Skip header and navigation

Refine By

59 records – page 1 of 6.

[ADP-based records in primary health care. Rationalization or reorganization?].

https://arctichealth.org/en/permalink/ahliterature211894
Source
Tidsskr Nor Laegeforen. 1996 May 10;116(12):1470-3
Publication Type
Article
Date
May-10-1996
Author
B. Hofmann
J. Tørstad
Author Affiliation
Telenor Forskning og Utvikling, Tromsø
Source
Tidsskr Nor Laegeforen. 1996 May 10;116(12):1470-3
Date
May-10-1996
Language
Norwegian
Publication Type
Article
Keywords
Efficiency, Organizational
Humans
Medical Records Systems, Computerized
Norway
Primary Health Care - organization & administration - standards
Abstract
Computer-based patient record systems have become very common in the primary health service, but their effects have seldom been documented. Three surveys were carried out in the municipality of Sør-Varanger, in 1993, 1994 and 1995, to discover how such a system has affected the running of the municipal medical centres. The most significant changes were organisational. Certain tasks changed hands, others were dispensed with, and new ones were added. Information on patients became more readily available, and services to the public were improved. Many more patients received an answer to questions concerning information in the case record, and far fewer forms had to be filled in manually. Despite this, computerisation had seemingly led to little change in effectiveness, and the total load of work remained the same. The survey also showed that simple extensions to the system could produce marked improvements.
PubMed ID
8650636 View in PubMed
Less detail

Age equity in different models of primary care practice in Ontario.

https://arctichealth.org/en/permalink/ahliterature129640
Source
Can Fam Physician. 2011 Nov;57(11):1300-9
Publication Type
Article
Date
Nov-2011
Author
Simone Dahrouge
William Hogg
Meltem Tuna
Grant Russell
Rose Ann Devlin
Peter Tugwell
Elizabeth Kristjansson
Author Affiliation
C.T. Lamont Primary Health Care Research Centre, �lisabeth Bruyère Research Institute, Ottawa, ON. sdahrouge@bruyere.org
Source
Can Fam Physician. 2011 Nov;57(11):1300-9
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Capitation Fee - standards
Chronic Disease
Community health centers - standards
Cross-Sectional Studies
Delivery of Health Care - organization & administration - standards
Fee-for-Service Plans - standards
Female
Health Care Surveys
Health promotion
Healthcare Disparities - organization & administration - standards
Humans
Linear Models
Logistic Models
Male
Middle Aged
Ontario
Primary Health Care - organization & administration - standards
Quality of Health Care
Socioeconomic Factors
Abstract
To assess whether the model of service delivery affects the equity of the care provided across age groups.
Cross-sectional study.
Ontario.
One hundred thirty-seven practices, including traditional fee-for-service practices, salaried community health centres (CHCs), and capitation-based family health networks and health service organizations.
To compare the quality of care across age groups using multilevel linear or logistic regressions. Health service delivery measures and health promotion were assessed through patient surveys (N = 5111), which were based on the Primary Care Assessment Tool, and prevention and chronic disease management were assessed, based on Canadian recommendations for care, through chart abstraction (N = 4108).
Older individuals reported better health service delivery in all models. This age effect ranged from 1.9% to 5.7%, and was larger in the 2 capitation-based models. Individuals aged younger than 30 years attending CHCs had more features of disadvantage (ie, living below the poverty line and without high school education) and were more likely than older individuals to report discussing at least 1 health promotion subject at the index visit. These differences were deemed an appropriate response to greater needs in these younger individuals. The prevention score showed an age-sex interaction in all models, with adherence to recommended care dropping with age for women. These results are largely attributable to the fact that maneuvers recommended for younger women are considerably more likely to be performed than other maneuvers. Chronic disease management scores showed an inverted U relationship with age in fee-for-service practices, family health networks, and health service organizations but not in CHCs.
The salaried model might have an organizational structure that is more conducive to providing appropriate care across age groups. The thrust toward adopting capitation-based payment is unlikely to have an effect on age disparities.
Notes
Cites: J Health Econ. 1993 Dec;12(4):431-5710131755
Cites: Int J Health Serv. 1992;22(3):429-451644507
Cites: Can J Cardiol. 1998 Jun;14 Suppl C:1C-23C9676173
Cites: Am J Public Health. 2005 Apr;95(4):674-8015798129
Cites: Ambul Pediatr. 2005 May-Jun;5(3):134-715913405
Cites: Patient Educ Couns. 2007 Feb;65(2):270-417125958
Cites: Eur J Public Health. 2007 Oct;17(5):492-617303583
Cites: Med Care. 2008 Mar;46(3):275-8618388842
Cites: BMC Public Health. 2010;10:15120331861
Cites: Soc Sci Med. 2001 Nov;53(9):1149-6211556606
Cites: Int J Health Serv. 2001;31(3):583-60311562007
Cites: Milbank Q. 2001;79(4):613-39, v11789119
Cites: Med Care Res Rev. 2002 Sep;59(3):293-31812205830
Cites: Cardiology. 2003;99(1):39-4612589121
Cites: Scand J Public Health. 2003;31(1):37-4312623523
Cites: Can J Cardiol. 2003 Mar 31;19(4):347-5612704478
Cites: Br J Clin Pharmacol. 2003 Jun;55(6):604-812814456
Cites: Soc Sci Med. 2003 Aug;57(4):757-6212821022
Cites: Nurse Pract. 2001 Mar;26(3):36, 39-42, 45-6 passim; quiz 50-111270159
Cites: Qual Health Care. 2001 Jun;10(2):90-511389317
Cites: Am J Ther. 2001 Jul-Aug;8(4):225-911441320
Cites: Stroke. 2003 Aug;34(8):1958-6412843344
Cites: J Am Board Fam Pract. 2003 Sep-Oct;16(5):412-2214645332
Cites: Can J Cardiol. 2004 Jan;20(1):31-4014968141
Cites: Arch Intern Med. 2004 Jul 12;164(13):1427-3615249352
Cites: Fam Med. 1990 Nov-Dec;22(6):447-522262106
Cites: CMAJ. 1998 Jan 27;158(2):185-939469139
PubMed ID
22084464 View in PubMed
Less detail

