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[337 home calls during daytime from the emergency medical center in Oslo]

https://arctichealth.org/en/permalink/ahliterature30514
Source
Tidsskr Nor Laegeforen. 2004 Feb 5;124(3):354-7
Publication Type
Article
Date
Feb-5-2004
Author
Erling Iveland
Jørund Straand
Author Affiliation
Oslo kommunale legevakt, Storgata 40, 0182 Oslo. ovrefoss.14@c2i.net
Source
Tidsskr Nor Laegeforen. 2004 Feb 5;124(3):354-7
Date
Feb-5-2004
Language
Norwegian
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Child, Preschool
Emergency Medical Services - statistics & numerical data
English Abstract
Female
Health Services Accessibility - statistics & numerical data
Health Services Needs and Demand - statistics & numerical data
House Calls - statistics & numerical data
Humans
Infant
Male
Middle Aged
Norway
Physicians, Family
Referral and Consultation - statistics & numerical data
Abstract
BACKGROUND: Few studies have addressed physicians' home calls in Norway. The aim of this study is to analyse home calls during daytime in Oslo in relation to patients (age, sex, district), diagnoses, request procedures, and clinical outcome. METHODS AND MATERIAL: General practitioners in the City of Oslo emergency medical centre recorded their home calls during three months using a standardised form. RESULTS: Calls to 337 patients (mean age 70, median 77 years; two thirds females; seven to children below two years of age) were recorded. The home calls were requested by relatives (36%), the patients themselves (32%), community care nurses (11%), and nursing homes (7%). The assessments made by the operators of the medical emergency telephone were generally correct. Physicians reported 77% full and 20% partial match between reported and found medical problem. The physicians assessed that 22% of the patients would have been able to go and see a doctor. 39% of all patients were admitted to hospital, 34 % needed ambulance transportation. The admitting GPs received hospital reports only after 27% of admissions. INTERPRETATION: Access to acute home calls by a physician during daytime is a necessary function in an urban public health service.
PubMed ID
14963510 View in PubMed
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The 2006 Canadian dyslipidemia guidelines will prevent more deaths while treating fewer people--but should they be further modified?

https://arctichealth.org/en/permalink/ahliterature155805
Source
Can J Cardiol. 2008 Aug;24(8):617-20
Publication Type
Article
Date
Aug-2008
Author
Douglas G Manuel
Sarah Wilson
Sarah Maaten
Author Affiliation
Institute for Clinical Evaluative Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada. doug.manuel@ices.on.ca
Source
Can J Cardiol. 2008 Aug;24(8):617-20
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Aged
Canada
Coronary Artery Disease - genetics - mortality - prevention & control
Cross-Cultural Comparison
Dyslipidemias - drug therapy - genetics - mortality
Health Services Accessibility - statistics & numerical data
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Middle Aged
Practice Guidelines as Topic - standards
Risk factors
Survival Analysis
Treatment Outcome
Abstract
When clinical guidelines affect large numbers of individuals or substantial resources, it is important to understand their benefits, harms and costs from a population perspective. Many countries' dyslipidemia guidelines include these perspectives.
To compare the effectiveness and efficiency of the 2003 and 2006 Canadian dyslipidemia guidelines for statin treatment in reducing deaths from coronary artery disease (CAD) in the Canadian population.
The 2003 and 2006 Canadian dyslipidemia guidelines were applied to data from the Canadian Heart Health Survey (weighted sample of 12,300,000 people), which includes information on family history and physical measurements, including fasting lipid profiles. The number of people recommended for statin treatment, the potential number of CAD deaths avoided and the number needed to treat to avoid one CAD death with five years of statin therapy were determined for each guideline.
Compared with the 2003 guidelines, 1.4% fewer people (20 to 74 years of age) are recommended statin treatment, potentially preventing 7% more CAD deaths. The number needed to treat to prevent one CAD death over five years decreased from 172 (2003 guideline) to 147 (2006 guideline).
From a population perspective, the 2006 Canadian dyslipidemia recommendations are an improvement of earlier versions, preventing more CAD events and deaths with fewer statin prescriptions. Despite these improvements, the Canadian dyslipidemia recommendations should explicitly address issues of absolute benefit and cost-effectiveness in future revisions.
Notes
Cites: CMAJ. 2005 Apr 12;172(8):1027-3115824409
Cites: Heart. 2005 Dec;91 Suppl 5:v1-5216365341
Cites: BMJ. 2006 Mar 18;332(7542):659-6216543339
Cites: BMJ. 2006 Jun 17;332(7555):141916737980
Cites: Can J Cardiol. 2006 Sep;22(11):913-2716971976
Cites: Lancet. 2007 Jan 20;369(9557):168-917240267
Comment In: Can J Cardiol. 2008 Aug;24(8):62118697284
PubMed ID
18685741 View in PubMed
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The 2012 SAGE wait times program: Survey of Access to GastroEnterology in Canada.

