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Access to primary care from the perspective of Aboriginal patients at an urban emergency department.

https://arctichealth.org/en/permalink/ahliterature139323
Source
Qual Health Res. 2011 Mar;21(3):333-48
Publication Type
Article
Date
Mar-2011
Author
Annette J Browne
Victoria L Smye
Patricia Rodney
Sannie Y Tang
Bill Mussell
John O'Neil
Author Affiliation
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada. annette.browne@nursing.ubc.ca
Source
Qual Health Res. 2011 Mar;21(3):333-48
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adult
Anthropology, Cultural
British Columbia
Canada
Emergency Service, Hospital - statistics & numerical data - utilization
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility - statistics & numerical data
Health services needs and demand
Health Status Disparities
Humans
Indians, North American - statistics & numerical data
Male
Middle Aged
Primary Health Care - statistics & numerical data
Time Factors
Triage
Urban Population - statistics & numerical data
Young Adult
Abstract
In this article, we discuss findings from an ethnographic study in which we explored experiences of access to primary care services from the perspective of Aboriginal people seeking care at an emergency department (ED) located in a large Canadian city. Data were collected over 20 months of immersion in the ED, and included participant observation and in-depth interviews with 44 patients triaged as stable and nonurgent, most of whom were living in poverty and residing in the inner city. Three themes in the findings are discussed: (a) anticipating providers' assumptions; (b) seeking help for chronic pain; and (c) use of the ED as a reflection of social suffering. Implications of these findings are discussed in relation to the role of the ED as well as the broader primary care sector in responding to the needs of patients affected by poverty, racialization, and other forms of disadvantage.
PubMed ID
21075979 View in PubMed
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Acute asthma among adults presenting to the emergency department: the role of race/ethnicity and socioeconomic status.

https://arctichealth.org/en/permalink/ahliterature183689
Source
Chest. 2003 Sep;124(3):803-12
Publication Type
Article
Date
Sep-2003
Author
Edwin D Boudreaux
Stephen D Emond
Sunday Clark
Carlos A Camargo
Author Affiliation
Department of Emergency Medicine, Cooper Hospital, One Cooper Plaza, Camden, NJ 08103-1489, USA. boudreaux-edwin@cooperhealth.edu
Source
Chest. 2003 Sep;124(3):803-12
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Asthma - epidemiology - ethnology
Canada - epidemiology
Cohort Studies
Emergency Service, Hospital - statistics & numerical data
Ethnic Groups - statistics & numerical data
Female
Health Services Accessibility - statistics & numerical data
Humans
Male
Middle Aged
Patient Admission - statistics & numerical data
Primary Health Care - statistics & numerical data
Prospective Studies
Socioeconomic Factors
United States - epidemiology
Abstract
To investigate racial/ethnic differences in acute asthma among adults presenting to the emergency department (ED), and to determine whether observed differences are attributable to socioeconomic status (SES).
Prospective cohort studies performed during 1996 to 1998 by the Multicenter Airway Research Collaboration. Using a standardized protocol, researchers provided 24-h coverage for a median duration of 2 weeks per year. Adults with acute asthma were interviewed in the ED and by telephone 2 weeks after hospital discharge.
Sixty-four North American EDs.
A total of 1,847 patients were enrolled into the study. Black and Hispanic asthma patients had a history of more hospitalizations than did whites (ever-hospitalized patients: black, 66%; Hispanic, 63%; white, 54%; p
PubMed ID
12970001 View in PubMed
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Adherence to health regimens among frequent attenders of Finnish healthcare.

https://arctichealth.org/en/permalink/ahliterature280267
Source
Int J Circumpolar Health. 2016;75:30726
Publication Type
Article
Date
2016
Author
Sari Hirsikangas
Outi Kanste
Juha Korpelainen
Helvi Kyngäs
Source
Int J Circumpolar Health. 2016;75:30726
Date
2016
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Cross-Sectional Studies
Female
Finland
Health Services Misuse - statistics & numerical data
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Office visits - statistics & numerical data
Outcome Assessment (Health Care)
Patient Compliance - statistics & numerical data
Primary Health Care - statistics & numerical data
Risk assessment
Self Care - statistics & numerical data
Sex Factors
Abstract
The aim of the study was to describe adherence to health regimens and the factors associated with it among adult frequent attenders (FAs).
This was a cross-sectional study. The study sample consisted of 462 healthcare FAs in 7 municipal health centres in northern Finland. An FA is a person who has had 8 or more outpatient visits to a GP (in a health centre) or 4 or more outpatient visits to a university hospital during 1 year. The main outcome was self-reported adherence to health regimens.
Of the FAs, 82% adhered well to their health regimens. Carrying out self-care, medical care and feeling responsible for self-care were the most significant predictors to good adherence in all models. No significant differences in adherence were found in male and female subjects, age groups or educational levels. Support from healthcare providers and support from relatives were not significant predictors of good adherence.
FAs in Finland adhere well to health regimens and exceptionally well to medication. Variables that predict the best adherence of FAs to health regimens are carrying out self-care, receiving medical care and feeling responsible for self-care.
Notes
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PubMed ID
26996780 View in PubMed
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Adoption of routine telemedicine in Norway: the current picture.

