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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
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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
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[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 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
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The asthma programme of Finland: an evaluation survey in primary health care.

https://arctichealth.org/en/permalink/ahliterature185016
Source
Int J Tuberc Lung Dis. 2003 Jun;7(6):592-8
Publication Type
Article
Date
Jun-2003
Author
M. Erhola
R. Mäkinen
K. Koskela
V. Bergman
T. Klaukka
M. Mäkelä
L. Tirkkonen
M. Kaila
Author Affiliation
Finnish Lung Health Association, Helsinki, Finland.
Source
Int J Tuberc Lung Dis. 2003 Jun;7(6):592-8
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Asthma - diagnosis - therapy
Clinical Competence - standards - statistics & numerical data
Finland
Health Care Surveys - standards - statistics & numerical data
Humans
Outcome Assessment (Health Care) - standards - statistics & numerical data
Physician's Practice Patterns - standards - statistics & numerical data
Physicians, Family - standards - statistics & numerical data
Practice Guidelines as Topic - standards
Primary Health Care - standards - statistics & numerical data
Program Evaluation - standards - statistics & numerical data
Quality of Health Care - standards - statistics & numerical data
Time Factors
Abstract
To evaluate the basic structures and processes of asthma care 6 years after the launch of the Finnish Asthma Programme. The evaluation will serve as the baseline for the implementation of the evidence-based guidelines for asthma published in 2000.
A descriptive type-2 evaluation (managerial monitoring of a policy implementation), based on operationalised statements of the Asthma Programme.
A co-ordinating doctor for asthma, usually a general practitioner (GP), was interviewed in 248 (91%) health centres; 83% of the health centres have at least one GP nominated as the local asthma co-ordinator and 94% have a nurse. Asthma education for the professionals had been organised in 71% of the health centres in the previous 2 years. First-line treatment consists of an inhaled corticosteroid. Guided self-management is used in 98% of the health centres, but its components were not clear to the doctors.
The basic structure of equipment and organisation for the diagnosis and treatment of asthma has been set up in the primary health care services.
PubMed ID
12797704 View in PubMed
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Awareness and perception of heart failure among European cardiologists, internists, geriatricians, and primary care physicians.

https://arctichealth.org/en/permalink/ahliterature93109
Source
Eur Heart J. 2008 Jul;29(14):1739-52
Publication Type
Article
Date
Jul-2008
Author
Remme Willem J
McMurray John J V
Hobbs F D Richard
Cohen-Solal Alain
Lopez-Sendon José
Boccanelli Alessandro
Zannad Faiez
Rauch Bernhard
Keukelaar Karen
Macarie Cezar
Ruzyllo Witold
Cline Charles
Author Affiliation
Sticares Cardiovascular Research Foundation, PO Box 882, 3160 AB Rhoon, The Netherlands. w.j.remme@sticares.org
Source
Eur Heart J. 2008 Jul;29(14):1739-52
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Attitude of Health Personnel
Chronic Disease
Clinical Competence
Diagnostic Techniques, Cardiovascular - utilization
Drug Utilization
Europe
Guideline Adherence - statistics & numerical data
Health Care Surveys
Heart Failure - diagnosis - therapy
Humans
Practice Guidelines as Topic
Primary Health Care - standards - statistics & numerical data
Specialties, Medical
Abstract
AIMS: To assess awareness of heart failure (HF) management recommendations in Europe among cardiologists (C), internists and geriatricians (I/G), and primary care physicians (PCPs). METHODS AND RESULTS: The Study group on HF Awareness and Perception in Europe (SHAPE) surveyed randomly selected C (2041), I/G (1881), and PCP (2965) in France, Germany, Italy, the Netherlands, Poland, Romania, Spain, Sweden, and the UK. Each physician completed a 32-item questionnaire about the diagnosis and treatment of HF (left ventricular ejection fraction 90% of their patients (64 vs. 82% C, P 50% of their patients (vs. 73% C, P
Notes
Comment In: Eur Heart J. 2008 Jul;29(14):1706-818544544
PubMed ID
18506054 View in PubMed
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Chinese and white Canadian satisfaction and compliance with physicians.

