scholarly journals A comparison of morbidity and services provided in three primary care settings

2003 ◽  
Vol 26 (3) ◽  
pp. 26 ◽  
Author(s):  
Patrick Bolton ◽  
Michael Mira

Objective:To describe and compare the pattern of morbidity in a general practice casualty with primary care patients inemergency departments (EDs).Setting and subjects:Patients presenting to a general practice casualty and primary care patients in two EDs in Sydney, NSW.Results:The pattern of morbidity in the general practice casualty was similar to that among ambulatory patients in EDs.Conclusion:Opportunities may exist to substitute care between casualty services provided by GPs and those provided in EDs.

2002 ◽  
Vol 8 (1) ◽  
pp. 91 ◽  
Author(s):  
Patrick Bolton ◽  
Michael Mira

Data were collected from clinicians at the time of consultation about the care that they provided in 12,813 encounters in a general practitioner (GP) staffed casualty department and 719 primary care encounters in two emergency departments (Bolton, 1999). Data were collected by the GPs themselves in general practice, and by a research officer located in the emergency departments. Patients seen in the emergency department were ambulatory patients whom the triage nurse assessed would not suffer an adverse outcome if they had to wait an hour or longer for care. Comparison of these two patient populations established that they were similar in terms of age, gender, ethnicity, and reason for encounter.


1985 ◽  
Vol 9 (1) ◽  
pp. 12-13 ◽  
Author(s):  
Greg Wilkinson

A Conference on the above topic took place at the Institute of Psychiatry, London, on 17 and 18 July 1984. The Conference was sponsored by the Department of Health and Social Security and was organized by the General Practice Research Unit. Over 100 invited clinicians, research workers and policy-makers took part. The majority of the participants were either psychiatrists or general practitioners, but representatives of all relevant disciplines attended.


2019 ◽  
Vol 30 (10) ◽  
pp. 496-500
Author(s):  
Shaun Heath

Student nurses are the future of the profession. Shaun Heath explains how changes to the Nursing and Midwifery Council's education standards will effect those currently acting as mentors and how all practice nurses can get involved and contribute to student placement experiences This article explores the Nursing and Midwifery Council's 2018 education standards and how these will affect the role of general practice nurses in primary care settings. The differing roles found in the standards will be discussed, alongside how primary care and the emerging Primary Care Networks can support learners in general practice through communities of practice.


1984 ◽  
Vol 8 (3) ◽  
pp. 59-60

The Department of Health and Social Security is sponsoring a conference on ‘Mental Illness in Primary Care Settings’ which will be held at the Institute of Psychiatry on 17 and 18 July 1984. The conference is being organized by the General Practice Research Unit. Topics will include classification, screening, treatment effectiveness, patterns of collaboration, international developments and future trends for research and policy. Although attendance will be by invitation only, limited places may be available. Those interested should contact Dr D. G. Wilkinson, General Practice Research Unit, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AZ, from whom further information is available.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Idar Mappangara ◽  
Andriany Qanitha ◽  
Cuno S. P. M. Uiterwaal ◽  
Jose P. S. Henriques ◽  
Bastianus A. J. M. de Mol

Abstract Background Telemedicine has been a popular tool to overcome the lack of access to healthcare facilities, primarily in underprivileged populations. We aimed to describe and assess the implementation of a tele-electrocardiography (ECG) program in primary care settings in Indonesia, and subsequently examine the short- and mid-term outcomes of patients who have received tele-ECG consultations. Methods ECG recordings from thirty primary care centers were transmitted to Makassar Cardiac Center, Indonesia from January to July 2017. We cross-sectionally measured the performance of this tele-ECG program, and prospectively sent a detailed questionnaire to general practitioners (GPs) at the primary care centers. We performed follow-up at 30 days and at the end of the study period to assess the patient outcomes. Results Of 505 recordings, all (100%) ECGs were qualified for analysis, and about half showed normal findings. The mean age of participants was 53.3 ± 13.6 years, and 40.2% were male. Most (373, 73.9%) of these primary care patients exhibited manifested CVD symptom with at least one risk factor. Male patients had more ischemic ECGs compared to women (p < 0.01), while older age (> 55 years) was associated with ischemic or arrhythmic ECGs (p < 0.05). Factors significantly associated with a normal ECG were younger age, female gender, lower blood pressure and heart rate, and no history of previous cardiovascular disease (CVD) or medication. More patients with an abnormal ECG had a history of hypertension, known diabetes, and were current smokers (p < 0.05). Of all tele-consultations, GPs reported 95% of satisfaction rate, and 296 (58.6%) used tele-ECG for an expert opinion. Over the total follow-up (14 ± 6.6 months), seven (1.4%) patients died and 96 (19.0%) were hospitalized for CVD. Of 88 patients for whom hospital admission was advised, 72 (81.8%) were immediately referred within 48 h following the tele-ECG consultation. Conclusions Tele-ECG can be implemented in Indonesian primary care settings with limited resources and may assist GPs in immediate triage, resulting in a higher rate of early hospitalization for indicated patients.