The Ambulatory Sentinel Practice Network: purpose, methods, and policies.

https://arctichealth.org/en/permalink/ahliterature240865
Source
J Fam Pract. 1984 Feb;18(2):275-80
Publication Type
Article
Date
Feb-1984
Author
L A Green
M. Wood
L. Becker
E S Farley
W L Freeman
J. Froom
C. Hames
L J Niebauer
W W Rosser
M. Seifert
Source
J Fam Pract. 1984 Feb;18(2):275-80
Date
Feb-1984
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Child
Child, Preschool
Confidentiality
Data Collection
Female
Governing Board - organization & administration
Humans
Infant
Informed consent
Male
Middle Aged
Organizational Objectives
Policy Making
Primary Health Care - organization & administration - standards
Quality Control
Research
United States
Abstract
The Ambulatory Sentinel Practice Network (ASPN) is a network of primary health care practices across the United States and Canada offering (1) a laboratory for the study of populations under the care of primary care providers, and (2) surveillance of primary care problems and services. This paper reports the methods and policies developed and used by ASPN to conduct studies and describes the initial sentinel practices.
PubMed ID
6699565 View in PubMed
Less detail

Assessing the evolution of primary healthcare organizations and their performance (2005-2010) in two regions of Québec province: Montréal and Montérégie.

