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[Activities performed by general practitioners before and after the introduction of an inter-municipal emergency service and the list patient system].

https://arctichealth.org/en/permalink/ahliterature181382
Source
Tidsskr Nor Laegeforen. 2004 Feb 19;124(4):506-7
Publication Type
Article
Date
Feb-19-2004
Author
Ola Jøsendal
Solfrid Aase
Author Affiliation
Radøy legesenter, 5936 Manger. ola.josendal@psyhp.uib.no
Source
Tidsskr Nor Laegeforen. 2004 Feb 19;124(4):506-7
Date
Feb-19-2004
Language
Norwegian
Publication Type
Article
Keywords
After-Hours Care - economics - organization & administration - utilization
Cost Savings
Efficiency, Organizational
Emergency Medical Services - economics - organization & administration - utilization
Family Practice - economics - organization & administration - statistics & numerical data
Health Care Reform - economics - organization & administration - statistics & numerical data
House Calls - economics - statistics & numerical data
Humans
Norway
Referral and Consultation - economics - organization & administration - utilization
Registries
Abstract
Over a span of four years we studied the number and type of patient contacts with the off-hour emergency service in a municipality in Western Norway. At the start of the period, the service was organised by each municipality, later more municipalities formed a regional service. At the end of the period, a list patient system was introduced.
All contacts from patients as well as activities performed by general practitioners on off-hour emergency duty were registered in four separate periods, from 1999 to 2002.
Simultaneously with shift from a local to a regional system, the proportion of home calls fell from 18% to less than 1%. The implementation of a list patient system combined with a regional system reduced the total number of contacts by 30%. Public expenditure was reduced by 66%.
The combination of a regional off-hour service and a list patient system gives an efficient organisation. The total work-load for doctors is significantly reduced and the quality of medical services improve; financial considerations also support a shift in off-hour emergency service towards regional organisation.
PubMed ID
14983200 View in PubMed
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[A questionnaire about compulsory referrals in Stockholm].

https://arctichealth.org/en/permalink/ahliterature177409
Source
Lakartidningen. 2004 Oct 21;101(43):3371
Publication Type
Article
Date
Oct-21-2004

[Are the Danish Society of General Practitioners' clinical guidelines concerning "Identification and investigation of dementia and dementia-like conditions" useful as the basis of dementia investigation in general practice?]

https://arctichealth.org/en/permalink/ahliterature71316
Source
Ugeskr Laeger. 2003 May 12;165(20):2105-7
Publication Type
Article
Date
May-12-2003
Author
Lisbeth Errebo-Knudsen
Ole Dinesen
Bo Gandil Jakobsen
Kim Agner Kristensen
Author Affiliation
Lunds Universitet, Forskningsmetodisk grundkurs VMF 521, og Sundhedsforvaltningen i Nykøbing Falster, Kvalitetsenheden FUAP.
Source
Ugeskr Laeger. 2003 May 12;165(20):2105-7
Date
May-12-2003
Language
Danish
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Cholinesterase Inhibitors - administration & dosage
Dementia - diagnosis - drug therapy
Denmark
English Abstract
Family Practice
Female
Humans
Male
Middle Aged
Neuropsychological Tests
Practice Guidelines
Questionnaires
Referral and Consultation - economics
Societies, Medical
Tomography, X-Ray
Abstract
INTRODUCTION: During the last five years better possibilities have appeared for investigation and medical treatment of dementia. Society and the national health authorities have a growing demand for systematical identification of dementia. In 1999, DSAM published a clinical guideline for identifying dementia. The aim of the study was to test the usefulness of that guideline. MATERIAL AND METHODS: A total of 22 out of 29 general practitioners (GPs) agreed to use the guidelines of the Danish Society of General Practitioners (DSAM) and the questionnaires from three consultations in order to systematically identify dementia. At the same time, the GPs gave their opinion about the usefulness of the guidelines. RESULTS: A total of 22 GPs sent results from 69 patients. A group of 49 patients had been CT-scanned, 13 patients had been examined by neuropsychologists, and nine patients had started acetylcholinesterase inhibitor treatment. CONCLUSION: Some GPs found it embarrassing to offer dementia identifying to their patients. Identifying dementia was complicated and time-consuming. Identifying dementia offered opportunities to look further into polypharmacy and cooperation with other health sectors. Necessary but not sufficient preconditions for starting identifying dementia in general practice will be fees, direct admission to CT-scanning and neuropsychologist, and possibly right to prescribe acetylcholinesterase inhibitors. The conclusion was that all GPs found the guidelines of DSAM useful for identifying dementia in general practice.
PubMed ID
12812104 View in PubMed
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Assessing the costs of activator treatments in general practice.

