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[Access to general practitioners in a county in Troms]

https://arctichealth.org/en/permalink/ahliterature70574
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Publication Type
Article
Date
Aug-25-2005
Author
Anne Helen Hansen
Ivar J Aaraas
Jorun Støvne Pettersen
Gerd Ersdal
Author Affiliation
Tromsø kommune, Rådhuset, 9299 Tromsø. anne.helen.hansen@tromso.kommune.no
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Date
Aug-25-2005
Language
Norwegian
Publication Type
Article
Keywords
Comparative Study
Emergency Medical Services - standards - statistics & numerical data
English Abstract
Family Practice - standards - statistics & numerical data
Female
Health Services Accessibility - standards - statistics & numerical data
Humans
Interviews
Male
Norway
Physicians, Family
Physicians, Women
Referral and Consultation - standards - statistics & numerical data
Rural Health Services - standards - statistics & numerical data
Telephone
Urban Health Services - standards - statistics & numerical data
Abstract
BACKGROUND: In 2002 the Norwegian Board of Health made a survey of the accessibility of general practitioners in Troms county in North Norway. MATERIAL AND METHODS: In a telephone interview one secretary in each surgery informed about telephone response time, planned time for telephone consultations, recorded numbers of urgent consultations, and waiting time to obtain a routine consultation. RESULTS: On average, the planned telephone time was two hours per week. Telephone time was in inverse proportion to the number of patients on the doctor's list. Rural doctors spent twice as much time as urban colleagues on the telephone with their patients. Doctors with lists between 500 and 1500 patients had a higher proportion of urgent consultations compared with doctors with shorter or longer lists. INTERPRETATION: Telephone response time below two minutes and waiting times for routine consultations below 20 days appear to be within acceptable norms. When patient lists are above 1500, doctors' capacity to offer telephone contact and emergency services to their patients seems reduced.
PubMed ID
16138139 View in PubMed
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[Electrocardiographic diagnosis of rural emergencies, by applying a tele-ECG recording and analysis system].

https://arctichealth.org/en/permalink/ahliterature104043
Source
Ter Arkh. 2014;86(6):74-83
Publication Type
Article
Date
2014
Author
G V Riabykina
N A Vishniakova
Source
Ter Arkh. 2014;86(6):74-83
Date
2014
Language
Russian
Publication Type
Article
Keywords
Aged
Electrocardiography - instrumentation - methods
Emergency Medical Services - standards - statistics & numerical data
Female
Heart Diseases - diagnosis - epidemiology
Humans
Male
Middle Aged
Rural Health Services - standards - statistics & numerical data
Rural Population - statistics & numerical data
Russia - epidemiology
Telemedicine - standards - statistics & numerical data
Abstract
To identify emergencies in rural dwellers during electrocardiographic examination using a tele-electrogram (ECG) analysis (Easy ECG) system.
The easy ECG system connected 4 therapeutic-and-prophylactic institutions of a rural area and the town of Uryupinsk with the Research Institute of Cardiology, Russian Cardiology Research-and-Production Complex (Moscow). A total of 1,027 ECGs were recorded and analyzed in March 25, 2013 to November 11, 2013.
Based on complaints, data of physical examinations, and results of ECG analysis, the investigators detected 188 (18.3%) emergency cases; 39 (3.8%) rural dwellers were first diagnosed as having emergencies. There were new found cases of acute coronary syndrome (n = 2), focal cicatricial changes (n = 11), including focal injury in the presence of left bundle-branch block (LBBB) (n = 2), and ischemic cardiomyopathy (n = 1) due to prior extensive myocardial infarction (as high as 28.2%). The frequent finding was intraventricular blocks (46.1%), including LBBB (n = 4) and right bundle-branch block (n = 1) (as high as 12.8%); the signs of left ventricular hypertrophy were encountered in 12 cases, as well as in 2 cases in the presence of LBBB (as high as 38.5%).
The findings show the value of bedside recording of ECG with its remote analysis in the absence of special diagnostic services. Each of the detected electrocardiographic syndromes is a risk factor of cardiac death.
PubMed ID
25095660 View in PubMed
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[How long does it take for an ambulance to arrive?].