https://arctichealth.org/en/permalink/ahliterature138946
Source
BMC Fam Pract. 2010;11:95
Publication Type
Article
Date
2010
Author
Jean-Frédéric Levesque
Raynald Pineault
Sylvie Provost
Pierre Tousignant
Audrey Couture
Roxane Borgès Da Silva
Mylaine Breton
Author Affiliation
Institut national de santé publique du Québec, Québec, Canada. jean-frederic.levesque@inspq.qc.ca
Source
BMC Fam Pract. 2010;11:95
Date
2010
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Community Health Centers - organization & administration
Cross-Sectional Studies
Health Care Surveys
Health Services Accessibility
Humans
Models, organizational
Organizational Innovation
Primary Health Care - organization & administration - standards
Quality Indicators, Health Care
Quebec
Questionnaires
Retrospective Studies
Abstract
The Canadian healthcare system is currently experiencing important organizational transformations through the reform of primary healthcare (PHC). These reforms vary in scope but share a common feature of proposing the transformation of PHC organizations by implementing new models of PHC organization. These models vary in their performance with respect to client affiliation, utilization of services, experience of care and perceived outcomes of care.
In early 2005 we conducted a study in the two most populous regions of Quebec province (Montreal and Montérégie) which assessed the association between prevailing models of primary healthcare (PHC) and population-level experience of care. The goal of the present research project is to track the evolution of PHC organizational models and their relative performance through the reform process (from 2005 until 2010) and to assess factors at the organizational and contextual levels that are associated with the transformation of PHC organizations and their performance.
This study will consist of three interrelated surveys, hierarchically nested. The first survey is a population-based survey of randomly-selected adults from two populous regions in the province of Quebec. This survey will assess the current affiliation of people with PHC organizations, their level of utilization of healthcare services, attributes of their experience of care, reception of preventive and curative services and perception of unmet needs for care. The second survey is an organizational survey of PHC organizations assessing aspects related to their vision, organizational structure, level of resources, and clinical practice characteristics. This information will serve to develop a taxonomy of organizations using a mixed methods approach of factorial analysis and principal component analysis. The third survey is an assessment of the organizational context in which PHC organizations are evolving. The five year prospective period will serve as a natural experiment to assess contextual and organizational factors (in 2005) associated with migration of PHC organizational models into new forms or models (in 2010) and assess the impact of this evolution on the performance of PHC.
The results of this study will shed light on changes brought about in the organization of PHC and on factors associated with these changes.
Notes
Cites: Sch Inq Nurs Pract. 2000 Summer;14(2):165-83; discussion 183-710983489
Cites: Health Aff (Millwood). 2009 Mar-Apr;28(2):w262-7119174388
Cites: JAMA. 2002 Oct 9;288(14):1775-912365965
Cites: BMJ. 2003 Apr 12;326(7393):796-912689977
Cites: Health Serv Res. 2003 Jun;38(3):831-6512822915
Cites: J R Soc Med. 2003 Sep;96(9):429-3112949196
Cites: Hosp Q. 2003;7(1):73-8214674182
Cites: BMJ. 2004 Mar 27;328(7442):763-515044296
Cites: Pediatrics. 2004 May;113(5 Suppl):1493-815121917
Cites: CMAJ. 2004 Aug 17;171(4):339-4215313992
Cites: J Health Serv Res Policy. 2005 Jul;10 Suppl 1:35-4816053582
Cites: J Gen Intern Med. 2005 Oct;20(10):953-716191145
Cites: Milbank Q. 2005;83(3):457-50216202000
Cites: Healthc Q. 2006;9(2):80-5, 416640137
Cites: Health Serv Res. 2006 Dec;41(6):2238-5417116118
Cites: Healthc Manage Forum. 2006 Winter;19(4):18-2317722757
Cites: Healthc Pap. 2008;8(2):10-2418453816
Cites: Can Fam Physician. 2008 May;54(5):712-2018474705
Cites: BMJ. 2002 Jan 19;324(7330):135-4111799029
PubMed ID
21122145 View in PubMed
Less detail

Behavioral and mental health challenges for indigenous youth: research and clinical perspectives for primary care.

https://arctichealth.org/en/permalink/ahliterature146924
Source
Pediatr Clin North Am. 2009 Dec;56(6):1461-79
Publication Type
Article
Date
Dec-2009
Author
Michael Storck
Timothy Beal
Jan Garver Bacon
Polly Olsen
Author Affiliation
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, P.O. Box 359300, Seattle, WA 98195, USA. storck@u.washington.edu
Source
Pediatr Clin North Am. 2009 Dec;56(6):1461-79
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior
Alcoholism - etiology - prevention & control
Child
Child Behavior
Child Behavior Disorders - prevention & control
Conduct Disorder - prevention & control
Cultural Characteristics
Health Services, Indigenous - organization & administration - standards - trends
History, 20th Century
Humans
Indians, North American - history - psychology
Mental health
Narration
Oceanic Ancestry Group - history - psychology
Population Groups - history - psychology
Primary Health Care - organization & administration - standards - trends
Research
Social Environment
Trust
United States
Abstract
After first discussing historical, community and epidemiologic perspectives pertaining to mental health problems of Indigenous youth and families, this article reviews available research data on behavioral and mental health interventions and the roles that Native and Indigenous research programs are serving. Given the legacy of transgenerational trauma experienced by Indigenous peoples, community-based research and treatment methods are essential for solving these problems. The primary care provider stands in a unique position within the community to offer a "coinvestigator spirit" to youth and families in the pursuit of improving behavioral health. Strategies are presented for using the research literature, and collaborating with communities and families to help solve behavioral and mental health problems.
PubMed ID
19962031 View in PubMed
Less detail

A care policy and its implementation.

