Skip header and navigation

Refine By

212 records – page 1 of 22.

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

[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

An implementation study of the PDRD primary care computerized guidelines.

https://arctichealth.org/en/permalink/ahliterature204085
Source
Scand J Prim Health Care. 1998 Sep;16(3):149-53
Publication Type
Article
Date
Sep-1998
Author
J. Jousimaa
I. Kunnamo
M. Mäkelä
Author Affiliation
University of Kuopio, Department of Community Health and General Practice, Finland.
Source
Scand J Prim Health Care. 1998 Sep;16(3):149-53
Date
Sep-1998
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Computer User Training
Databases, Factual
Decision Support Systems, Clinical
Family Practice - education - standards
Female
Finland
Follow-Up Studies
Guideline Adherence
Humans
Male
Middle Aged
Practice Guidelines as Topic
Primary Health Care - standards
Questionnaires
Reference Books
Therapy, Computer-Assisted - organization & administration
Abstract
To study the implementation of electronic guidelines designed for general practitioners (GPs).
A descriptive 3-year follow-up study.
All new subscribers to Physician's Desk Reference and Database (PDRD) in 1992.
Locations of computers, where PDRD software was installed for the first time in 1992.
Expectations of the program and changes in attitudes towards it, getting started with the system, frequency and continuity of use and estimated usefulness of the program.
The guidelines were expected to enhance diagnostic accuracy (60% of subscribers), save time (45%), and reduce costs (11%). After 1 year's use, the opinions of the users on these topics had become slightly more positive. Technical problems delayed starting to use the program in 27%. After 1 year 72% were using the program at least weekly. Using frequency was associated with having the computer in the office. The subscribers who renewed their subscription after one year often became regular users.
The study provides insight into the implementation phase of computer-based guidelines in a population of early adopters. Technical support was essential to overcome the barriers associated with computer technology. The perceived need for information was independent of the age and experience of the physicians.
PubMed ID
9800227 View in PubMed
Less detail

An investigation of routes to cancer diagnosis in 10 international jurisdictions, as part of the International Cancer Benchmarking Partnership: survey development and implementation.