https://arctichealth.org/en/permalink/ahliterature164517
Source
BMC Fam Pract. 2007;8:11
Publication Type
Article
Date
2007
Author
Richard Liu
Lawrence So
Hude Quan
Author Affiliation
Faculty of Medicine and Dentistry, University of Alberta, Canada. ryliu@ualberta.ca
Source
BMC Fam Pract. 2007;8:11
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alberta - epidemiology
Asian Americans - statistics & numerical data
Cross-Sectional Studies
Emigration and Immigration - classification - statistics & numerical data
European Continental Ancestry Group - statistics & numerical data
Female
Humans
Male
Middle Aged
Patient Compliance - ethnology
Patient Satisfaction - ethnology
Population Surveillance
Primary Health Care - standards - statistics & numerical data
Abstract
Patient satisfaction has become an important indicator of primary care and healthcare system performance. Ethnic disparities in patient satisfaction and compliance with physician care have been studied in several countries. However, this issue has not received significant attention in Canada. The unique characteristics of the Canadian healthcare system and ethnic population make it worthwhile to examine this issue in this population. Therefore, we conducted a survey among Chinese and Whites in a Canadian city to determine their reported satisfaction, and perceptions of physicians.
The survey was conducted in English, Mandarin and Cantonese in 2005 among Chinese and White Canadians, 18 years of age or older, who had visited at least one physician in Canada.
We analyzed 746 Chinese and 711 Whites in the general practitioner (GP) visit group and 485 Chinese and 637 Whites in the specialist visit group. A lower proportion of Chinese compared to Whites reported that they were very satisfied or satisfied with GP (73.7% vs. 92.8%) and specialist care (75.5% vs. 85.6%) and the differences between the two groups remained after adjustment for demographic variables and chronic conditions (risk adjusted OR: 0.70, 95%CI: 0.42-1.18 for the GP visit group and OR: 0.77, 95%CI: 0.48-1.23 for the specialist visit group). A similar proportion of Chinese and Whites reported that they always followed a physician's advice (59.4% vs. 59.6% for the GP visit group and 67.2% vs. 62.8% for the specialist visit group). Non-English speaking Chinese and recent arrivals in Canada were less likely to be satisfied with GPs than Chinese born in Canada [risk adjusted OR: 0.5, 95%CI: 0.3-0.9, 0.2 and 0.1-0.7, respectively].
Chinese Canadians reported lower satisfaction with physicians and perceived physicians slightly more negatively than White Canadians. Particularly, Chinese with limited English and short length of stay in Canada were less satisfied than Canadian born Chinese.
Notes
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PubMed ID
17376235 View in PubMed
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Delays in assessment of patients with rheumatoid arthritis: variations across Europe.

https://arctichealth.org/en/permalink/ahliterature132389
Source
Ann Rheum Dis. 2011 Oct;70(10):1822-5
Publication Type
Article
Date
Oct-2011
Author
Karim Raza
Rebecca Stack
Kanta Kumar
Andrew Filer
Jacqueline Detert
Hans Bastian
Gerd R Burmester
Prodromos Sidiropoulos
Eleni Kteniadaki
Argyro Repa
Tore Saxne
Carl Turesson
Herman Mann
Jiri Vencovsky
Anca Catrina
Aikaterini Chatzidionysiou
Aase Hensvold
Solbritt Rantapää-Dahlqvist
Alexa Binder
Klaus Machold
Brygida Kwiakowska
Adrian Ciurea
Giorgio Tamborrini
Diego Kyburz
Christopher D Buckley
Author Affiliation
Rheumatology Research Group, MRC Centre for Immune Regulation, Institute for Biomedical Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. k.raza@bham.ac.uk
Source
Ann Rheum Dis. 2011 Oct;70(10):1822-5
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Arthritis, Rheumatoid - diagnosis
Delayed Diagnosis - statistics & numerical data
Europe
Female
Humans
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Primary Health Care - standards - statistics & numerical data
Referral and Consultation - standards - statistics & numerical data
Time Factors
Abstract
The first 3 months after symptom onset represent an important therapeutic window for rheumatoid arthritis (RA). This study investigates the extent and causes of delay in assessment of patients with RA in eight European countries.
Data on the following levels of delay were collected from 10 centres (Berlin, Birmingham, Heraklion, Lund, Prague, Stockholm, Umeå, Vienna, Warsaw and Zurich): (1) from onset of RA symptoms to request to see healthcare professional (HCP); (2) from request to see HCP to assessment by that HCP; (3) from initial assessment by HCP to referral to rheumatologist; and (4) from referral to rheumatologist to assessment by that rheumatologist.
Data were collected from 482 patients with RA. The median delay across the 10 centres from symptom onset to assessment by the rheumatologist was 24 weeks, with the percentage of patients seen within 12 weeks of symptom onset ranging from 8% to 42%. There were important differences in the levels underlying the total delays at individual centres.
This research highlights the contribution of patients, professionals and health systems to treatment delay for patients with RA in Europe. Although some centres have strengths in minimising certain types of delay, interventions are required in all centres to ensure timely treatment for patients.
PubMed ID
21821867 View in PubMed
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Estimated prevalences of respiratory symptoms, asthma and chronic obstructive pulmonary disease related to detection rate in primary health care.