https://arctichealth.org/en/permalink/ahliterature71775
Source
Int J Nurs Pract. 2001 Apr;7(2):92-103
Publication Type
Article
Date
Apr-2001
Author
G. Lövgren
G. Aström
B. Engström
Author Affiliation
Department of Nursing, Umeå University, Sweden. gunvor.lovgren@nurs.umu.se
Source
Int J Nurs Pract. 2001 Apr;7(2):92-103
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Female
Hospital Administration - standards
Humans
Male
Organizational Innovation
Organizational Policy
Primary Health Care - organization & administration - standards
Research Support, Non-U.S. Gov't
Sweden
Total Quality Management
Abstract
Chief physicians, nurse managers and head nurses (n = 50) in hospital care and primary health care in Västerbotten, Sweden, were interviewed to explore their views on adopting and implementing a new care policy. The results indicated agreement among the respondents concerning the values of the care policy and its adaptability to the health-care system. More respondents in hospital care than in primary health care expressed a positive view (63%, respectively 55%), reported involvement in the implementation process (64%, respectively 35%) and planned or ongoing activities (63%, respectively 45%). Obstacles in the implementation process due to a frustrated situation and barriers between professional groups were, however, expressed by 67% of the respondents, more among the respondents in primary health care than among those in hospital care (75%, respectively 62%). Divergent views among respondents working in the same department were seen in both hospital care and primary health care. The findings indicated demands for further efforts if the implementation is to move on from its early stages, especially in primary health care.
PubMed ID
11811322 View in PubMed
Less detail

Chronic obstructive pulmonary disease (COPD) rehabilitation at primary health-care centres - the KOALA project.

https://arctichealth.org/en/permalink/ahliterature129663
Source
Clin Respir J. 2012 Jul;6(3):186-92
Publication Type
Article
Date
Jul-2012
Author
Nina Skavlan Godtfredsen
Ove Grann
Hanne Bormann Larsen
Tina Brandt Sørensen
Marie Lavesen
Birthe Pors
Lone Sander Dalsgaard
Luise Cederkvist Kristiansen
Klaus Kaae Andersen
Jens Dollerup
Author Affiliation
Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark. ngod0001@bbh.regionh.dk
Source
Clin Respir J. 2012 Jul;6(3):186-92
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Community Health Centers - organization & administration - standards
Data Collection
Databases, Factual
Denmark
Feasibility Studies
Female
Humans
Information Dissemination - methods
Internet
Male
Middle Aged
Primary Health Care - organization & administration - standards
Program Evaluation - methods
Pulmonary Disease, Chronic Obstructive - rehabilitation
Quality Assurance, Health Care - methods
Referral and Consultation - organization & administration
Rehabilitation Centers - organization & administration - standards
Abstract
Implementation of pulmonary rehabilitation in primary health care in Denmark is a new challenge in the management of patients with chronic obstructive pulmonary disease (COPD).
To assess the feasibility of introducing a nationwide web-based tool for data recording and quality assurance in the rehabilitation programmes and to evaluate whether patients are referred correctly according to Danish guidelines for community based COPD rehabilitation.
Participation in the KOALA project has been offered to the municipalities since October 2007. As of October 2010, 62 health-care centres have been invited to participate. We present summary statistics and correlation analyses of the 1699 patients who have been enrolled so far.
Thirty-three municipalities are currently engaged in the KOALA project. Descriptive analyses reveal that 33% of the patients do not meet the criteria for pulmonary rehabilitation in terms of dyspnoea upon exertion at the baseline visit. Furthermore, information on severity of COPD is missing for 18% of the attendants. The majority of the referred patients have moderate COPD, which is in accordance with the intentions of rehabilitation in the community. Statistical analyses show that COPD-level and grade of dyspnoea are positively correlated and expose significant correlations between both COPD-level and dyspnoea and 6 minutes walking distance (6MWD), incremental shuttle walk distance (ISWT) and quality of life.
We conclude that the municipalities in general are interested in the KOALA project as a mean of data recording and sharing and as a quality instrument. Summary statistics show that there is room for improvement in referral and baseline assessments of patients suitable for pulmonary rehabilitation in a community setting.
PubMed ID
22081963 View in PubMed
Less detail

Client perceptions of the performance of public and independent not-for-profit primary healthcare.