https://arctichealth.org/en/permalink/ahliterature115731
Source
Can J Gastroenterol. 2013 Feb;27(2):83-9
Publication Type
Article
Date
Feb-2013
Author
Desmond Leddin
David Armstrong
Mark Borgaonkar
Ronald J Bridges
Carlo A Fallone
Jennifer J Telford
Ying Chen
Palma Colacino
Paul Sinclair
Source
Can J Gastroenterol. 2013 Feb;27(2):83-9
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adult
Canada
Colonoscopy - statistics & numerical data
Female
Gastroenterology - statistics & numerical data - trends
Health Care Surveys
Health Services Accessibility - statistics & numerical data - trends
Humans
Male
Mass Screening - methods - statistics & numerical data
Questionnaires
Referral and Consultation - statistics & numerical data
Time Factors
Waiting Lists
Abstract
Periodically surveying wait times for specialist health services in Canada captures current data and enables comparisons with previous surveys to identify changes over time.
During one week in April 2012, Canadian gastroenterologists were asked to complete a questionnaire (online or by fax) recording demographics, reason for referral, and dates of referral and specialist visits for at least 10 consecutive new patients (five consultations and five procedures) who had not been seen previously for the same indication. Wait times were determined for 18 indications and compared with those from similar surveys conducted in 2008 and 2005.
Data regarding adult patients were provided by 173 gastroenterologists for 1374 consultations, 540 procedures and 293 same-day consultations and procedures. Nationally, the median wait times were 92 days (95% CI 85 days to 100 days) from referral to consultation, 55 days (95% CI 50 days to 61 days) from consultation to procedure and 155 days (95% CI 142 days to 175 days) (total) from referral to procedure. Overall, wait times were longer in 2012 than in 2005 (P
Notes
Cites: Can J Gastroenterol. 2006 Jun;20(6):411-2316779459
Cites: Colorectal Dis. 2006 Jul;8(6):480-316784466
Cites: Am J Gastroenterol. 2007 Mar;102(3):478-8117335442
Cites: Can J Gastroenterol. 2008 Feb;22(2):155-6018299734
Cites: Can J Gastroenterol. 2008 Feb;22(2):161-718299735
Cites: Healthc Q. 2009;12(3):72-919553768
Cites: Health Manag Technol. 2012 Mar;33(3):12-322515048
Cites: Can J Gastroenterol. 2010 Jan;24(1):33-920186354
Cites: Qual Saf Health Care. 2010 Oct;19(5):e2720584706
Cites: Can J Gastroenterol. 2011 Feb;25(2):78-8221321678
Cites: Can J Gastroenterol. 2011 Oct;25(10):547-5422059159
Cites: Can J Gastroenterol. 2012 Jan;26(1):17-3122308578
Cites: Can J Gastroenterol. 2010 Jan;24(1):20-520186352
PubMed ID
23472243 View in PubMed
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Aboriginal patients on the road to kidney transplantation: is residence location a barrier?

https://arctichealth.org/en/permalink/ahliterature167757
Source
Kidney Int. 2006 Sep;70(5):826-8
Publication Type
Article
Date
Sep-2006
Author
K E Yeates
Author Affiliation
Department of Medicine, Queen's University, Kingston, Ontario, Canada. yeatesk@post.queensu.ca
Source
Kidney Int. 2006 Sep;70(5):826-8
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Canada
Health Services Accessibility - statistics & numerical data
Hospitals, Rural
Humans
Indians, North American
Kidney Failure, Chronic - ethnology - surgery
Kidney Transplantation - ethnology - statistics & numerical data - utilization
Rural Population
Tissue and Organ Procurement - methods
Transportation
Abstract
Aboriginal dialysis patients have reduced access to kidney transplantation. The reasons for this disparity are unknown. Tonelli et al. show that in Canada, residence location does not significantly impact on an Aboriginal dialysis patient's likelihood of receiving kidney transplantation. This Commentary explores the issue of decreased access and examines issues surrounding the findings of Tonelli et al.
Notes
Comment On: Kidney Int. 2006 Sep;70(5):924-3016788690
PubMed ID
16929330 View in PubMed
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Access for all? Assessing vertical and horizontal inequities in healthcare utilization among young people in northern Sweden.