https://arctichealth.org/en/permalink/ahliterature15499
Source
Scand J Prim Health Care. 2001 Mar;19(1):54-7
Publication Type
Article
Date
Mar-2001
Author
M. Hasselgren
M. Arne
A. Lindahl
S. Janson
B. Lundbäck
Author Affiliation
Centre for Public Health Research, University of Karlstad, Sweden. mikael.hasselgren@swipnet.se
Source
Scand J Prim Health Care. 2001 Mar;19(1):54-7
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Asthma - epidemiology - physiopathology
Cross-Sectional Studies
Female
Humans
Lung Diseases, Obstructive - epidemiology - physiopathology
Male
Middle Aged
Population Surveillance
Prevalence
Primary Health Care - standards - statistics & numerical data
Research Support, Non-U.S. Gov't
Respiratory Insufficiency - epidemiology
Sweden - epidemiology
Abstract
OBJECTIVE: To assess the prevalence of respiratory symptoms, asthma and chronic obstructive pulmonary disease (COPD), and to relate it to an estimated detection rate in primary health care. DESIGN: A two-staged study with a cross-sectional survey and a clinical validation. SETTING: The adult population of Värmland, a county in Sweden. SUBJECTS: 4814 persons completed the survey and 206 the confirmative validation study. MAIN OUTCOME MEASURES: Prevalence of respiratory symptoms, of asthma and COPD. RESULTS: More than 40% reported respiratory symptoms. Wheeze was reported by 8.0%, shortness of breath by 11.4% and sputum production by 14.1%. Smoking was more common among women than among men. The prevalence of asthma was 8.2% and COPD 2.1%. Of persons with asthma, 33% were estimated to be undiagnosed, 67% used medication and nearly 60% attended primary health care services. CONCLUSION: Respiratory symptoms as well as asthma were common in this study and equivalent to earlier findings. The difference between the epidemiologically estimated prevalence of asthma and the lower detection rate in primary health care can be explained by at least three factors: persons who did not seek any care, were underdiagnosed or attended other health care providers.
PubMed ID
11303549 View in PubMed
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[It is incorrect to measure only the number of patient admissions].

https://arctichealth.org/en/permalink/ahliterature220643
Source
Lakartidningen. 1993 Jul 28;90(30-31):2583-4
Publication Type
Article
Date
Jul-28-1993

Managing Matajoosh: determinants of first Nations' cancer care decisions.

https://arctichealth.org/en/permalink/ahliterature286005
Source
BMC Health Serv Res. 2016 Aug 18;16(1):402
Publication Type
Article
Date
Aug-18-2016
Author
Josée G Lavoie
Joseph Kaufert
Annette J Browne
John D O'Neil
Source
BMC Health Serv Res. 2016 Aug 18;16(1):402
Date
Aug-18-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Decision Making
Female
Health Services Accessibility - standards - statistics & numerical data
Healthcare Disparities - statistics & numerical data
Humans
Indians, North American
Male
Manitoba - ethnology
Middle Aged
Minority Groups
Neoplasms - ethnology - therapy
Primary Health Care - standards - statistics & numerical data
Rural Health
Abstract
Accessing cancer treatment requires First Nation peoples living in rural and remote communities to either commute to care, or to relocate to an urban centre for the length or part of the treatment. While Canadians living in rural and remote communities must often make difficult decisions following a cancer diagnosis, such decisions are further complicated by the unique policy and socio-historical contexts affecting many First Nation peoples in Canada. These contexts often intersect with negative healthcare experiences which can be related to jurisdictional confusion encountered when seeking care. Given the rising incidence of cancer within First Nation populations, there is a growing potential for negative health outcomes.
The analysis presented in this paper focuses on the experience of First Nation peoples' access to cancer care in the province of Manitoba. We analyzed policy documents and government websites; interviewed individuals who have experienced relocation (N?=?5), family members (N?=?8), healthcare providers and administrators (N?=?15).
Although the healthcare providers (social workers, physicians, nurses, patient navigators, and administrators) we interviewed wanted to assist patients and their families, the focus of care remained informed by patients' clinical reality, without recognition of the context which impacts and constrains access to cancer care services. Contrasting and converging narratives identify barriers to early diagnosis, poor coordination of care across jurisdictions and logistic complexities that result in fatigue and undermine adherence. Providers and decision-makers who were aware of this broader context were not empowered to address system's limitations.
We argue that a whole system's approach is required in order to address these limitations.
Notes
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PubMed ID
27538389 View in PubMed
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21 records – page 1 of 3.