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Access to osteoporosis treatment is critically linked to access to dual-energy x-ray absorptiometry testing.

https://arctichealth.org/en/permalink/ahliterature161794
Source
Med Care. 2007 Sep;45(9):896-901
Publication Type
Article
Date
Sep-2007
Author
Suzanne M Cadarette
Monique A M Gignac
Susan B Jaglal
Dorcas E Beaton
Gillian A Hawker
Author Affiliation
Osteoporosis Research Program, Women's College Hospital, University of Toronto, Ontario, Canada. s.cadarette@utoronto.ca
Source
Med Care. 2007 Sep;45(9):896-901
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon - utilization
Aged
Aged, 80 and over
Cohort Studies
Female
Health Services Accessibility - statistics & numerical data
Humans
Mass Screening - utilization
Ontario - epidemiology
Osteoporosis, Postmenopausal - diagnosis - epidemiology - prevention & control
Professional-Patient Relations
Quality Assurance, Health Care - statistics & numerical data
Questionnaires
Referral and Consultation - statistics & numerical data
Reproducibility of Results
Risk assessment
Women's health
Abstract
To determine if inequities in access to osteoporosis investigation [dual-energy x-ray absorptiometry (DXA) testing] and treatment (bisphosphonate, calcitonin, and/or raloxifene) exist among older women in a region with universal health care coverage.
Community-dwelling women aged 65-89 years residing within 2 regions of Ontario, Canada were randomly sampled. Data were collected by standardized telephone interview. Potential correlates of DXA testing (verified by physician records), and current treatment were grouped by type as: "predisposing characteristics," "enabling resources," or "need factors" based on hypothesized relationships formulated before data collection. Variables associated with each outcome independent of "need factors" identified inequities in the system.
Of the 871 participants (72% response rate), 55% had been tested by DXA and 20% were receiving treatment. Using multiple variable logistic regression to adjust for need factors, significant inequities in access to DXA testing existed by age, health beliefs, education, income, use of preventive health services, region, and provider sex. DXA testing mediated access to treatment; 34% of those having had a DXA were treated compared with 2% of those who did not. Among women with osteoporosis, correctly reporting that their DXA test indicated osteoporosis and higher perceived benefits of taking pharmacological agents for osteoporosis were associated with treatment.
Significant inequities in access to fracture prevention exist in a region with universal health care coverage. Improved access to DXA and better communication to patients of both their DXA results and the benefits of treatment has the potential to reduce the burden of osteoporosis.
PubMed ID
17712261 View in PubMed
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Advantages and pitfalls of macrostatistics for health planning at the local as well as top national level.

https://arctichealth.org/en/permalink/ahliterature204380
Source
Scand Cardiovasc J. 1998;32(3):131-2
Publication Type
Article
Date
1998
Author
T T Nielsen
Source
Scand Cardiovasc J. 1998;32(3):131-2
Date
1998
Language
English
Publication Type
Article
Keywords
Angioplasty, Balloon, Coronary - statistics & numerical data
Cardiac Surgical Procedures - statistics & numerical data
Data Interpretation, Statistical
Europe
Humans
Quality Assurance, Health Care - statistics & numerical data
Scandinavia
United States
Notes
Comment On: Scand Cardiovasc J. 1997;31(6):365-79455787
Comment On: Scand Cardiovasc J. 1998;32(3):183-69764437
PubMed ID
9764426 View in PubMed
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Analysing current trends in care of acute myocardial infarction using PERFECT data.