https://arctichealth.org/en/permalink/ahliterature288091
Source
BMJ Open. 2016 07 25;6(7):e009641
Publication Type
Article
Date
07-25-2016
Author
David Weller
Peter Vedsted
Chantelle Anandan
Alina Zalounina
Evangelia Ourania Fourkala
Rakshit Desai
William Liston
Henry Jensen
Andriana Barisic
Anna Gavin
Eva Grunfeld
Mats Lambe
Rebecca-Jane Law
Martin Malmberg
Richard D Neal
Jatinderpal Kalsi
Donna Turner
Victoria White
Martine Bomb
Usha Menon
Source
BMJ Open. 2016 07 25;6(7):e009641
Date
07-25-2016
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Antineoplastic Combined Chemotherapy Protocols
Australia - epidemiology
Benchmarking
Breast Neoplasms - diagnosis - epidemiology
Canada - epidemiology
Colorectal Neoplasms - diagnosis - epidemiology
Cross-Sectional Studies
Denmark - epidemiology
Early Detection of Cancer - standards
Female
Humans
Lung Neoplasms - diagnosis - epidemiology
Norway - epidemiology
Ovarian Neoplasms - diagnosis - epidemiology
Pilot Projects
Practice Patterns, Physicians' - organization & administration - statistics & numerical data
Primary Health Care - standards
Registries
Reproducibility of Results
Survival Rate
Sweden - epidemiology
United Kingdom - epidemiology
Abstract
This paper describes the methods used in the International Cancer Benchmarking Partnership Module 4 Survey (ICBPM4) which examines time intervals and routes to cancer diagnosis in 10 jurisdictions. We present the study design with defining and measuring time intervals, identifying patients with cancer, questionnaire development, data management and analyses.
Recruitment of participants to the ICBPM4 survey is based on cancer registries in each jurisdiction. Questionnaires draw on previous instruments and have been through a process of cognitive testing and piloting in three jurisdictions followed by standardised translation and adaptation. Data analysis focuses on comparing differences in time intervals and routes to diagnosis in the jurisdictions.
Our target is 200 patients with symptomatic breast, lung, colorectal and ovarian cancer in each jurisdiction. Patients are approached directly or via their primary care physician (PCP). Patients' PCPs and cancer treatment specialists (CTSs) are surveyed, and 'data rules' are applied to combine and reconcile conflicting information. Where CTS information is unavailable, audit information is sought from treatment records and databases.
Reliability testing of the patient questionnaire showed that agreement was complete (?=1) in four items and substantial (?=0.8, 95% CI 0.333 to 1) in one item. The identification of eligible patients is sufficient to meet the targets for breast, lung and colorectal cancer. Initial patient and PCP survey response rates from the UK and Sweden are comparable with similar published surveys. Data collection was completed in early 2016 for all cancer types.
An international questionnaire-based survey of patients with cancer, PCPs and CTSs has been developed and launched in 10 jurisdictions. ICBPM4 will help to further understand international differences in cancer survival by comparing time intervals and routes to cancer diagnosis.
Notes
Cites: Lancet. 2015 Mar 14;385(9972):977-101025467588
Cites: Health Policy. 2013 Sep;112(1-2):148-5523693117
Cites: Biometrics. 1989 Mar;45(1):255-682720055
Cites: Br J Gen Pract. 2011 Aug;61(589):e508-1221801563
Cites: BMC Fam Pract. 2008 Jan 30;9:918234092
Cites: Br J Cancer. 2012 Oct 9;107(8):1220-622996611
Cites: BMC Med Res Methodol. 2003 Oct 20;3:2114567763
Cites: Nat Rev Cancer. 2006 Aug;6(8):603-1216862191
Cites: JAMA Surg. 2013 Jun;148(6):516-2323615681
Cites: BMC Health Serv Res. 2011 Oct 25;11:28422027084
Cites: Clin Epidemiol. 2014 Jul 17;6:237-4625083137
Cites: Br J Cancer. 2011 Mar 15;104(6):934-4021364593
Cites: Lancet Oncol. 2014 Jan;15(1):23-3424314615
Cites: Br J Cancer. 2013 Feb 5;108(2):292-30023370208
Cites: Acta Oncol. 2013 Jun;52(5):919-3223581611
Cites: Gynecol Oncol. 2012 Oct;127(1):75-8222750127
Cites: BMC Cancer. 2013 Apr 23;13:20323617741
Cites: Lung Cancer. 2012 Oct;78(1):51-622841591
Cites: Br J Cancer. 2008 Jan 15;98(1):60-7018059401
Cites: BMJ Open. 2015 May 27;5(5):e00721226017370
Cites: Fam Pract. 2012 Feb;29(1):69-7821828375
Cites: Eur J Cancer. 2009 Mar;45(5):747-5519117750
Cites: Br J Cancer. 2015 Mar 31;112 Suppl 1:S92-10725734382
Cites: Br J Cancer. 2013 Mar 19;108(5):1195-20823449362
Cites: J Clin Epidemiol. 2012 Jun;65(6):669-7822459430
Cites: Cancer Epidemiol. 2014 Feb;38(1):100-524238619
Cites: Br J Gen Pract. 2011 May;61(586):e215-2221619745
Cites: Lancet. 2011 Jan 8;377(9760):127-3821183212
Cites: Br J Cancer. 2012 Mar 27;106(7):1262-722415239
Cites: Fam Pract. 2007 Feb;24(1):3-617142248
Cites: Thorax. 2013 Jun;68(6):551-6423399908
Cites: Eur J Cancer. 2013 Jun;49(9):2187-9823453935
Cites: Br J Cancer. 2013 Feb 19;108(3):686-9023392082
Cites: Radiother Oncol. 2007 Jul;84(1):5-1017493700
Cites: Br J Gen Pract. 2013 Jan;63(606):e30-623336455
Cites: Am J Public Health. 1989 Aug;79(8):1053-52751028
Cites: PLoS One. 2015 Aug 07;10(8):e013502726252203
Cites: Br J Gen Pract. 2001 Dec;51(473):967-7111766868
PubMed ID
27456325 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

Anticoagulant treatment in primary health care in Finland.