https://arctichealth.org/en/permalink/ahliterature256873
Source
Glob Health Action. 2014;7:22801
Publication Type
Article
Date
2014
Author
Paolo Zanaboni
Undine Knarvik
Richard Wootton
Author Affiliation
Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway; paolo.zanaboni@telemed.no.
Source
Glob Health Action. 2014;7:22801
Date
2014
Language
English
Publication Type
Article
Keywords
Health Care Surveys
Hospitals - statistics & numerical data
Humans
Norway - epidemiology
Primary Health Care - statistics & numerical data
Secondary Care - statistics & numerical data
Telemedicine - utilization
Abstract
Telemedicine appears to be ready for wider adoption. Although existing research evidence is useful, the adoption of routine telemedicine in healthcare systems has been slow.
We conducted a study to explore the current use of routine telemedicine in Norway, at national, regional, and local levels, to provide objective and up-to-date information and to estimate the potential for wider adoption of telemedicine. Design : A top-down approach was used to collect official data on the national use of telemedicine from the Norwegian Patient Register. A bottom-up approach was used to collect complementary information on the routine use of telemedicine through a survey conducted at the five largest publicly funded hospitals.
Results show that routine telemedicine has been adopted in all health regions in Norway and in 68% of hospitals. Despite being widely adopted, the current level of use of telemedicine is low compared to the number of face-to-face visits. Examples of routine telemedicine can be found in several clinical specialties. Most services connect different hospitals in secondary care, and they are mostly delivered as teleconsultations via videoconference.
Routine telemedicine in Norway has been widely adopted, probably for geographical reasons, as in other settings. However, the level of use of telemedicine in Norway is rather low, and it has significant potential for further development as an alternative to face-to-face outpatient visits. This study is a first attempt to map routine telemedicine at regional, institutional, and clinical levels, and it provides useful information to understand the adoption of telemedicine in routine healthcare and to measure change in future updates.
Notes
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PubMed ID
24433942 View in PubMed
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Air pollution is associated with primary health care visits for asthma in Sweden: A case-crossover design with a distributed lag non-linear model.

https://arctichealth.org/en/permalink/ahliterature286937
Source
Spat Spatiotemporal Epidemiol. 2016 May;17:37-44
Publication Type
Article
Date
May-2016
Author
Tahir Taj
Kristina Jakobsson
Emilie Stroh
Anna Oudin
Source
Spat Spatiotemporal Epidemiol. 2016 May;17:37-44
Date
May-2016
Language
English
Publication Type
Article
Keywords
Air Pollutants - analysis
Air Pollution - statistics & numerical data
Asthma - epidemiology
Cross-Over Studies
Humans
Nonlinear Dynamics
Office visits - statistics & numerical data
Primary Health Care - statistics & numerical data
Sweden - epidemiology
Urban Population
Abstract
Air pollution can increase the symptoms of asthma and has an acute effect on the number of emergency room visits and hospital admissions because of asthma, but little is known about the effect of air pollution on the number of primary health care (PHC) visits for asthma.
To investigate the association between air pollution and the number of PHC visits for asthma in Scania, southern Sweden.
Data on daily PHC visits for asthma were obtained from a regional healthcare database in Scania, which covers approximately half a million people. Air pollution data from 2005 to 2010 were obtained from six urban background stations. We used a case-crossover study design and a distributed lag non-linear model in the analysis.
The air pollution levels were generally within the EU air quality guidelines. The mean number of daily PHC visits for asthma was 34. The number of PHC visits increased by 5% (95% confidence interval (CI): 3.91-6.25%) with every 10µg m(-3) increase in daily mean NO2 lag (0-15), suggesting that daily air pollution levels are associated with PHC visits for asthma.
Even though the air quality in Scania between 2005 and 2010 was within EU's guidelines, the number of PHC visits for asthma increased with increasing levels of air pollution. This suggests that as well as increasing hospital and emergency room visits, air pollution increases the burden on PHC due to milder symptoms of asthma.
PubMed ID
27246271 View in PubMed
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Alexithymia and psychological distress among frequent attendance patients in health care.