https://arctichealth.org/en/permalink/ahliterature36173
Source
Br J Orthod. 1993 Aug;20(3):235-40
Publication Type
Article
Date
Aug-1993
Author
M E Follin
E. Kahnberg
O. Sjöström
Author Affiliation
Faculty of Odontology, University of Göteborg, Gothenburg, Sweden.
Source
Br J Orthod. 1993 Aug;20(3):235-40
Date
Aug-1993
Language
English
Publication Type
Article
Keywords
Activator Appliances - economics
Adolescent
Child
Comparative Study
Female
General Practice, Dental - economics
Humans
Male
Orthodontics - economics
Orthodontics, Corrective - economics
Outcome and Process Assessment (Health Care)
Referral and Consultation - economics
Retrospective Studies
Sweden
Time Factors
Abstract
From a register of patients with malocclusion, 1688 patients were selected, of which 208 (12.3 per cent) had received activator treatment in general practice. Fifteen patients having moved from the area, the remaining 193 patients were selected for the study. From the patients' records, activator treatment time, and the costs of activator and additional orthodontic treatment were estimated. The results of activator treatment were graded according to a three-grade scale. Most activator treatments (83 per cent) had a duration of 2 years or less. Approximately half (48 per cent) of the patients were estimated to have good or excellent results. There was great variation in activator treatment costs and these did not appear to be associated with treatment results. There were also extreme variations between patients in number of visits to the clinic as well as in chairside-time. Additional orthodontic treatments were performed by the GDPs in 55 per cent of the patients and 12 per cent of the patients were referred to orthodontic specialist clinics for treatment.
PubMed ID
8399057 View in PubMed
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Barriers to measles and pertussis immunization: the knowledge and attitudes of Pennsylvania primary care physicians.

https://arctichealth.org/en/permalink/ahliterature209192
Source
Am J Prev Med. 1997 Mar-Apr;13(2):89-97
Publication Type
Article
Author
R K Zimmerman
B J Bradford
J E Janosky
T A Mieczkowski
E. DeSensi
S. Grufferman
Author Affiliation
Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, PA 15261, USA.
Source
Am J Prev Med. 1997 Mar-Apr;13(2):89-97
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Chi-Square Distribution
Child, Preschool
Female
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Immunization - economics - psychology
Immunization Schedule
Infant
Insurance, Health - statistics & numerical data
Linear Models
Male
Measles - prevention & control - transmission
Multivariate Analysis
Pennsylvania
Physicians, Family - education - psychology
Pregnancy
Referral and Consultation - economics
Sampling Studies
Vaccines - administration & dosage - contraindications - economics
Whooping Cough - prevention & control - therapy
Abstract
To understand the causes of low childhood immunization rates, physicians were interviewed about their knowledge, attitudes, and self-reported immunization practices.
Trained interviewers conducted a standardized telephone survey of physicians. A random sample of Pennsylvania family physicians, pediatricians, and general practitioners younger than 65 years of age who were in office-based practices was selected from the combined listings of the American Medical Association and American Osteopathic Association. Physicians seeing > or = 5 patients per week under age 6 years, seeing a total of > or = 15 patients per week, and having > or = 50% primary care patients were eligible. Of 383 eligible physicians, 70% (268) responded. The questionnaire was designed using the Health Belief Model, immunization barriers, and input from practitioners in primary care, pediatric infectious disease, maternal/ child health, and preventive medicine.
Respondents were more likely to refer to public vaccine clinics those children without insurance (P 90%) respondents thought that vaccine efficacy was high and that the likelihood of serious side effects was low. However, only 37% gave estimates that corresponded with the literature regarding the likelihood of an infant with pertussis to need hospitalization. Many respondents used invalid vaccine contraindications; for instance, 37% would not administer MMR to a boy whose mother was pregnant. Many respondents (21%) would not administer four vaccines simultaneously.
If the Healthy People 2000 goal to eliminate indigenous cases of measles is to be achieved, free vaccine supplies and increased provider education are needed.
PubMed ID
9088444 View in PubMed
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Clinical response of salaried consultants to economic incentives.

