Skip header and navigation

Refine By

32 records – page 1 of 4.

Abdominal complaints in general practice.

https://arctichealth.org/en/permalink/ahliterature178352
Source
Scand J Prim Health Care. 2004 Sep;22(3):157-62
Publication Type
Article
Date
Sep-2004
Author
Per Olav Vandvik
Pål Kristensen
Lars Aabakken
Per G Farup
Author Affiliation
Department of Medicine, Innlandet Hospital Health Authority, NO-2819 Gjøvik, Norway. per.vandvic@start.no
Source
Scand J Prim Health Care. 2004 Sep;22(3):157-62
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Abdominal Pain - diagnosis - epidemiology
Adult
Aged
Cross-Sectional Studies
Family Practice - standards - statistics & numerical data
Female
Gastrointestinal Diseases - diagnosis - epidemiology
Humans
Male
Middle Aged
Norway - epidemiology
Questionnaires
Workload
Abstract
The study evaluates the prevalence and diagnoses of abdominal complaints in general practice, and compares characteristics and symptoms of patients with functional gastrointestinal disorders (FGIDs) and organic diseases.
A cross-sectional study.
Nine centres with 26 participating general practitioners (GPs) in Norway.
3097 out of 3369 consecutive adult patients answered a questionnaire regarding abdominal complaints IN the last 3 months. Those who consulted for the complaints were eligible for this study.
The GPs' diagnoses and patients' characteristics were reported in questionnaires.
460 out of 1499 patients with abdominal complaints consulted for these complaints; 392 were included in this study. The GPs diagnosed an FGID in 167 (42.6%) patients, organic disease in 145 (37.0%), and made no diagnosis in 80 (20.4%). Stress-related symptoms were a statistically significant predictor of a FGID (OR 1.95) and weight loss predicted in addition organic disease (OR 2.7) in 128 patients with a verified diagnosis.
Abdominal complaints are a common problem in general practice. The distinction between FGID, which accounted for half of the diagnoses, and organic disease was difficult. The only significant predictor for FGID was stress-related symptoms.
Notes
Comment In: Scand J Prim Health Care. 2005 Jun;23(2):126; author reply 126-716036553
PubMed ID
15370792 View in PubMed
Less detail

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
Less detail

[Access to general practitioners in a county in Troms]

https://arctichealth.org/en/permalink/ahliterature70574
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Publication Type
Article
Date
Aug-25-2005
Author
Anne Helen Hansen
Ivar J Aaraas
Jorun Støvne Pettersen
Gerd Ersdal
Author Affiliation
Tromsø kommune, Rådhuset, 9299 Tromsø. anne.helen.hansen@tromso.kommune.no
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Date
Aug-25-2005
Language
Norwegian
Publication Type
Article
Keywords
Comparative Study
Emergency Medical Services - standards - statistics & numerical data
English Abstract
Family Practice - standards - statistics & numerical data
Female
Health Services Accessibility - standards - statistics & numerical data
Humans
Interviews
Male
Norway
Physicians, Family
Physicians, Women
Referral and Consultation - standards - statistics & numerical data
Rural Health Services - standards - statistics & numerical data
Telephone
Urban Health Services - standards - statistics & numerical data
Abstract
BACKGROUND: In 2002 the Norwegian Board of Health made a survey of the accessibility of general practitioners in Troms county in North Norway. MATERIAL AND METHODS: In a telephone interview one secretary in each surgery informed about telephone response time, planned time for telephone consultations, recorded numbers of urgent consultations, and waiting time to obtain a routine consultation. RESULTS: On average, the planned telephone time was two hours per week. Telephone time was in inverse proportion to the number of patients on the doctor's list. Rural doctors spent twice as much time as urban colleagues on the telephone with their patients. Doctors with lists between 500 and 1500 patients had a higher proportion of urgent consultations compared with doctors with shorter or longer lists. INTERPRETATION: Telephone response time below two minutes and waiting times for routine consultations below 20 days appear to be within acceptable norms. When patient lists are above 1500, doctors' capacity to offer telephone contact and emergency services to their patients seems reduced.
PubMed ID
16138139 View in PubMed
Less detail

[Albin--a primary health care patient]

https://arctichealth.org/en/permalink/ahliterature97724
Source
Lakartidningen. 2010 Jan 20-26;107(3):122-3
Publication Type
Article

