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221 records – page 1 of 23.

[A care program for primary health care: improved care of patients with dyspepsia].

https://arctichealth.org/en/permalink/ahliterature210802
Source
Lakartidningen. 1996 Oct 30;93(44):3892-6
Publication Type
Article
Date
Oct-30-1996
Author
B. Lennholm
Source
Lakartidningen. 1996 Oct 30;93(44):3892-6
Date
Oct-30-1996
Language
Swedish
Publication Type
Article
Keywords
Cost-Benefit Analysis
Dyspepsia - diagnosis - economics - therapy
Humans
Patient Care Planning
Primary Health Care - economics
Sweden
PubMed ID
8965575 View in PubMed
Less detail

Access to primary health care among homeless adults in Toronto, Canada: results from the Street Health survey.

https://arctichealth.org/en/permalink/ahliterature131318
Source
Open Med. 2011;5(2):e94-e103
Publication Type
Article
Date
2011
Author
Erika Khandor
Kate Mason
Catharine Chambers
Kate Rossiter
Laura Cowan
Stephen W Hwang
Author Affiliation
Toronto Public Health, Toronto, Ontario, Canada.
Source
Open Med. 2011;5(2):e94-e103
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Chronic Disease - epidemiology
Communication Barriers
Cost of Illness
Family Practice - statistics & numerical data
Female
Health Care Costs
Health Services Accessibility - economics - statistics & numerical data
Health Status Disparities
Health Surveys
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Middle Aged
Ontario - epidemiology
Primary Health Care - economics - statistics & numerical data
Risk factors
Sexual Behavior - statistics & numerical data
Substance-Related Disorders - epidemiology
Abstract
Despite experiencing a disproportionate burden of acute and chronic health issues, many homeless people face barriers to primary health care. Most studies on health care access among homeless populations have been conducted in the United States, and relatively few are available from countries such as Canada that have a system of universal health insurance. We investigated access to primary health care among a representative sample of homeless adults in Toronto, Canada.
Homeless adults were recruited from shelter and meal programs in downtown Toronto between November 2006 and February 2007. Cross-sectional data were collected on demographic characteristics, health status, health determinants and access to health care. We used multivariable logistic regression analysis to investigate the association between having a family doctor as the usual source of health care (an indicator of access to primary care) and health status, proof of health insurance, and substance use after adjustment for demographic characteristics.
Of the 366 participants included in our study, 156 (43%) reported having a family doctor. After adjustment for potential confounders and covariates, we found that the odds of having a family doctor significantly decreased with every additional year spent homeless in the participant's lifetime (adjusted odds ratio [OR] 0.91, 95% confidence interval [CI] 0.86-0.97). Having a family doctor was significantly associated with being lesbian, gay, bisexual or transgendered (adjusted OR 2.70, 95% CI 1.04-7.00), having a health card (proof of health insurance coverage in the province of Ontario) (adjusted OR 2.80, 95% CI 1.61-4.89) and having a chronic medical condition (adjusted OR 1.91, 95% CI 1.03-3.53).
Less than half of the homeless people in Toronto who participated in our study reported having a family doctor. Not having a family doctor was associated with key indicators of health care access and health status, including increasing duration of homelessness, lack of proof of health insurance coverage and having a chronic medical condition. Increased efforts are needed to address the barriers to appropriate health care and good health that persist in this population despite the provision of health insurance.
Notes
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PubMed ID
21915240 View in PubMed
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Access to primary health care for immigrants: results of a patient survey conducted in 137 primary care practices in Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature117685
Source
BMC Fam Pract. 2012;13:128
Publication Type
Article
Date
2012
Author
Elizabeth Muggah
Simone Dahrouge
William Hogg
Author Affiliation
CT Lamont Primary Health Care Research Centre, Élisabeth Bruyère Research Institute, Ottawa, ON, Canada. emuggah@bruyere.org
Source
BMC Fam Pract. 2012;13:128
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Capitation Fee - statistics & numerical data - utilization
Community Health Centers - statistics & numerical data - utilization
Cross-Sectional Studies
Emigrants and Immigrants - statistics & numerical data
Fee-for-Service Plans - statistics & numerical data - utilization
Female
Health Services Accessibility - economics - statistics & numerical data
Health status
Humans
Male
Middle Aged
Ontario
Primary Health Care - economics - statistics & numerical data - utilization
Questionnaires
Self Report
Abstract
Immigrants make up one fifth of the Canadian population and this number continues to grow. Adequate access to primary health care is important for this population but it is not clear if this is being achieved. This study explored patient reported access to primary health care of a population of immigrants in Ontario, Canada who were users of the primary care system and compared this with Canadian-born individuals; and by model of primary care practice.
This study uses data from the Comparison of Models of Primary Care Study (COMP-PC), a mixed-methods, practice-based, cross-sectional study that collected information from patients and providers in 137 primary care practices across Ontario, Canada in 2005-2006. The practices were randomly sampled to ensure an equal number of practices in each of the four dominant primary care models at that time: Fee-For-Service, Community Health Centres, and the two main capitation models (Health Service Organization and Family Health Networks). Adult patients of participating practices were identified when they presented for an appointment and completed a survey in the waiting room. Three measures of access were used, all derived from the patient survey: First Contact Access, First Contact Utilization (both based on the Primary Care Assessment Tool) and number of self-reported visits to the practice in the past year.
Of the 5,269 patients who reported country of birth 1,099 (20.8%) were born outside of Canada. In adjusted analysis, recent immigrants (arrival in Canada within the past five years) and immigrants in Canada for more than 20 years were less likely to report good health compared to Canadian-born (Odds ratio 0.58, 95% CI 0.36,0.92 and 0.81, 95% CI 0.67,0.99). Overall, immigrants reported equal access to primary care services compared with Canadian-born. Within immigrant groups recently arrived immigrants had similar access scores to Canadian-born but reported 5.3 more primary care visits after adjusting for health status. Looking across models, recent immigrants in Fee-For-Service practices reported poorer access and fewer primary care visits compared to Canadian-born.
Overall, immigrants who were users of the primary care system reported a similar level of access as Canadian-born individuals. While recent immigrants are in poorer health compared with Canadian-born they report adequate access to primary care. The differences in access for recently arrived immigrants, across primary care models suggests that organizational features of primary care may lead to inequity in access.
Notes
Cites: Health Serv Res. 2002 Jun;37(3):529-5012132594
Cites: J Immigr Health. 2004 Jan;6(1):15-2714762321
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PubMed ID
23272805 View in PubMed
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The ADDITION study: proposed trial of the cost-effectiveness of an intensive multifactorial intervention on morbidity and mortality among people with Type 2 diabetes detected by screening.