https://arctichealth.org/en/permalink/ahliterature166329
Source
Scand J Public Health. 2006;34(6):598-608
Publication Type
Article
Date
2006
Author
Ritva Laamanen
John Ovretveit
Jari Sundell
Nina Simonsen-Rehn
Sakari Suominen
Mats Brommels
Author Affiliation
Department of Public Health, University of Helsinki, Finland. ritva.laamanen@kolumbus.fi
Source
Scand J Public Health. 2006;34(6):598-608
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Community Health Centers - organization & administration - standards
Female
Finland
Health Maintenance Organizations - organization & administration - standards
Health Services Accessibility - organization & administration - standards
Humans
Male
Middle Aged
Organizations, Nonprofit
Patient Acceptance of Health Care
Patient satisfaction
Primary Health Care - organization & administration - standards
Private Sector
Public Sector
Questionnaires
Trust
Abstract
To compare primary healthcare (PHC) provided by an independent not-for-profit organization (INPO) with that provided by two public municipal organizations (MO1 and MO2), in terms of clients' perceptions of performance, acceptance, and trust.
A survey using a pre-tested questionnaire to all clients visiting a health centre (HC) doctor or nurse during one week in 2000 (n = 511, 51% response rate) and 2002 (n = 275, 47%). The data were analysed by descriptive statistics and cumulative logistic regression analysis.
The INPO differed from both publicly provided services in accessibility, consistency of service, and outcomes. Clients reported lower trust in HC provided by public organizations compared with the INPO. Trust was higher if clients also reported experiencing "very good" or "moderate" organizational access--or if general satisfaction was "very high" or "moderate" or if they experienced outcomes as "very good" or "moderate" compared with the "very poor or low" situation. Women reported lower trust in HC than men. When the family doctor was included in the same logistic regression model with the service provider, only the family doctor was a significant explanatory variable. Reported acceptance of private alternative service providers among clients was similar between the study organizations.
Clients of the INPO generally rated the service more positively than clients of publicly provided services. The results indicate that trust in HC depends more on a family doctor system than a service provider.
PubMed ID
17132593 View in PubMed
Less detail

Comparing and improving chronic illness primary care in Sweden and the USA.

https://arctichealth.org/en/permalink/ahliterature283052
Source
Int J Health Care Qual Assur. 2016 Jun 13;29(5):582-95
Publication Type
Article
Date
Jun-13-2016
Author
John Øvretveit
Patricia Ramsay
Stephen M Shortell
Mats Brommels
Source
Int J Health Care Qual Assur. 2016 Jun 13;29(5):582-95
Date
Jun-13-2016
Language
English
Publication Type
Article
Keywords
Case Management - organization & administration
Chronic Disease - therapy
Electronic Health Records - organization & administration
Evidence-Based Medicine
Humans
Patient Care Team - organization & administration
Point-of-Care Systems - organization & administration
Practice Guidelines as Topic
Primary Health Care - organization & administration - standards
Reminder Systems
Sweden
United States
Abstract
Purpose - The purpose of this paper is to identify opportunities for improving primary care services for people with chronic illnesses by comparing how Sweden and US services use evidence-based practices (EBPs), including digital health technologies (DHTs). Design/methodology/approach - A national primary healthcare center (PHCC) heads surveys in 2012-2013 carried out in both countries in 2006. Findings - There are large variations between the two countries. The largest, regarding effective DHT use in primary care centers, were that few Swedish primary healthcare compared to US heads reported having reminders or prompts at the point of care (38 percent Sweden vs 84 percent USA), despite Sweden's established electronic medical records (EMR). Swedish heads also reported 30 percent fewer centers receiving laboratory results (67 percent Sweden vs 97 percent USA). Regarding following other EBPs, 70 percent of Swedish center heads reported their physicians had easy access to diabetic patient lists compared to 14 percent in the USA. Most Swedish PHCC heads (96 percent) said they offered same day appointment compared to 36 percent in equivalent US practices. Practical implications - There are opportunities for improvement based on significant differences in effective practices between the countries, which demonstrates to primary care leaders that their peers elsewhere potentially provide better care for people with chronic illnesses. Some improvements are under primary care center control and can be made quickly. There is evidence that people with chronic illnesses in these two countries are suffering unnecessarily owing to primary care staff failing to provide proven EBP, which would better meet patient needs. Public finance has been invested in DHT, which are not being used to their full potential. Originality/value - The study shows the gaps between current and potential proven effective EBPs for services to patients with chronic conditions. Findings suggest possible explanations for differences and practical improvements by comparing the two countries. Many enhancements are low cost and the proportionate reduction in suffering and costs they bring is high.
PubMed ID
27256779 View in PubMed
Less detail

59 records – page 1 of 6.