonparametric
Treatment Outcome
Abstract
INTRODUCTION: Utilisation of healthcare resources because of pulmonary diseases have previously been presented according to lung function or symptom severity. We aimed to compare the associations of symptoms and lung function to healthcare and social service utilisation in subjects with self-reported obstructive lung diseases (OLDs) (asthma, chronic obstructive pulmonary disease, chronic bronchitis, emphysema). MATERIALS AND METHODS: Of 2819 participants aged 27-82 years in the Hordaland County Respiratory Health Survey, 200 subjects (7.1%) self-reported OLD. They answered 13 questions on respiratory symptoms and 5 questions on use of healthcare and social services. Altogether, 161 participants (81%) completed post-bronchodilation spirometry. RESULTS: Use of anti-asthmatic drugs, regular physician's appointment, sick leave payment for the last 12 months, hospital admission for the last 12 months and disability pension were reported by 68%, 63%, 18%, 8% and 7% of those with self-reported OLD, respectively. Twenty per cent of subjects with self-reported OLD had not received any healthcare or social services. In adjusted multivariate logistic regression analyses, increase in the respiratory symptom score was significantly associated with more healthcare and social services. Lower forced expiratory volume in 1 s in % predicted, however, was not significantly associated with more use of healthcare and social services. CONCLUSION: The majority (80%) of subjects in a general population with self-reported OLD received healthcare services. The utilisation of healthcare and social services was strongly associated to the burden of respiratory symptoms, and, to a lesser degree, to the level and pattern of lung function.
PubMed ID
20298370 View in PubMed
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Association of sexually transmitted disease-related stigma with sexual health care among women attending a community clinic program.

https://arctichealth.org/en/permalink/ahliterature157562
Source
Sex Transm Dis. 2008 Jun;35(6):553-7
Publication Type
Article
Date
Jun-2008
Author
Melanie Rusch
Jean Shoveller
Susan Burgess
Karen Stancer
David Patrick
Mark Tyndall
Author Affiliation
Division of International Health and Cross Cultural Medicine, University of California, San Diego, La Jolla, California 92093-0622, USA. mrusch@ucsd.edu
Source
Sex Transm Dis. 2008 Jun;35(6):553-7
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Adult
Ambulatory Care
Canada - epidemiology
Community Health Services - utilization
Female
Humans
Mass Screening - methods
Papanicolaou test
Patient Acceptance of Health Care
Sexually Transmitted Diseases - diagnosis - epidemiology - prevention & control - psychology
Stereotyping
Vaginal Smears
Abstract
The objective of this study was to assess the association of sexually transmitted disease (STD)-related stigma on sexual health care behaviors, including Papanicolaou smears and STD testing/treatment, among women from a high-risk community.
Descriptive statistics were used to assess the association of demographics, sexual and drug-related risk behaviors, and 3 measures of STD-stigma (internal, social, and tribal stigma, the latter referring to "tribes" of womanhood) with sexual health care in the past year. Pearson's chi-square test and Mann-Whitney test were used to assess significance. Multivariate logistic models were used to determine the association of STD-stigma with sexual health care after controlling for other factors.
Lower internal stigma score was marginally associated with reporting an STD test in the past year [median score (interquartile range) for those reporting and not reporting an STD test were 0.79 (0.30-1.59) and 1.35 (0.67-1.93), respectively]. In an adjusted model, internal stigma retained a negative association with reporting of STD testing in the past year (adjusted odds ratio, 0.92; 95% confidence interval, 0.85-0.99).
Most women had received a Papanicolaou smear in the past year, and none of the STD-stigma scales were associated with reporting this behavior. Internal stigma retained an association with not having any STD test or treatment. Although sexual stigma is a deeply rooted social construct, paying attention to how prevention messages and STD information are delivered may help remove one barrier to sexual health care.
PubMed ID
18434941 View in PubMed
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Availability and use of medical services in an Alaskan Eskimo community

https://arctichealth.org/en/permalink/ahliterature827
Source
Public Health Reports. 1969 Oct; 84(10):845-856
Publication Type
Article
Date
Oct-1969
  1 website  
Author
Fortuine, R.
Author Affiliation
U.S. Indian Health Service
Source
Public Health Reports. 1969 Oct; 84(10):845-856
Date
Oct-1969
Language
English
Geographic Location
U.S.
Publication Type
Article
Physical Holding
Alaska Medical Library
Keywords
Communications
Community health aides
Community health workers
Demography
Health services
Hooper Bay
Infant mortality
Physicians
Adolescent
Adult
Age Factors
Aged
Alaska
Child
Child, Preschool
Community Health Services - utilization
Female
Health Manpower
Hospitalization
Hospitals - utilization
Humans
Infant
Inuits
Male
Middle Aged
Personal Health Services - supply & distribution - utilization
Physicians - utilization
Radio
Rural Health
Sampling Studies
United States
United States Public Health Service
Abstract
This paper describes the unusual problems encountered in making medical services available to a remote Eskimo community and the pattern of utilization of these services by the people of the community. The findings may be of some assistance to other persons concerned with the health needs of a population living under similar adverse circumstances.
Notes
Alaska Medical Library - From: Fortuine, Robert et al. 1993. The Health of the Inuit of North America: A Bibliography from the Earliest Times through 1990. University of Alaska Anchorage. Citation number 1474.
Cites: Can Med Assoc J. 1966 Jan 1;94(1):19-225322362
Cites: JAMA. 1967 Jun 12;200(11):927-314290501
Cites: Public Health Rep. 1967 Aug;82(8):714-204962121
Cites: Arch Environ Health. 1968 Jul;17(1):101-65671077
Cites: Cancer. 1969 Feb;23(2):468-745764985
Cites: Public Health Rep. 1961 Jan;76:19-2413694948
Cites: Arch Otolaryngol. 1965 Jan;81:29-3314236664
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Cites: J Parasitol. 1950 Jun;36(3):232-415422459
Cites: Alaska Med. 1966 Sep;8(3):56-635341612
Online Resources
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Battered women: a diagnostic and therapeutic dilemma.

https://arctichealth.org/en/permalink/ahliterature74077
Source
Acta Chir Scand. 1987 Jan;153(1):1-5
Publication Type
Article
Date
Jan-1987
Author
B. Brismar
B. Bergman
G. Larsson
A. Strandberg
Source
Acta Chir Scand. 1987 Jan;153(1):1-5
Date
Jan-1987
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Community Health Services - utilization
Community Psychiatry
Demography
Female
Humans
Middle Aged
Prospective Studies
Research Support, Non-U.S. Gov't
Socioeconomic Factors
Spouse Abuse
Sweden
Wounds and Injuries - diagnosis - therapy
Abstract
A prospective study of women attending a surgical emergency department in an 8-month period showed that 117 (9%) had been battered. Offered in-patient treatment was accepted and completed by 58 women (the index group), while 59 declined or did not complete treatment (the drop-out group). Both groups were compared with age-matched controls. In the battered group there were more foreign-born women and more divorces than in the control group. The drop-out group differed from the index group either in being less severely injured and seeking only certification of injury for legal purposes, or in having more previous psychiatric morbidity. The consumption of somatic and psychiatric care during the preceding 10 years was significantly greater in the battered group than in the controls, probably due to the maltreatment and reluctance to report it spontaneously. Breaking of a battering pattern at an early stage requires awareness by surgeons, general practitioners and psychiatrists that recurrent injuries of unclear origin may be due to such violence.
PubMed ID
3577565 View in PubMed
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97 records – page 1 of 10.