https://arctichealth.org/en/permalink/ahliterature47804
Source
Int J Obes Relat Metab Disord. 2000 Sep;24 Suppl 3:S6-11
Publication Type
Article
Date
Sep-2000
Author
T. Lauritzen
S. Griffin
K. Borch-Johnsen
N J Wareham
B H Wolffenbuttel
G. Rutten
Author Affiliation
Department of General Practice, University of Aarhus, Denmark.
Source
Int J Obes Relat Metab Disord. 2000 Sep;24 Suppl 3:S6-11
Date
Sep-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Glucose - analysis
Cost-Benefit Analysis
Denmark - epidemiology
Diabetes Mellitus, Type 2 - diagnosis - economics - epidemiology - therapy
England - epidemiology
Female
Humans
Hyperglycemia - complications - economics - therapy
Intervention Studies
Male
Mass Screening - economics
Middle Aged
Multicenter Studies
Netherlands - epidemiology
Practice Guidelines
Prevalence
Primary Health Care - economics
Randomized Controlled Trials - methods
Risk factors
Vascular Diseases - etiology - mortality - therapy
Abstract
OBJECTIVE: The overall aims of the ADDITION study are to evaluate whether screening for prevalent undiagnosed Type 2 diabetes is feasible, and whether subsequent optimised intensive treatment of diabetes, and associated risk factors, is feasible and beneficial. DESIGN: Population-based screening in three European countries followed by an open, randomised controlled trial. SUBJECTS AND METHODS: People aged 40-69 y in the community, without known diabetes, will be offered a random capillary blood glucose screening test by their primary care physicians, followed, if equal to or greater than 5.5 mmol/l, by fasting and 2-h post-glucose-challenge blood glucose measurements. Three thousand newly diagnosed patients will subsequently receive conventional treatment (according to current national guidelines) or intensive multifactorial treatment (lifestyle advice, prescription of aspirin and ACE-inhibitors, in addition to protocol-driven tight control of blood glucose, blood pressure and cholesterol). Patients allocated to intensive treatment will be further randomised to centre-specific interventions to motivate adherence to lifestyle changes and medication. Duration of follow-up is planned for 5 y. Endpoints will include mortality, macrovascular and microvascular complications, patient health status and satisfaction, process-of-care indicators and costs.
PubMed ID
11063279 View in PubMed
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Ageing may have limited impact on future costs of primary care providers.