https://arctichealth.org/en/permalink/ahliterature199604
Source
Dev Health Econ Public Policy. 1998;6:137-58
Publication Type
Article
Date
1998
Author
T. Iversen
Author Affiliation
University of Oslo, Norway.
Source
Dev Health Econ Public Policy. 1998;6:137-58
Date
1998
Language
English
Publication Type
Article
Keywords
Ambulatory Surgical Procedures - economics - utilization
Decision Making
Fees, Medical - statistics & numerical data
Health Care Costs - statistics & numerical data
Health Priorities - economics
Health Services Research
Hospital Charges - statistics & numerical data
Hospitals, Public - economics - manpower
Humans
Medical Staff, Hospital - economics - statistics & numerical data
Models, Econometric
Motivation
Norway
Operating Rooms - economics - utilization
Patient Selection
Physician's Practice Patterns - economics - statistics & numerical data
Referral and Consultation - economics
Salaries and Fringe Benefits
Sampling Studies
Social Justice
Surgical Procedures, Operative - economics - utilization
Abstract
Several studies have found a relation between economic incentives and physicians' clinical decisions. The bulk of these studies deals with data from private organisations providing medical care. The purpose of the present study is to explore whether a similar relationship is valid in a system where hospital care is provided by salaried physicians in the public sector. A distinction is made between medical and economic prioritysetting. If the relative fees influence the proportion of outpatient surgery or the compositions of treatments, economic prioritysetting is said to take place. Data were collected from a sample of Norwegian hospitals. The main findings of the empirical section can be summarised in two points: (i) Economic prioritysetting seems to be applied in the choice between inpatient and outpatient surgical treatment for patients with an identical diagnosis. (ii) Medical priority setting seems to be applied in the priority among patients with different diagnoses.
PubMed ID
10662401 View in PubMed
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Comparison of different stepwise screening strategies for type 2 diabetes: Finding from Danish general practice, Addition-DK.

https://arctichealth.org/en/permalink/ahliterature141806
Source
Prim Care Diabetes. 2010 Dec;4(4):223-9
Publication Type
Article
Date
Dec-2010
Author
Else-Marie Dalsgaard
Jesper O Christensen
Mette Vinter Skriver
Knut Borch-Johnsen
Torsten Lauritzen
Annelli Sandbaek
Author Affiliation
Department of General Health, Aarhus University, Denmark. emdl@alm.au.dk
Source
Prim Care Diabetes. 2010 Dec;4(4):223-9
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Appointments and Schedules
Biological Markers - blood
Blood Glucose - analysis
Chi-Square Distribution
Cost Savings
Denmark
Diabetes Mellitus, Type 2 - blood - diagnosis - economics
Female
General Practice - economics
Glucose Tolerance Test - economics
Health Care Costs
Hemoglobin A, Glycosylated - metabolism
Humans
Male
Mass Screening - economics - methods
Middle Aged
Predictive value of tests
Questionnaires - economics
Referral and Consultation - economics
Risk assessment
Risk factors
Abstract
To examine attendance, number of people with T2DM and costs of three different stepwise screening strategies for T2DM in general practice (GP).
Diabetes risk questionnaires were mailed to individuals aged 40-69 years from 45 general practices in 2001-2002 and individuals at high risk for T2DM, were asked to contact their GP to arrange a screening test. In 2005-2006, 26 general practices were randomised into two different opportunistic screening programmes (OP-direct and OP-subsequent) and risk questionnaires were distributed to individuals aged 40-69 years during GP consultations. In the OP-direct approach, high-risk individuals were offered to start the screening during the actual consultation while high-risk individuals in the OP-subsequent approach, were invited to a screening test at a later date. We report attendance, number of people with T2DM and costs of each screening approach.
The mail-distributed approach identified 0.8% of the target population with T2DM, the OP-direct approach and the OP-subsequent approach, 0.9% and 0.5% respectively. Cost per person with T2DM was in the mail-distributed approach: € 1058, OP-direct approach: € 707 and the OP-subsequent approach: € 727.
This study indicates that opportunistic screening identifies the same level of unknown diabetes as a mail-distributed approach but with lower costs.
PubMed ID
20675208 View in PubMed
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Comparison of liaison and staff nurses in discharge referrals of postpartum patients for public health nursing follow-up.