Allergological examination in general practice and in the specialist field of allergology. A comparative study of the concordance between a group of general practitioners and the allergological specialised health care services to which they refer.

https://arctichealth.org/en/permalink/ahliterature72225
Source
Scand J Prim Health Care. 1999 Dec;17(4):221-5
Publication Type
Article
Date
Dec-1999
Author
A F Jørgensen
P A Pedersen
Author Affiliation
Central Research Unit of General Practice, University of Copenhagen, Panum Institute, Denmark.
Source
Scand J Prim Health Care. 1999 Dec;17(4):221-5
Date
Dec-1999
Language
English
Publication Type
Article
Keywords
Allergy and Immunology - standards - statistics & numerical data
Clinical Competence
Comparative Study
Denmark
Family Practice - standards - statistics & numerical data
Female
Humans
Hypersensitivity - diagnosis
Male
Referral and Consultation
Reproducibility of Results
Abstract
OBJECTIVE: To study the concordance between specially trained general practitioners (GPs) and specialist doctors working as consultants to GPs, with regard to diagnosis of allergic illnesses, evaluation of indications for hyposensitisation, and referrals from GPs to specialists. DESIGN: Thirty-four GPs and five specialists practising privately and eight allergologic outpatient clinics participated. The patients included had symptoms indicating allergologic examination. An identical diagnostic procedure was used by the GPs and by the specialists/outpatient clinics. SETTING: General practices, specialist practices, outpatient clinics. SUBJECTS: One-hundred and forty-eight patients. MAIN OUTCOME MEASURES: With regard to skin-prick test there was concordance between the GPs and the specialists in 82.5% of 1322 paired comparisons, in 74.0% with regard to anamnesis + skin-prick test, and in 66.5% with regard to the statement allergy. There was concordance with regard to indication for hyposensitisation in 88.3%, and for referral in 54.1%. There was symmetry concerning prick test and anamnesis + prick test, and asymmetry concerning the statement allergy, and indication for hyposensitisation and for referral. CONCLUSIONS: Specially trained GPs diagnosed specific allergy in concordance with specialists. There was asymmetry between GPs and specialists concerning the statement allergy, indication for hyposensitisation and for referral.
PubMed ID
10674299 View in PubMed
Less detail

An observer-participant study in primary care of assessments of inability to work in immigrant patients with ongoing sick leave.

https://arctichealth.org/en/permalink/ahliterature71171
Source
Scand J Prim Health Care. 2003 Dec;21(4):199-204
Publication Type
Article
Date
Dec-2003
Author
Monica Löfvander
Alf Engström
Author Affiliation
Department of Clinical Sciences, Division of Family Medicine, Karolinska Institutet, Stockholm, Sweden. monica.lofvander@rinkeby.vsso.sll.se
Source
Scand J Prim Health Care. 2003 Dec;21(4):199-204
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Adult
Comparative Study
Emigration and Immigration
Family Practice - standards - statistics & numerical data
Female
Health Services Research
Humans
Male
Middle Aged
Observer Variation
Primary Health Care - standards - statistics & numerical data
Reproducibility of Results
Sick Leave
Sweden
Work Capacity Evaluation
Abstract
OBJECTIVE: To explore the factors related to doctors' assessments of incapacity to work (IW). MATERIAL: Two general practitioners and 49 men and 102 women aged 20-45 years with ongoing sick leave. METHODS: The doctors saw all the patients jointly and discussed their emotions afterwards. Mental status, psychosocial stress, pain behaviour, tender structures, mobility and self-rated inability to work were assessed. Finally, the doctors separately rated the degree (0-100%) of reduced capacity for vocational work (DRCW). The inter-rater agreement was measured by kappa statistics. Prevalence odds ratios (OR) with 95% confidence intervals (95% CI) for IW (75-100% DRCW) were calculated by logistic regression. RESULTS: The patients were immigrants working in service. All reported pain, 53.7% had much psychosocial stress, 74.8% said they were unable to work and 22.5% were depressed. We were often touched by their life stories. The women had many tender-structure locations and many men had restricted mobility. Two-thirds (67.5%) had pain behaviour. The kappa value on the DRCW was 0.73. A third of the men (38.8%) and 26.5% of the women were assessed as having IW. The raters disagreed only in a few cases. Depressed men or men with pain behaviour had high ORs for IW (OR 12.8, 95% CI 3.3-68.5 and OR 5.6, 95% CI 1.5-21.1, respectively) as did women with self-rated inability to work (OR 7.0; 95% CI 1.6-32.0). CONCLUSIONS: Factors not clearly related to function had determined doctors' assessments of IW.
PubMed ID
14695068 View in PubMed
Less detail