https://arctichealth.org/en/permalink/ahliterature213347
Source
Psychother Psychosom. 1996;65(4):199-202
Publication Type
Article
Date
1996
Author
M. Joukamaa
H. Karlsson
B. Sholman
V. Lehtinen
Author Affiliation
Department of Psychiatry, University of Turku, Finland.
Source
Psychother Psychosom. 1996;65(4):199-202
Date
1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Affective Symptoms - epidemiology - psychology
Causality
Chi-Square Distribution
Comorbidity
Female
Finland - epidemiology
Humans
Logistic Models
Male
Middle Aged
Primary Health Care - statistics & numerical data
Sampling Studies
Stress, Psychological - epidemiology
Abstract
The aim of the present study was to find out whether alexithymia is common in frequently attending primary health care patients and whether alexithymia and psychological distress are associated in these patients.
Alexithymia was measured by the TAS-26 and psychological distress by the SCL-25 in a random sample of 394 working-age primary health care patients. Frequent attendance was defined as a minimum of 11 visits during 1 year to different kinds of outpatient health care services, excluding specialized psychiatric care.
Frequently attending patients with psychological distress were found to be alexithymic more commonly than other patients, but this was not the case with other frequently attending patients. In other words, frequent attendance and alexithymia had an association mediated by psychological distress.
There is a subgroup of frequently attending patients, who are alexithymic and have psychological distress, too. They usually visit health-care services because of a somatic complaint. We hypothesize that their expression of psychological distress was masked and somatized just because of alexithymia.
PubMed ID
8843500 View in PubMed
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Analysis of factors associated with waiting times for GP appointments in Finnish health centres: a QUALICOPC study.

https://arctichealth.org/en/permalink/ahliterature294992
Source
BMC Res Notes. 2018 Apr 03; 11(1):220
Publication Type
Journal Article
Date
Apr-03-2018
Author
Elina Tolvanen
Tuomas H Koskela
Kari J Mattila
Elise Kosunen
Author Affiliation
Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland. elina.tolvanen@uta.fi.
Source
BMC Res Notes. 2018 Apr 03; 11(1):220
Date
Apr-03-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Appointments and Schedules
Female
Finland
General Practitioners - statistics & numerical data
Health Services Accessibility - statistics & numerical data
Health Services Research
Humans
Male
Middle Aged
Primary Health Care - statistics & numerical data
Time Factors
Young Adult
Abstract
Access to care is a multidimensional concept, considered as a structural aspect of health care quality; it reflects the functioning of a health care organization. The aim of this study was to investigate patients' experiences of access to care and to analyse factors associated with waiting times to GP appointments at Finnish health centres. A questionnaire survey was addressed to Finnish GPs within the Quality and Costs of Primary Care in Europe study framework. Two to nine patients per GP completed the questionnaire, altogether 1196. Main outcome measures were waiting times for appointments with GPs and factors associated with waiting times. In addition, patients' opinions of access to appointments were analysed.
Of the 988 patients who had made their appointment in advance, 84.9% considered it easy to secure an appointment, with 51.9% obtaining an appointment within 1 week. Age and reason for contact were the most significant factors affecting the waiting time. Elderly patients tended to have longer waiting times than younger ones, even when reporting illness as their reason for contact. Thus, waiting times for appointments tend to be prolonged in particular for the elderly and there is room for improvement in the future.
Notes
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PubMed ID
29615135 View in PubMed
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An analysis of psychotropic drug sales. Increasing sales of selective serotonin reuptake inhibitors are closely related to number of products.

https://arctichealth.org/en/permalink/ahliterature133729
Source
Int J Risk Saf Med. 2011;23(2):125-32
Publication Type
Article
Date
2011
Author
Margrethe Nielsen
Peter Gøtzsche
Author Affiliation
The Nordic Cochrane Centre, Rigs hospitalet, Copenhagen, Denmark. marn@phmetropol.dk
Source
Int J Risk Saf Med. 2011;23(2):125-32
Date
2011
Language
English
Publication Type
Article
Keywords
Antidepressive Agents - economics
Benzodiazepines - economics
Commerce
Denmark
Drug Prescriptions - economics - statistics & numerical data
Drug Utilization - economics - statistics & numerical data
Economics, Pharmaceutical
Humans
Inappropriate Prescribing - economics
Marketing
Primary Health Care - statistics & numerical data
Psychotropic Drugs - economics
Serotonin Uptake Inhibitors - economics
Abstract
Prescribing of selective serotonin reuptake inhibitors (SSRIs) has increased dramatically.
To compare the sales of benzodiazepines and SSRIs within the primary care sector in Denmark and relate changes in usage to number of indications and products on the market.
We used data from various sources to establish the sales curves of psychotropic drugs in the period 1970 to 2007, based on the Anatomic Therapeutic Classification system and Defined Daily Doses.
Fluctuations in sales of psychotropic drugs that cannot be explained by disease prevalence were caused by changes in sales of the benzodiazepines and SSRIs. We found a decline in the sales of benzodiazepines after a peak in 1986, likely due to the recognition that they cause dependence. From a low level in 1992, we found that the sales of SSRIs increased almost linearly by a factor of 18, up to 44 DDD per 1000 inhabitants, which was closely related to the number of products on the market that increased by a factor of 16.
Sales of antidepressant drugs are mainly determined by market availability of products indicating that marketing pressures are playing an important role. Thus the current level of use of SSRIs may not be evidence-based, which is supported by studies showing that the effect of SSRIs has been overestimated.
PubMed ID
21673422 View in PubMed
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An assessment of the Cardiovascular Health Education Program in primary health care.