https://arctichealth.org/en/permalink/ahliterature211177
Source
Scand J Prim Health Care. 1996 Sep;14(3):165-70
Publication Type
Article
Date
Sep-1996
Author
K. Eskola
P. Aittoniemi
H. Kurunmäki
A. Latva-Nevala
M. Paloneva
A M Wallin
M. Viitaniemi
I. Virjo
S. Ylinen
S. Ohman
M. Isokoski
Author Affiliation
Department of General Practice, University of Tampere, Finland.
Source
Scand J Prim Health Care. 1996 Sep;14(3):165-70
Date
Sep-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Atrial Fibrillation - drug therapy
Child
Cross-Sectional Studies
Female
Finland
Humans
Male
Middle Aged
Prevalence
Primary Health Care - standards
Prothrombin Time
Quality of Health Care
Sex Factors
Thrombophlebitis - drug therapy
Abstract
To establish the prevalence of anticoagulant (AC) treatment, the indications, and the quality of care in primary health care.
A cross-sectional study, in which patients on AC treatment were identified from laboratory records. The main and second indications for AC treatment and the last value of the AC-test were taken from medical records.
Eight Finnish health centres with a total population of 182091 inhabitants.
A total of 1255 patients on AC treatment were identified, 48% of them men. The mean age was 68.9 years. The age-adjusted prevalence of AC treatment was 0.65%. The commonest main indication was atrial fibrillation (38%). It was the main or second indication in 591 patients (age-adjusted prevalence 0.30%). The next commonest main indication was deep vein thrombosis (15%), followed by pulmonary embolism (8%). A total of 274 (22%) patients were anticoagulated for cerebral circulatory disturbances. 86% of the latest prothrombin time values fell within recommended ranges.
The prevalence of AC treatment in Finland seems to be high. The proportion of patients with atrial fibrillation is high, differing from the results in other countries. The monitoring of AC-treatment as the general practitioner's responsibility functions well. The quality of care is good, even in older age groups.
PubMed ID
8885029 View in PubMed
Less detail

Anticoagulant treatment of patients with chronic atrial fibrillation in primary health care in Sweden--a retrospective study of incidence and quality in a registered population.

https://arctichealth.org/en/permalink/ahliterature51950
Source
Fam Pract. 2004 Dec;21(6):612-6
Publication Type
Article
Date
Dec-2004
Author
Gunnar H Nilsson
Ingela Björholt
Ingvar Krakau
Author Affiliation
Department of Clinical Sciences, Center of Family Medicine, Karolinska Institute, Stockholm, Sweden. gunnar.nilsson@nlpo.sll.se
Source
Fam Pract. 2004 Dec;21(6):612-6
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anticoagulants - therapeutic use
Atrial Fibrillation - drug therapy - epidemiology
Chronic Disease
Cohort Studies
Community health centers - standards
Drug Utilization Review
Female
Humans
Incidence
Linear Models
Male
Medical Records Systems, Computerized
Middle Aged
Prevalence
Primary Health Care - standards
Quality of Health Care
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Time Factors
Warfarin - therapeutic use
Abstract
BACKGROUND: The number of patients receiving anticoagulant treatment is increasing. Chronic atrial fibrillation is the most common treatment diagnosis. The literature indicates a variable level of treatment control. Estimates of time within the therapeutic range have been recommended as a measurement of quality. Electronic patient records are providing clinical data that are useful for audits concerning anticoagulant treatment in real-life practice. OBJECTIVE: Our aim was to assess warfarin treatment for chronic atrial fibrillation in primary health care with regard to prevalence, incidence and quality. METHODS: A 2 year retrospective study was carried out of electronic patient records up to April 2002 in primary health care in Stockholm, including 12 primary health care centres with a registered population of 203 407. Main outcome measures were the number of new patients on wafarin treatment for chronic atrial fibrillation, and time within the therapeutic prothrombin range in the first 90 days of treatment using a linear interpolation method. RESULTS: In total, 827 patients were on warfarin treatment for chronic atrial fibrillation, giving a prevalence of 0.41%. Of these, 144 patients (study group) started treatment with warfarin for chronic atrial fibrillation during the study period, giving a yearly incidence of 0.07%. Their mean age was 73.1 years and 61.1% were men. There were 1721 prothrombin monitoring episodes registered in the first 90 days of treatment, on average once a week per patient. The average proportion of time within the therapeutic range was 54.1% (95% confidence interval (CI) 50.1-58.1), and the proportion of therapeutic tests was 50.2% (95% CI 47.8-52.6). CONCLUSIONS: During the first, second and third months of warfarin treatment for chronic atrial fibrillation, patients were outside the therapeutic range time nearly half the time. There was a gender difference favouring men regarding initiation of treatment.
PubMed ID
15465879 View in PubMed
Less detail

[Are primary health care patients really so special?].

https://arctichealth.org/en/permalink/ahliterature143878
Source
Lakartidningen. 2010 Mar 24-30;107(12):846; discussion 847
Publication Type
Article
Author
Tomas Fritz
Author Affiliation
Gustavsbergs vårdcentral. t.fritz@telia.com
Source
Lakartidningen. 2010 Mar 24-30;107(12):846; discussion 847
Language
Swedish
Publication Type
Article
Keywords
Family Practice - standards
Humans
Primary Health Care - standards
Quality Assurance, Health Care
Registries
Sweden
Notes
Comment On: Lakartidningen. 2010 Mar 10-16;107(10):656; discussion 65720402248
PubMed ID
20432836 View in PubMed
Less detail

Assessing methods for measurement of clinical outcomes and quality of care in primary care practices.