[Are we missing something serious? Study of emergency visits to a health center].

https://arctichealth.org/en/permalink/ahliterature218185
Source
Lakartidningen. 1994 May 4;91(18):1823-4
Publication Type
Article
Date
May-4-1994

Association between licensing examination scores and resource use and quality of care in primary care practice.

https://arctichealth.org/en/permalink/ahliterature204494
Source
JAMA. 1998 Sep 16;280(11):989-96
Publication Type
Article
Date
Sep-16-1998
Author
R. Tamblyn
M. Abrahamowicz
C. Brailovsky
P. Grand'Maison
J. Lescop
J. Norcini
N. Girard
J. Haggerty
Author Affiliation
Department of Medicine, McGill University, Montreal, Québec, Canada. mi64@musica.mcgill.ca
Source
JAMA. 1998 Sep 16;280(11):989-96
Date
Sep-16-1998
Language
English
Publication Type
Article
Keywords
Adult
Aged
Clinical Competence
Drug Utilization - statistics & numerical data
Educational Measurement
Family Practice - standards - statistics & numerical data
Female
Health Policy
Health Resources - utilization
Humans
Licensure, Medical
Linear Models
Male
Mammography - utilization
Middle Aged
Physician's Practice Patterns - statistics & numerical data
Primary Health Care - standards
Prospective Studies
Quality of Health Care
Quebec
Referral and Consultation - utilization
United States
Abstract
Clinical competence is a determinant of the quality of care delivered, and may be associated with use of health care resources by primary care physicians. Clinical competence is assumed to be assessed by licensing examinations, yet there is a paucity of information on whether scores achieved predict subsequent practice.
To determine if licensing examination scores were associated with selected aspects of quality of care and resource use in initial primary care practice.
Prospective cohort study of recently licensed family physicians, followed up for the first 18 months of practice.
The Quebec health care system.
A total of 614 family physicians who passed the licensing examination between 1991 and 1993 and entered fee-for-service practice in Quebec.
All patients seen by physicians were identified by the universal health insurance board and all health services provided to these patients were retrieved for the 18 months prior to (baseline) and after (follow-up) the physicians' entry into practice. Medical service and prescription claims files were used to measure rates of resource use (specialty consultation, symptom-relief prescribing compared with disease-specific prescribing) and quality of care (inappropriate prescribing, mammography screening). Baseline data were used to adjust for differences in practice population.
Study physicians saw a total of 1116389 patients, of whom 113535 (10.2%) were elderly and 83391 (7.5%) were women aged 50 to 69 years. Physicians with higher licensing examination scores referred more of their patients for consultation (3.8/1000 patients per SD increase in score; 95% confidence interval [CI], 1.2-7.0; P = .005), prescribed to elderly patients fewer inappropriate medications (-2.7/1000 patients per SD increase in score; 95% CI, -4.8 to -0.7; P=.009) and more disease-specific medications relative to symptom-relief medications (3.9/1000 patients per SD increase in score; 95% CI, 0.3 to 7.4; P= .03), and referred more women aged 50 to 69 years (6.6/1000 patients per SD increase in score; 95% CI, 1.2-11.9; P = .02) for mammography screening. If patients of physicians with the lowest scores had experienced the same rates of consultation, prescribing, and screening as patients of physicians with the highest scores, an additional 3027 patients would have been referred, 179 fewer elderly patients would have been prescribed symptom-relief medication, 912 more elderly patients would have been prescribed disease-specific medication, 189 fewer patients would have received inappropriate medication, and 121 more women would have received mammography screening.
Licensing examination scores are significant predictors of consultation, prescribing, and mammography screening rates in initial primary care practice.
PubMed ID
9749481 View in PubMed
Less detail