https://arctichealth.org/en/permalink/ahliterature214606
Source
Appl Nurs Res. 1995 Aug;8(3):114-7
Publication Type
Article
Date
Aug-1995
Author
S A MacDonald
Author Affiliation
School of Nursing, Memorial University School of Newfoundland, St. John's, Canada.
Source
Appl Nurs Res. 1995 Aug;8(3):114-7
Date
Aug-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Cardiovascular Diseases - nursing - prevention & control
Health Education - statistics & numerical data
Health Knowledge, Attitudes, Practice
Humans
Newfoundland and Labrador
Primary Health Care - statistics & numerical data
Program Evaluation - methods - statistics & numerical data
Questionnaires
Abstract
Primary health care is an effective means of improving health for all while at the same time containing rising health care costs. In an effort to improve the health of one community, the Cardiovascular Health Education Program (CHEP) was implemented in a study of 44 eighth-grade adolescents. The purpose of this study was to assess the influence of the CHEP on adolescents' cardiovascular health knowledge. It was found that participants' knowledge improved significantly, whereas a control group showed no comparable improvement. This study showed that community-based health education programs for targeted populations can influence health knowledge.
PubMed ID
7668852 View in PubMed
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Antibiotic consumption in relation to socio-demographic factors, co-morbidity, and accessibility of primary health care.

https://arctichealth.org/en/permalink/ahliterature262680
Source
Scand J Infect Dis. 2014 Dec;46(12):888-96
Publication Type
Article
Date
Dec-2014
Author
Anders Ternhag
Maria Grünewald
Pontus Nauclér
Karin Tegmark Wisell
Source
Scand J Infect Dis. 2014 Dec;46(12):888-96
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Child
Child, Preschool
Comorbidity
Demography
Drug Prescriptions
Drug Utilization - statistics & numerical data
Female
Health Services Accessibility - statistics & numerical data
Humans
Infant
Logistic Models
Male
Middle Aged
Primary Health Care - statistics & numerical data
Respiratory Tract Infections - drug therapy - epidemiology
Socioeconomic Factors
Sweden - epidemiology
Young Adult
Abstract
Differences in antibiotic consumption between individuals are not only due to differences in primary infection morbidity, other non-medical factors are important. Our objective was to investigate how socio-demographic factors, co-morbidity, and access to primary care affect antibiotic prescribing.
The study population included all 2 078 481 persons in Sweden who received at least one antibiotic prescription during 2010, and an unmatched control population of 788 580 individuals. We used record linkage to obtain data on co-morbidity, various socio-demographic variables, and waiting times for doctor appointments in primary care. We used logistic regression to estimate odds ratios (ORs) for antibiotic prescription.
The results showed that over 20% of the population were prescribed antibiotics during 2010. Children aged 0-5 years, persons = 75 years of age, those living in urban areas, and women compared with men, received many prescriptions. Co-morbidity was a strong factor that determined the number of antibiotic prescriptions: those with Charlson's index = 3 had an OR of 3.03 (95% CI: 3.00-3.07) to obtain antibiotics in the adjusted analysis, compared with individuals without co-morbidity (Charlson's index 0). Short waiting times for a doctor's visit in primary care were associated with a higher number of antibiotic prescriptions. Individuals born in Sweden were prescribed more antibiotics compared with those born in another country. Specifically, persons born in any of the 27 EU countries (excluding Scandinavia) had an OR of antibiotic prescription of 0.78 (95% CI: 0.77-0.78) compared with native-born individuals.
We conclude that non-medical factors strongly influence antibiotic prescriptions.
PubMed ID
25268280 View in PubMed
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242 records – page 1 of 25.