https://arctichealth.org/en/permalink/ahliterature122368
Source
BMC Health Serv Res. 2012;12:214
Publication Type
Article
Date
2012
Author
Michael E Green
William Hogg
Colleen Savage
Sharon Johnston
Grant Russell
R Liisa Jaakkimainen
Richard H Glazier
Janet Barnsley
Richard Birtwhistle
Author Affiliation
Department of Family Medicine, Queen's University, Kingston, Ontario, Canada. michael.green@dfm.queensu.ca
Source
BMC Health Serv Res. 2012;12:214
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Chronic Disease - epidemiology - therapy
Cross-Sectional Studies
Diagnosis-Related Groups - statistics & numerical data
Female
Health Knowledge, Attitudes, Practice
Health Surveys
Humans
Male
Medical Audit - methods
Middle Aged
Ontario - epidemiology
Outcome Assessment (Health Care) - methods
Patient Acceptance of Health Care - psychology - statistics & numerical data
Patient Credit and Collection
Patients - psychology
Physicians, Family - psychology - standards
Preventive Health Services - economics - standards - statistics & numerical data
Primary Health Care - standards
Quality Indicators, Health Care
Social Class
Abstract
To evaluate the appropriateness of potential data sources for the population of performance indicators for primary care (PC) practices.
This project was a cross sectional study of 7 multidisciplinary primary care teams in Ontario, Canada. Practices were recruited and 5-7 physicians per practice agreed to participate in the study. Patients of participating physicians (20-30) were recruited sequentially as they presented to attend a visit. Data collection included patient, provider and practice surveys, chart abstraction and linkage to administrative data sets. Matched pairs analysis was used to examine the differences in the observed results for each indicator obtained using multiple data sources.
Seven teams, 41 physicians, 94 associated staff and 998 patients were recruited. The survey response rate was 81% for patients, 93% for physicians and 83% for associated staff. Chart audits were successfully completed on all but 1 patient and linkage to administrative data was successful for all subjects. There were significant differences noted between the data collection methods for many measures. No single method of data collection was best for all outcomes. For most measures of technical quality of care chart audit was the most accurate method of data collection. Patient surveys were more accurate for immunizations, chronic disease advice/information dispensed, some general health promotion items and possibly for medication use. Administrative data appears useful for indicators including chronic disease diagnosis and osteoporosis/ breast screening.
Multiple data collection methods are required for a comprehensive assessment of performance in primary care practices. The choice of which methods are best for any one particular study or quality improvement initiative requires careful consideration of the biases that each method might introduce into the results. In this study, both patients and providers were willing to participate in and consent to, the collection and linkage of information from multiple sources that would be required for such assessments.
Notes
Cites: Qual Saf Health Care. 2003 Apr;12(2):122-812679509
Cites: Health Serv Res. 2002 Jun;37(3):791-82012132606
Cites: Ann Fam Med. 2003 Jul-Aug;1(2):81-915040437
Cites: Med Care. 1988 Jun;26(6):519-353379984
Cites: J Clin Epidemiol. 1990;43(6):543-92348207
Cites: Lancet. 1994 Oct 22;344(8930):1129-337934497
Cites: Am J Public Health. 1995 Jun;85(6):795-8007762712
Cites: Med Care. 1998 Jun;36(6):851-679630127
Cites: N Engl J Med. 1961 Nov 2;265:885-9214006536
Cites: Nicotine Tob Res. 2005 Apr;7 Suppl 1:S35-4316036268
Cites: Can J Aging. 2005 Spring;24 Suppl 1:153-7016080132
Cites: Health Serv Res. 2006 Dec;41(6):2238-5417116118
Cites: Ann Fam Med. 2007 Mar-Apr;5(2):159-6317389541
Cites: Can Fam Physician. 2008 Sep;54(9):1215-7, 1220-218791081
Cites: Ann Fam Med. 2009 Mar-Apr;7(2):121-719273866
Cites: Can Fam Physician. 2010 May;56(5):495-620463278
Cites: BMJ. 2010;341:c422620724404
Cites: BMC Fam Pract. 2010;11:9121087516
Cites: Can Fam Physician. 2010 Dec;56(12):1375-621156900
Cites: BMC Fam Pract. 2011;12:1421443806
Cites: J Fam Pract. 2000 Sep;49(9):796-80411032203
Cites: Diabetes Care. 2002 Mar;25(3):512-611874939
Cites: Health Policy. 2002 Jun;60(3):201-1811965331
Cites: Health Serv Res. 2003 Jun;38(3):831-6512822915
PubMed ID
22824551 View in PubMed
Less detail

212 records – page 1 of 22.