[Benzodiazepines--quality assurance of prescriptions in own general practice]

https://arctichealth.org/en/permalink/ahliterature46147
Source
Tidsskr Nor Laegeforen. 2000 Oct 30;120(26):3121-5
Publication Type
Article
Date
Oct-30-2000
Author
D. Krogsaeter
J. Straand
Author Affiliation
Seksjon for allmennmedisin, Universitet i Bergen. dagfinnkr@sf.telia.no
Source
Tidsskr Nor Laegeforen. 2000 Oct 30;120(26):3121-5
Date
Oct-30-2000
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Anti-Anxiety Agents - administration & dosage - adverse effects
Benzodiazepines
Drug Information Services
Drug Utilization - standards - statistics & numerical data
English Abstract
Family Practice - standards - statistics & numerical data
Female
Follow-Up Studies
Humans
Male
Medical Audit
Middle Aged
Norway
Physician's Practice Patterns
Prescriptions, Drug - standards - statistics & numerical data
Questionnaires
Research Support, Non-U.S. Gov't
Time Factors
Abstract
BACKGROUND: Even if benzodiazepines are recommended for short-term use, they are prescribed for years. Doctors often feel uncomfortable about this. MATERIAL AND METHODS: In this audit the prescription of benzodiazepines by one general practitioner was studied on the basis of the medical records, a mailed questionnaire to patients, and special benzodiazepine consultations which included diagnostic assessment. 17 long-term benzodiazepine users were given a follow-up which included general information, personal advice and alternative treatment aimed at discontinuing their use of benzodiazepines. RESULTS: 76 out of 754 patients had received prescriptions for a benzodiazepine during the previous three years. The questionnaire was completed by 63 patients. The results revealed that the treatment had originally been initiated by a general practitioner in 78% of the cases, most commonly for anxiety (40%), sleeping difficulties (23%), or depression (10%). Their doctor had previously suggested benzodiazepine withdrawal in 46% of the patients. One third were long-term users. 46% of these had used this medication more than ten years; 90% suffered from chronic illness. After 17 months, 47% of the patients had stopped using benzodiazepines while another 29% used significantly less than before. INTERPRETATION: A broad and individually tailored intervention towards patients in general practice may be a useful tool in reducing long-term use of benzodiazepines.
PubMed ID
11109357 View in PubMed
Less detail

Care and outcomes of patients newly hospitalized for heart failure in the community treated by cardiologists compared with other specialists.

https://arctichealth.org/en/permalink/ahliterature184813
Source
Circulation. 2003 Jul 15;108(2):184-91
Publication Type
Article
Date
Jul-15-2003
Author
Philip Jong
Yanyan Gong
Peter P Liu
Peter C Austin
Douglas S Lee
Jack V Tu
Author Affiliation
Heart & Stroke/Richard Lewar Centre of Excellence, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Source
Circulation. 2003 Jul 15;108(2):184-91
Date
Jul-15-2003
Language
English
Publication Type
Article
Keywords
Aged
Cardiology - standards - statistics & numerical data
Cohort Studies
Comorbidity
Databases as Topic - statistics & numerical data
Family Practice - standards - statistics & numerical data
Female
Heart Failure - mortality - therapy
Hospitalization - statistics & numerical data
Humans
Internal Medicine - standards - statistics & numerical data
Logistic Models
Male
Medicine - standards - statistics & numerical data
Odds Ratio
Ontario
Outcome Assessment (Health Care) - statistics & numerical data
Patient Care Management
Patient Readmission - statistics & numerical data
Poisson Distribution
Proportional Hazards Models
Risk assessment
Specialization
Abstract
It is not known whether subspecialty care by cardiologists improves outcomes in heart failure patients from the community over care by other physicians.
Using administrative data, we monitored 38 702 consecutive patients with first-time hospitalization for heart failure in Ontario, Canada, between April 1994 and March 1996 and examined differences in processes of care and clinical outcomes between patients attended by physicians of different disciplines. We found that patients attended by cardiologists had lower 1-year risk-adjusted mortality than those attended by general internists, family practitioners, and other physicians (28.5% versus 31.7%, 34.9%, and 35.9%, respectively; all pairwise comparisons, P
Notes
Comment In: Circulation. 2003 Jul 15;108(2):129-3112860891
PubMed ID
12821540 View in PubMed
Less detail

32 records – page 1 of 4.