https://arctichealth.org/en/permalink/ahliterature31324
Source
Scand J Prim Health Care. 2002 Sep;20(3):169-73
Publication Type
Article
Date
Sep-2002
Author
Jannie Madsen
Niels Serup-Hansen
Jakob Kragstrup
Ivar Sønbø Kristiansen
Author Affiliation
Institute of Public Health, Health Economics and Aging Research Center, University of Southern Denmark, Odense.
Source
Scand J Prim Health Care. 2002 Sep;20(3):169-73
Date
Sep-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Comparative Study
Denmark
Female
Forecasting
Health Care Costs - trends
Health Services Needs and Demand - economics - trends
Humans
Infant
Infant, Newborn
Male
Middle Aged
Population Dynamics
Primary Health Care - economics - organization & administration
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVE: To project the future costs of primary care providers in Denmark, taking into account high costs in the last year of life. DESIGN: Observational study and modelling. SETTING: Primary health care providers (doctors, dentists, physiotherapists, etc.), but not nursing homes and home help services. METHODS: The Danish population for the years 1995-2020 was projected on the basis of the current population using the cohort-component method. Average costs of use of various types of primary care providers were estimated from a 19.2% random sample of the 1995 population. Future costs were then projected using the population projection and age- and sex-specific average costs for survivors and non-survivors. RESULTS: The population was projected to increase by 8.2%, while the estimated increase was 36.1% for people aged over 50 years. Future costs of primary care providers were projected to increase by 8.2%, i.e. proportionally to the population increase. CONCLUSIONS: The results of the study indicate that demographic changes will Influence future costs of primary care providers through an increasing population size, but not because of ageing. This conclusion is independent of whether high costs in the last year of life are accounted for or not.
PubMed ID
12389755 View in PubMed
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Age-specific direct healthcare costs attributable to diabetes in a Swedish population: a register-based analysis.