https://arctichealth.org/en/permalink/ahliterature133898
Source
Ann Med. 2011 Jun;43 Suppl 1:S14-21
Publication Type
Article
Date
Jun-2011
Author
Unto Häkkinen
Juha Hartikainen
Merja Juntunen
Antti Malmivaara
Mikko Peltola
Ilkka Tierala
Author Affiliation
National Institute for Health and Welfare, Helsinki, Finland. unto.hakkinen@thl.fi
Source
Ann Med. 2011 Jun;43 Suppl 1:S14-21
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Finland - epidemiology
Hospital Costs - statistics & numerical data - trends
Humans
Male
Middle Aged
Myocardial Infarction - economics - epidemiology - therapy
Outcome and Process Assessment (Health Care) - economics - statistics & numerical data - trends
Quality Assurance, Health Care - statistics & numerical data - trends
Registries - statistics & numerical data
Abstract
This article in the supplement issue on the Performance, Effectiveness, and Costs of Treatment episodes (PERFECT)-project describes the PERFECT AMI (acute myocardial infarction) Database, which is developed to measure the performance of hospitals and hospital districts in Finland. We analyse annual trends and regional differences in performance indicators and whether the utilisation of services and costs of hospital care are related to improvement in survival of AMI patients.
The study population consists of ten annual cohorts (1998-2007) of patients hospitalised for AMI.
Since 1998 the treatment pattern has changed rather radically, the utilisation rate of percutaneous coronary intervention (PCI) has increased and coronary procedures have been performed earlier after myocardial infarction. Outcome measured by various measures of mortality has improved considerably. However, trends in the development of the use of services and outcomes are not similar between hospital districts. An increase in cost was positively and statistically significantly related to decrease in mortality, but the effect was not very strong.
There is potential for decreased mortality from actions that do not increase the costs and for enhancing performance in the regions and hospitals with poor performance.
PubMed ID
21639713 View in PubMed
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An evaluation of the QSP and the QPP: two methods for measuring patient satisfaction.

https://arctichealth.org/en/permalink/ahliterature71895
Source
Int J Qual Health Care. 2001 Jun;13(3):257-64
Publication Type
Article
Date
Jun-2001
Author
J. Nathorst-Böös
I M Munck
I. Eckerlund
C. Ekfeldt-Sandberg
Author Affiliation
Department of Obstetrics and Gynaecology, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden. jorgen.nathorst-boos@ks.se
Source
Int J Qual Health Care. 2001 Jun;13(3):257-64
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Female
Health Care Surveys - methods
Hospitals, University - standards
Humans
Models, Statistical
Multivariate Analysis
Obstetrics and Gynecology Department, Hospital - standards
Patient Acceptance of Health Care
Patient Satisfaction - statistics & numerical data
Quality Assurance, Health Care - statistics & numerical data
Questionnaires
Sweden
Abstract
BACKGROUND: Patient satisfaction is a function of several variables addressing reasons why it is important to use methods in which these different factors can be isolated and their importance analysed. OBJECTIVE: In this project, two methods using this approach were used: the 'Quality from the Patient's Perspective' and the 'Quality, Satisfaction, Performance' models. The aim of the present study is to evaluate these two different methods with respect to application, strengths and weaknesses. DESIGN: In the Quality from the Patient's Perspective model, the patient judges the different domains in two dimensions: perceived reality and subjective importance. The Quality, Satisfaction, Performance model uses a multivariate analysis to capture the patient's priorities. Four hundred and sixty forms for each model were distributed to a random sample of patients at the Department of Obstetrics and Gynecology at Karolinska Hospital. MAIN MEASURES: The quality factors 'treatment by the nurse', 'participation', 'information', 'environment' and 'accessibility' were measured. RESULTS: On both forms, 'medical care', 'treatment by the doctor' and 'access to nursing treatment' received high scores in perceived reality' while 'accessibility' and 'participation' received low scores. 'Subjective importance' measured directly and indirectly, respectively, in the two models showed high values for 'medical care' and 'treatment by the doctor'. CONCLUSION: The advantages of the Quality from the Patient's Perspective model are that it has a comprehensive and solid question bank. The Quality, Satisfaction, Performance model's advantage is its immediate usefulness and its clear graphic presentation. An integration and further development of these two approaches may prove useful.
PubMed ID
11476150 View in PubMed
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Autopsy and cause of death in randomized mammography studies.