https://arctichealth.org/en/permalink/ahliterature298271
Source
Scand J Public Health. 2019 Feb; 47(1):1-8
Publication Type
Journal Article
Date
Feb-2019
Author
Cecilia M Wagenius
Miguel San Sebastián
Per E Gustafsson
Isabel Goicolea
Author Affiliation
1 Norrbotten County Council, Public Health Centre, Sweden.
Source
Scand J Public Health. 2019 Feb; 47(1):1-8
Date
Feb-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Female
Health Care Surveys
Health Services Accessibility - statistics & numerical data
Healthcare Disparities - statistics & numerical data
Humans
Male
Patient Acceptance of Health Care - statistics & numerical data
Socioeconomic Factors
Sweden
Young Adult
Abstract
Previous studies in Sweden have detected socioeconomic inequities in access to healthcare services. However, there is limited information regarding access in younger populations. The aim of this study was to explore vertical and horizontal inequities in access to healthcare services in young adults in the north of Sweden.
The study used data from the Health on Equal Terms survey (age group 16-24 years, n = 2726) for the health and healthcare variables and from national registers for the sociodemographic characteristics. Self-rated healthcare utilization was measured as visits to general practitioners, youth clinics and nurses. Crude and multivariable binomial regression analysis, stratified by sex, was used to assess vertical equity, adjusting for sociodemographic characteristics, and horizontal equity, adjusting for need variables.
Vertical inequity was detected for all three healthcare services (youth clinics, general practitioners and nurses), with variations for men and women. Horizontal inequities were also found for both men and women in relation to all three healthcare services.
These findings suggest that both vertical and horizontal inequities in access exist for young people in northern Sweden and that the associations between sociodemographic characteristics and healthcare utilization are complex and need further investigation.
PubMed ID
29779450 View in PubMed
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Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

https://arctichealth.org/en/permalink/ahliterature190330
Source
Air Med J. 2002 May-Jun;21(3):39-45
Publication Type
Article
Author
Torhild Heggestad
Knut Yngve Børsheim
Author Affiliation
SINTEF Unimed Health Services Research, Trondheim, Norway.
Source
Air Med J. 2002 May-Jun;21(3):39-45
Language
English
Publication Type
Article
Keywords
Air Ambulances - supply & distribution - utilization
Emergency Medical Services - supply & distribution - utilization
Geography
Health Services Accessibility - statistics & numerical data
Health services needs and demand
Health Services Research
Humans
Multivariate Analysis
National Health Programs
Norway
Physician's Practice Patterns
Regression Analysis
Safety Management
Time Factors
Transportation of Patients
Abstract
To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998.
The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases.
The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS.
Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.
PubMed ID
11994734 View in PubMed
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Accessibility, continuity and appropriateness: key elements in assessing integration of perinatal services.

https://arctichealth.org/en/permalink/ahliterature183622
Source
Health Soc Care Community. 2003 Sep;11(5):397-404
Publication Type
Article
Date
Sep-2003
Author
Danielle D'Amour
Lise Goulet
Jean-François Labadie
Liette Bernier
Raynald Pineault
Author Affiliation
Faculté des sciences infirmières and Groupe de recherche interdisciplinaire en santé (GRIS), Université de Montréal, Montreal, Quebec, Canada. Danielle.damour@umontreal.ca
Source
Health Soc Care Community. 2003 Sep;11(5):397-404
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Continuity of Patient Care - statistics & numerical data
Delivery of Health Care, Integrated - statistics & numerical data
Female
Health Care Rationing - statistics & numerical data
Health Services Accessibility - statistics & numerical data
House Calls - statistics & numerical data
Humans
Infant, Newborn
Length of Stay
Patient Education as Topic - standards
Perinatal Care - statistics & numerical data
Postnatal Care - statistics & numerical data
Pregnancy
Quebec
Regional Health Planning - methods
Telemedicine - statistics & numerical data
Abstract
A trend toward the reduction in the length of hospital stays has been widely observed. This increasing shift is particularly evident in perinatal care. A stay of less than 48 hours after delivery has been shown to have no negative effects on the health of either the mother or the baby as long as they receive an adequate follow-up. This implies a close integration between hospital and community health services. The present article addresses the following questions: To what extent are postnatal services accessible to mothers and neonates? Are postnatal services in the community in continuity with those of the hospital? Are the services provided by the appropriate source of care? The authors conducted a telephone survey among 1158 mothers in a large urban area in the province of Quebec, Canada. The results were compared to clinical guidelines widely recognised by professionals. The results show serious discrepancies with these guidelines. The authors found a low accessibility to services: less than half of the mothers received a home visit by a nurse. In terms of continuity of care, less than 10% of the mothers received a follow-up telephone call within the recommended time frame and only 18% benefited from a home visit within the recommended period. Finally, despite guidelines to the contrary, hospitals continue to intervene after discharge. This results in a duplication of services for 44.7% of the new-borns. On the other hand, 40.7% are not seen in the recommended period after hospital discharge at all. These results raise concerns about the integration of services between agencies. Following earlier work, the present authors have grouped explanatory factors under four dimensions: the strategic dimension, particularly leadership; the structural dimension, including the size of the network; the technological dimension, with respect to information transmission system; and the cultural dimension, which concerns the collaboration process and the development of relationships based on trust.
PubMed ID
14498836 View in PubMed
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Accessibility of Norwegian dental services according to family income from 1977 to 1989.