https://arctichealth.org/en/permalink/ahliterature93267
Source
Diabet Med. 2008 Jun;25(6):732-7
Publication Type
Article
Date
Jun-2008
Author
Wiréhn A-B
Andersson A.
Ostgren C J
Carstensen J.
Author Affiliation
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. ann-britt.wirehn@lio.se
Source
Diabet Med. 2008 Jun;25(6):732-7
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Child
Child, Preschool
Cost-Benefit Analysis - economics - statistics & numerical data
Cross-Sectional Studies
Diabetes Mellitus - epidemiology - therapy
Female
Humans
Infant
Male
Middle Aged
Primary Health Care - economics
Registries
Sweden - epidemiology
Abstract
AIMS: The aim of this population-based study was to explore the age-specific additional direct healthcare cost for patients with diabetes compared with the non-diabetic population. METHODS: In 1999-2005, patients with diabetes in the Swedish county of Ostergötland (n = 20,876) were identified from an administrative database. Cost data on the healthcare expenditure in primary healthcare, out-patient hospital care and in-patient care for the entire county population (n = approximately 415,000) in 2005 were extracted from a cost per patient (CPP) database, which includes information on all utilized healthcare resources in the county. Data on drug sales were obtained from the Swedish Prescribed Drug Register. RESULTS: The cost per person was 1.8 times higher in patients with diabetes than in the non-diabetic population, 7.7 times higher in children and 1.3 times higher in subjects aged > 75 years. The additional cost per person for diabetes was euro 1971; euro 3930 and euro 1367, respectively, for children and subjects aged > 75 years. The proportion of total additional diabetes costs attributable to in-patient care increased with age from 25 to 50%; in-patient care was the most expensive component at all ages except in children, for whom visiting a specialist was most expensive. The diabetes-related segment of the total healthcare cost was 6.6%, increasing from 2.0% in children to 10.3% in the age group 65-74 years, declining to 6.2% in the oldest age group. CONCLUSIONS: The direct medical cost of diabetes varies considerably by age. Knowledge about the influence of age on healthcare costs to society will be important in future planning of diabetes management.
PubMed ID
18435778 View in PubMed
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[Aid for better health--role of Norway].

https://arctichealth.org/en/permalink/ahliterature146831
Source
Tidsskr Nor Laegeforen. 2009 Dec 3;129(23):2471
Publication Type
Article
Date
Dec-3-2009

Alberta doctors seek relief from oil patch boom.

https://arctichealth.org/en/permalink/ahliterature167568
Source
CMAJ. 2006 Sep 12;175(6):571
Publication Type
Article
Date
Sep-12-2006
Author
Wayne Kondro
Source
CMAJ. 2006 Sep 12;175(6):571
Date
Sep-12-2006
Language
English
Publication Type
Article
Keywords
Alberta
Humans
Petroleum
Physicians - supply & distribution
Population Growth
Primary Health Care - economics
PubMed ID
16966655 View in PubMed
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Alcohol advice in primary health care--is it a wise use of resources?

https://arctichealth.org/en/permalink/ahliterature10882
Source
Health Policy. 1998 Jul;45(1):47-56
Publication Type
Article
Date
Jul-1998
Author
L. Lindholm
Author Affiliation
Umeå University, Sweden. Lars.Lindholm@epih.umu.se
Source
Health Policy. 1998 Jul;45(1):47-56
Date
Jul-1998
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alcohol Drinking - adverse effects - mortality - prevention & control
Cohort Studies
Comparative Study
Cost Savings
Cost-Benefit Analysis
Health Care Rationing - economics
Health Policy
Health Services Research
Humans
Middle Aged
Primary Health Care - economics
Quality of Life
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
Many attempts to calculate costs caused by the use of alcohol in accordance with the cost-of-illness method have been reported in the literature. However, in a decision-making perspective and with a focus on what possible interventions to undertake, cost-benefit or cost-effectiveness studies are more useful. In this study the cost-effectiveness of advice aimed at reducing 'heavy' drinking to 'moderate' drinking is calculated. Results from controlled trials, showing the short-range effects of advice, are combined with observations from long-term epidemiological studies showing the association between alcohol consumption and total mortality. This study shows that advice from primary health care staff has a potential to be a very cost-effective means of intervention. The crucial point seems to be the number of people that makes durable changes in consumption. If about 1% make lasting changes a brief intervention is relatively cost-effective (20,000 ECU/YLS), and if about 10% change resources will be saved in health care. Important effects such as increased quality of life and decreasing production losses are not taken into account.
PubMed ID
10183012 View in PubMed
Less detail

Alternative funding and delivery models: practice and prospects in Ontario.

https://arctichealth.org/en/permalink/ahliterature220892
Source
J Ambul Care Manage. 1993 Jul;16(3):19-29
Publication Type
Article
Date
Jul-1993

221 records – page 1 of 23.