https://arctichealth.org/en/permalink/ahliterature23863
Source
Qual Assur Health Care. 1993 Dec;5(4):303-7
Publication Type
Article
Date
Dec-1993
Author
A. Lindgren
Author Affiliation
Department of Pathology, Academic Hospital, Uppsala, Sweden.
Source
Qual Assur Health Care. 1993 Dec;5(4):303-7
Date
Dec-1993
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Autopsy - statistics & numerical data
Bias (epidemiology)
Breast - pathology
Breast Neoplasms - mortality - pathology - prevention & control
Cause of Death
Female
Humans
Mammography - standards - utilization
Mass Screening - standards
Middle Aged
Quality Assurance, Health Care - statistics & numerical data
Randomized Controlled Trials
Sweden - epidemiology
Abstract
Four randomized Swedish studies on the usefulness of mammography in screening for breast cancer have been published. The results have shown a variable but positive effect of screening in women more than 50 years of age but the effect is questionable before this age. The protocol and end points however differ between the studies and in order to summarize the results of the present studies, an unbiased, blinded end-point committee was created. The results of this study have been published recently. The present communication only concerns the role of autopsy in this study. The deaths of 1367 patients with a diagnosis of breast cancer have been studied. The percentage of autopsy varied from 21 to 74% between the four studies. When autopsy was performed, 58% were found to have died from breast cancer, 13% from other malignancies and the rest from other diseases. In cases with no autopsy, 73% were considered to have died of breast cancer and 9% of other malignancies. Deaths due to other cancers included a surprising number of cancers of the stomach, gallbladder and pancreas, two to three times higher than expected.
PubMed ID
8018887 View in PubMed
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Choices, persistence and adherence to antihypertensive agents: evidence from RAMQ data.

https://arctichealth.org/en/permalink/ahliterature157813
Source
Can J Cardiol. 2008 Apr;24(4):269-73
Publication Type
Article
Date
Apr-2008
Author
Jean Lachaine
Robert J Petrella
Elizabeth Merikle
Farzad Ali
Author Affiliation
Faculty of Pharmacy, University of Montreal, Montreal, Quebec. jean.lachaine@umontreal.ca
Source
Can J Cardiol. 2008 Apr;24(4):269-73
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Adult
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Antihypertensive Agents - therapeutic use
Calcium Channel Blockers - therapeutic use
Diuretics - therapeutic use
Female
Health Surveys
Humans
Hypertension - drug therapy - epidemiology
Insurance Coverage - statistics & numerical data
Male
Middle Aged
National Health Programs - statistics & numerical data
Patient Compliance - statistics & numerical data
Quality Assurance, Health Care - statistics & numerical data
Quebec
Abstract
Most treatment recommendations for hypertension are based on criteria that consider efficacy, safety and cost. Given the need for long-term use of antihypertensive agents, treatment compliance should also be taken into consideration in the selection process.
The purpose of the present study was to estimate persistence and adherence to antihypertensive agents in a real-life setting.
Persistence and adherence to treatment were estimated using data from the Regie de l'assurance maladie du Quebec.
Data from a random sample of 4561 subjects with a diagnosis of hypertension covered by the Regie de l'assurance maladie du Quebec drug plan and using one of the antihypertensive agents reimbursed by the drug plan for the first time between January 2000 and December 2001 were analyzed. The persistence rate observed after a two-year period with diuretics was significantly lower (52.8%) than with any other classes of antihypertensive agent (P
Notes
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PubMed ID
18401466 View in PubMed
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Comparing patient and nurse perceptions of perioperative care quality.

https://arctichealth.org/en/permalink/ahliterature186352
Source
Appl Nurs Res. 2003 Feb;16(1):29-37
Publication Type
Article
Date
Feb-2003
Author
Tuija Leinonen
Helena Leino-Kilpi
Marja-Riitta Ståhlberg
Kalle Lertola
Author Affiliation
Department of Surgery, Turku University Central Hospital, Turku, Finland. tuija.leinonen@pp3.inet.fi
Source
Appl Nurs Res. 2003 Feb;16(1):29-37
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Attitude of Health Personnel
Female
Finland
Humans
Male
Middle Aged
Nurse-Patient Relations
Nursing Process
Nursing Staff, Hospital - psychology - statistics & numerical data
Patient Satisfaction - statistics & numerical data
Perioperative Nursing - standards
Quality Assurance, Health Care - statistics & numerical data
Questionnaires
Statistics, nonparametric
Abstract
This study compared surgical patients' (n = 874) and perioperative nurses' (n = 143) perceptions of the quality of perioperative nursing care. The data were collected with a structured questionnaire in five hospital operating departments in Finland. The questionnaire items were divided into five main categories (staff characteristics, nursing activities, preconditions, progress of nursing process and environment); some of these categories were further divided into subcategories. Overall, patients tended to give significantly higher (P
PubMed ID
12624860 View in PubMed
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Comparison of patient evaluations of health care quality in relation to WHO measures of achievement in 12 European countries.