https://arctichealth.org/en/permalink/ahliterature75798
Source
Community Dent Oral Epidemiol. 1992 Feb;20(1):1-5
Publication Type
Article
Date
Feb-1992
Author
J. Grytten
Author Affiliation
Institute of Community Dentistry, University of Oslo, Norway.
Source
Community Dent Oral Epidemiol. 1992 Feb;20(1):1-5
Date
Feb-1992
Language
English
Publication Type
Article
Keywords
Adult
Dental Health Services - statistics & numerical data - utilization
Dental Restoration, Permanent - statistics & numerical data - utilization
Health Services Accessibility - statistics & numerical data
Health Services Needs and Demand - statistics & numerical data
Humans
Income
Logistic Models
Norway - epidemiology
Odds Ratio
Tooth Extraction - statistics & numerical data - utilization
Abstract
During the last 10-20 yr there has been a marked increase in demand for dental services in most western countries. An important issue is how this increase in demand has influenced inequalities in use of services among different income groups in the population. It is of particular interest to study this in Norway, as almost all the costs for dental care among adults are borne by the patient. The aim of the present study was to examine how the effect of family income on demand for dental services has changed over time. The analyses were performed on three sets of national data from 1977, 1983, and 1989. The samples were representative of the non-institutionalized Norwegian population aged 20 yr and above. Inequalities in use of dental services among different income groups have decreased between 1977 and 1989. However, separate analyses on the data from 1989 showed that some inequalities still exist. A non-selective subsidizing policy for dental care is unlikely to have any great effect in reducing these inequalities. Subsidized dental care is likely to raise the total amount of dental care demanded. However, it is difficult to assess accurately the size of this increase as the elasticity of demand for dental care in Norway with respect to price is unknown.
PubMed ID
1547604 View in PubMed
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Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents.

https://arctichealth.org/en/permalink/ahliterature139831
Source
Int J Health Geogr. 2010;9:52
Publication Type
Article
Date
2010
Author
Antonio Paez
Ruben G Mercado
Steven Farber
Catherine Morency
Matthew Roorda
Author Affiliation
School of Geography and Earth Sciences, McMaster University, Hamilton Ontario, Canada. paezha@mcmaster.ca
Source
Int J Health Geogr. 2010;9:52
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Health Services Accessibility - statistics & numerical data
Humans
Middle Aged
Mobility Limitation
Quebec
Regression Analysis
Residence Characteristics
Socioeconomic Factors
Transportation - statistics & numerical data
Young Adult
Abstract
Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to examine the mobility situation of seniors vis-a-vis the spatial distribution of health care facilities, to identify areas where accessibility is low and interventions may be required.
Accessibility is implemented using a cumulative opportunities measure. Instead of assuming a fixed bandwidth (i.e. a distance threshold) for measuring accessibility, in this paper the bandwidth is defined using model-based estimates of average trip length. Average trip length is an all-purpose indicator of individual mobility and geographical reach. Adoption of a spatial modelling approach allows us to tailor these estimates of travel behaviour to specific locations and person profiles. Replacing a fixed bandwidth with these estimates permits us to calculate customized location- and person-based accessibility measures that allow inter-personal as well as geographical comparisons.
The case study is Montreal Island. Geo-coded travel behaviour data, specifically average trip length, and relevant traveller's attributes are obtained from the Montreal Household Travel Survey. These data are complemented with information from the Census. Health care facilities, also geo-coded, are extracted from a comprehensive business point database. Health care facilities are selected based on Standard Industrial Classification codes 8011-21 (Medical Doctors and Dentists).
Model-based estimates of average trip length show that travel behaviour varies widely across space. With the exception of seniors in the downtown area, older residents of Montreal Island tend to be significantly less mobile than people of other age cohorts. The combination of average trip length estimates with the spatial distribution of health care facilities indicates that despite being more mobile, suburban residents tend to have lower levels of accessibility compared to central city residents. The effect is more marked for seniors. Furthermore, the results indicate that accessibility calculated using a fixed bandwidth would produce patterns of exposure to health care facilities that would be difficult to achieve for suburban seniors given actual mobility patterns.
The analysis shows large disparities in accessibility between seniors and non-seniors, between urban and suburban seniors, and between vehicle owning and non-owning seniors. This research was concerned with potential accessibility levels. Follow up research could consider the results reported here to select case studies of actual access and usage of health care facilities, and related health outcomes.
Notes
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PubMed ID
20973969 View in PubMed
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Access to advanced diagnostic services.

https://arctichealth.org/en/permalink/ahliterature125251
Source
Can Fam Physician. 2012 Apr;58(4):e202
Publication Type
Article
Date
Apr-2012

458 records – page 1 of 46.