https://arctichealth.org/en/permalink/ahliterature220743
Source
Nurs Res. 1993 Jul-Aug;42(4):245-9
Publication Type
Article
Author
A. Mitchell
C. Van Berkel
V. Adam
D. Ciliska
K. Sheppard
A. Baumann
J. Underwood
S. Walter
A. Gafni
N. Edwards
Author Affiliation
Hamilton-Wentworth Department of Public Health Services, Teaching Health Unit, McMaster University, Hamilton, Ontario, Canada.
Source
Nurs Res. 1993 Jul-Aug;42(4):245-9
Language
English
Publication Type
Article
Keywords
Adult
Community Health Nursing - economics - manpower - organization & administration - statistics & numerical data
Costs and Cost Analysis
Efficiency
Female
Follow-Up Studies
Humans
Interprofessional Relations
Nursing Staff, Hospital - economics - organization & administration - statistics & numerical data
Ontario
Patient Discharge - economics - statistics & numerical data
Postnatal Care - economics - manpower - organization & administration - statistics & numerical data
Public Health Nursing - economics - manpower - organization & administration - statistics & numerical data
Referral and Consultation - economics - organization & administration - statistics & numerical data
Abstract
The purpose of this study was to compare hospital staff nurses to public health liaison nurses in the accuracy and cost of postpartum referrals for public health nursing follow-up in the community. In the before phase of the study, public health liaison nurses assessed 304 mothers to determine the need for a follow-up visit by the public health nurse. In the after phase, staff nurses assessed 326 mothers. Public health nurses, unaware of the identity of the referring nurse and the referral decision, judged whether their visit had been required. Staff nurses correctly identified a higher proportion of referrals requiring public health nurse follow-up than liaison nurses. Although they referred more clients who did not require a public health nurse visit, costs of referrals by staff nurses remained lower.
PubMed ID
8337164 View in PubMed
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Comparison of public and private bariatric surgery services in Canada.

https://arctichealth.org/en/permalink/ahliterature134221
Source
Can J Surg. 2011 Jun;54(3):154-69
Publication Type
Article
Date
Jun-2011
Author
Allan R Martin
Jason Klemensberg
Laz V Klein
David Urbach
Chaim M Bell
Author Affiliation
Department of Medicine, University of Toronto, Ont., Canada.
Source
Can J Surg. 2011 Jun;54(3):154-69
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Bariatric Surgery - economics - methods
Canada
Confounding Factors (Epidemiology)
Gastric Bypass - adverse effects - economics
Health Care Costs - statistics & numerical data
Health Care Surveys
Humans
Interdisciplinary Communication
Private Sector
Public Assistance
Questionnaires
Referral and Consultation - economics - statistics & numerical data
Research Design
Telephone
Abstract
Surgical treatment of obesity is cost-effective and improves life expectancy. Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB) are dominant surgical techniques, but RYGB is the only publicly insured procedure in all Canadian provinces. Private clinics currently offer AGB with minimal wait times. We sought to compare RYGB in public facilities with AGB in private clinics in terms of cost, wait times and certain aspects of patient care.
We conducted telephone interviews of all bariatric surgery providers across Canada (100% response rate). We asked about various aspects of care, such as wait time, cost, pre- and postoperative care and surgeon experience.
The median out-of-pocket cost for AGB at private facilities is $16,000 (range $13,160-$18,375). Private clinics have much shorter wait times for AGB than public facilities do for RYGB (1 v. 21 mo, p
Notes
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Cites: Obes Surg. 2005 Apr;15(4):546-5115946436
Cites: Surg Obes Relat Dis. 2007 Mar-Apr;3(2):127-32; discussion 132-317331805
Cites: N Engl J Med. 2007 Aug 23;357(8):753-6117715409
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Comment In: Can J Surg. 2011 Jun;54(3):152-321755619
PubMed ID
21609516 View in PubMed
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[Consultations in a casualty department during a period when direct payment was required for consultation in general practice].

https://arctichealth.org/en/permalink/ahliterature237158
Source
Ugeskr Laeger. 1986 Apr 14;148(16):975-8
Publication Type
Article
Date
Apr-14-1986

76 records – page 1 of 8.