https://arctichealth.org/en/permalink/ahliterature50638
Source
Bull World Health Organ. 2004 Feb;82(2):106-14
Publication Type
Article
Date
Feb-2004
Author
Jan J Kerssens
Peter P Groenewegen
Herman J Sixma
Wienke G W Boerma
Ingrid van der Eijk
Author Affiliation
Netherlands Institute for Health Services Research, Utrecht, Netherlands. j.kerssens@nivel.nl
Source
Bull World Health Organ. 2004 Feb;82(2):106-14
Date
Feb-2004
Language
English
Publication Type
Article
Keywords
Comparative Study
Cross-Cultural Comparison
Databases
Europe
Family Practice - standards
Health Care Surveys
Hospitals - standards
Humans
Inflammatory Bowel Diseases - therapy
Patient Satisfaction - statistics & numerical data
Primary Health Care - standards
Psychometrics
Quality Assurance, Health Care - statistics & numerical data
Quality Indicators, Health Care
Research Support, Non-U.S. Gov't
World Health Organization
Abstract
OBJECTIVES: To gain insight into similarities and differences in patient evaluations of quality of primary care across 12 European countries and to correlate patient evaluations with WHO health system performance measures (for example, responsiveness) of these countries. METHODS: Patient evaluations were derived from a series of Quote (QUality of care Through patients' Eyes) instruments designed to measure the quality of primary care. Various research groups provided a total sample of 5133 patients from 12 countries: Belarus, Denmark, Finland, Greece, Ireland, Israel, Italy, the Netherlands, Norway, Portugal, United Kingdom, and Ukraine. Intraclass correlations of 10 Quote items were calculated to measure differences between countries. The world health report 2000 - Health systems: improving performance performance measures in the same countries were correlated with mean Quote scores. FINDINGS: Intra-class correlation coefficients ranged from low to very high, which indicated little variation between countries in some respects (for example, primary care providers have a good understanding of patients' problems in all countries) and large variation in other respects (for example, with respect to prescription of medication and communication between primary care providers). Most correlations between mean Quote scores per country and WHO performance measures were positive. The highest correlation (0.86) was between the primary care provider's understanding of patients' problems and responsiveness according to WHO. CONCLUSIONS: Patient evaluations of the quality of primary care showed large differences across countries and related positively to WHO's performance measures of health care systems.
PubMed ID
15042232 View in PubMed
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Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients.

https://arctichealth.org/en/permalink/ahliterature92764
Source
Langenbecks Arch Surg. 2008 Sep;393(5):667-73
Publication Type
Article
Date
Sep-2008
Author
Bergenfelz A.
Jansson S.
Kristoffersson A.
Mårtensson H.
Reihnér E.
Wallin G.
Lausen I.
Author Affiliation
Scandanavian Quality Register for Thyroid and Parathyroid Surgery, Lund, Sweden. anders.bergenfelz@med.lu.se
Source
Langenbecks Arch Surg. 2008 Sep;393(5):667-73
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Data Collection - statistics & numerical data
Databases, Factual - statistics & numerical data
Female
Follow-Up Studies
Humans
Incidence
Male
Medical Audit
Middle Aged
Postoperative Complications - epidemiology - etiology
Postoperative Hemorrhage - epidemiology - etiology
Prospective Studies
Quality Assurance, Health Care - statistics & numerical data
Registries - statistics & numerical data
Reoperation
Risk factors
Sweden
Thyroid Diseases - surgery
Thyroid Neoplasms - surgery
Thyroidectomy - methods
Young Adult
Abstract
BACKGROUND AND AIM: During recent years, more radical surgery for thyroid disease, i.e., total instead of subtotal resection, has been evident. Results following this strategy on national levels are scarce. MATERIALS AND METHODS: From 2004 to 2006, 26 Scandinavian Departments registered 3,660 thyroid operations in a database. Risk factors for complications were analyzed with multiple logistic regression. RESULTS: After thyroidectomy, re-bleeding occurred in 2.1% and was associated with older age (OR 1.04; p
PubMed ID
18633639 View in PubMed
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48 records – page 1 of 5.