https://arctichealth.org/en/permalink/ahliterature194837
Source
Tidsskr Nor Laegeforen. 2001 Mar 20;121(8):904-7
Publication Type
Article
Date
Mar-20-2001
Author
J E Steen-Hansen
E H Folkestad
Author Affiliation
AMK/Ambulanseseksjonen Avdeling for anestesiologi Sentralsykehuset i Vestfold, Tønsberg Postboks 2168 3103 Tønsberg. jesh2@online.no
Source
Tidsskr Nor Laegeforen. 2001 Mar 20;121(8):904-7
Date
Mar-20-2001
Language
Norwegian
Publication Type
Article
Keywords
Ambulances - standards - statistics & numerical data
Databases, Factual
Emergency Medical Services - standards - statistics & numerical data
Humans
Norway
Retrospective Studies
Rural Health Services - standards - statistics & numerical data
Suburban Health Services - standards - statistics & numerical data
Time and Motion Studies
Urban Health Services - statistics & numerical data
Abstract
There are few Norwegian recommendations for quality and efficacy of ambulance performance. A report commissioned by the Ministry of Health and Social Affairs concluded that the ambulance service was the weakest link in the chain of survival. The report proposed standards for response intervals in emergencies: 90% of the population in cities and urban areas should be reached by an ambulance within eight minutes. In rural areas, 90% should be reached within 25 minutes.
This study describes the ambulance response interval for the 2,589 red code emergencies in the 15 municipalities in Vestfold County in 1998, a county with a population of 208,687, or 97.5 inhabitants per square kilometre, with seven ambulance stations. A retrospective analysis was made of data for the year 1998.
The proposed standard was not reached in any municipality in the county. The city of Tønsberg had the best performance, but even here only 48.9% of the population were reached by ambulance within eight minutes. The worst performance was found in the rural municipality of Tjøme; here, only 63.3% were reached within 25 minutes.
Achieving the standards proposed will require a major restructuring of existing ambulance services.
PubMed ID
11332375 View in PubMed
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Potential gaps in congestive heart failure management in a rural hospital.

https://arctichealth.org/en/permalink/ahliterature173480
Source
Can J Rural Med. 2005;10(3):155-61
Publication Type
Article
Date
2005
Author
Margaret D Sanborn
Douglas G Manuel
Ewa Ciechanska
Douglas S Lee
Author Affiliation
South Bruce Grey Health Care Centre, Chesley, Ont. msanborn@sbghc.on.ca
Source
Can J Rural Med. 2005;10(3):155-61
Date
2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Health Care Surveys
Health Services Accessibility - standards - statistics & numerical data
Heart Failure - drug therapy - epidemiology - therapy
Hospitals, Community - standards - statistics & numerical data
Hospitals, Rural - standards - statistics & numerical data
Humans
Middle Aged
Ontario - epidemiology
Patient Care Planning - standards - statistics & numerical data
Retrospective Studies
Rural Health
Rural Health Services - standards - statistics & numerical data
Rural Population - statistics & numerical data
Abstract
Congestive heart failure (CHF) is increasingly recognized as an important cause of morbidity and mortality. Previous studies in urban settings have shown that patients frequently are not receiving recommended therapy. There is a paucity of studies that have evaluated CHF management in a rural setting. We therefore reviewed hospital and outpatient care in this setting as an initial step toward improving CHF care.
A retrospective chart review was used to examine the care of all 34 patients hospitalized for CHF from 2000-2001 in a small rural hospital, to assess the need for improved CHF management.
The median age of the patients was 78 yr, and a number of them had many co-morbid cardiovascular risks. Similar to other studies, only 23% of patients were prescribed recommended doses of angiotensin-converting enzyme (ACE) inhibitors. Use of beta-blockers was far below expected rates. Although there was follow-up care for nearly all patients (97%), few patients had echocardiography performed (38%) or had their medications altered in the outpatient setting.
There is a need for improved management of CHF in the rural setting. Approaches to improving CHF care should use the continuity of care advantage provided by primary care physicians to optimize outpatient medical treatment regimens and improve access to diagnostic services such as echocardiography.
PubMed ID
16079031 View in PubMed
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