2010 ◽  
Vol 23 (4) ◽  
pp. 634-643 ◽  
Author(s):  
Paul R. Duberstein ◽  
Yan Ma ◽  
Benjamin P. Chapman ◽  
Yeates Conwell ◽  
Joanne McGriff ◽  
...  

ABSTRACTBackground: The capacity of friends and family member informants to make judgments about the presence of a mood disorder history in an older primary care patient has theoretical, clinical, and public health significance. This study examined the accuracy of informant-reported mood disorder diagnoses in a sample of primary care patients aged 65 years or older. We hypothesized that the accuracy (sensitivity and specificity) of informant reports would vary with the patient's personality.Methods: Hypotheses were tested in 191 dyads consisting of patients and their friends or relatives (informants) recruited from primary care settings. Gold-standard mood disorder diagnoses were established at consensus conferences based on a review of medical charts and data collected in a structured interview with the patient. Patients completed an assessment battery that included the NEO-Five Factor Inventory.Results: Sensitivity and specificity of informant-derived mood disorder diagnoses were related to patient personality. Sensitivity of informant-derived lifetime mood disorder diagnoses was compromised by higher Extraversion and higher Agreeableness. Specificity of informant-derived lifetime mood disorder diagnoses was compromised by lower Agreeableness and higher Conscientiousness.Conclusion: Patient personality has implications for the accuracy of mood disorder histories provided by friends and family members. Given that false negatives can have grave consequences, we recommend that practitioners be particularly vigilant when interpreting collateral information about their extraverted, agreeable patients.


BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032057
Author(s):  
Mariko Carey ◽  
Rob Sanson-Fisher ◽  
Nick Zwar ◽  
Danielle Mazza ◽  
Graham Meadows ◽  
...  

IntroductionDepression is a common and debilitating condition. In Australia, general practitioners (GPs) are the key providers of depression care. However, available evidence suggests that case finding for depression in primary care is poor. This study will examine whether a systematic approach to screening for depression and assessing patient preferences for depression care improves depression outcomes among primary care patients.Methods and analysisA cluster randomised controlled design will be used with general practice clinics randomly assigned to either the intervention (n=12) or usual care group (n=12). Patients who are aged 18 and older, presenting for general practice care, will be eligible to participate. Eighty-three participants will be recruited at each clinic. Participants will be asked to complete a baseline survey administered on a touch screen computer at their GP clinic, and then a follow-up survey at 3, 6 and 12 months. Those attending usual care practices will receive standard care. GPs at intervention practices will complete an online Clinical e-Audit, and will be provided with provider and patient-directed resources for depression care. Patients recruited at intervention practices who score 10 or above on the Patient Health Questionnaire-9 will have feedback regarding their depression screening results and preferences for care provided to their GP. The primary analysis will compare the number of cases of depression between the intervention and control groups.Ethics and disseminationThe study has been approved by the University of Newcastle Human Research Ethics Committee, and registered with Human Research Ethics Committees of the University of Wollongong, Monash University and University of New South Wales. Results will be disseminated through peer-reviewed journal publications and conference presentations.Trial registration numberACTRN12618001139268; Pre-results.


2005 ◽  
Vol 11 (1_suppl) ◽  
pp. 39-41 ◽  
Author(s):  
S Linke ◽  
R Harrison ◽  
P Wallace

Down Your Drink is a Web-based brief intervention for hazardous drinkers. We conducted a pilot study of its usefulness in general practice. Visitors to the Website were invited to complete the Fast Alcohol Screening Test and positive responders were offered a six-week interactive Web-based programme. There were 1 319 registrations in the six-month study period. In all, 815 (62%) registrants completed week one, and 79 (6%) stayed with the programme until the end. Usage of the Website was distributed through the day, with the highest levels between 10:00 and 14:00. Two focus groups with general practitioners were conducted to explore the potential for using the site in primary-care settings. Website interventions for excessive drinkers therefore appear to be feasible and may prove a useful additional tool for intervention in general practice.


2019 ◽  
Vol 38 (4) ◽  
Author(s):  
Danny Hills ◽  
Sharon Hills ◽  
Tracy Robinson ◽  
Holly Northam ◽  
Catherine Hungerford

2015 ◽  
Vol 17 (01) ◽  
pp. 33-41 ◽  
Author(s):  
E. Amy Janke ◽  
Michelle L. Ramirez ◽  
Brittany Haltzman ◽  
Megan Fritz ◽  
Andrea T. Kozak

AimThe aim of this research is to examine perceptions of those with comorbid chronic pain and obesity regarding their experience of comorbidity management in primary care settings.BackgroundChronic pain and obesity are common comorbidities frequently managed in primary care settings. Evidence suggests individuals with this comorbidity may be at risk for suboptimal clinical interactions; however, treatment experiences and preferences of those with comorbid chronic pain and obesity have received little attention.MethodsSemi-structured interviews conducted with 30 primary care patients with mean body mass index=36.8 and comorbid persistent pain. The constant comparative method was used to analyze data.FindingsParticipants discussed frustration with a perceived lack of information tailored to their needs and a desire for a personalized treatment experience. Participants found available medical approaches unsatisfying and sought a more holistic approach to management. Discussions also focused around the need for providers to initiate efforts at education and motivation enhancement and to show concern for and understanding of the unique difficulties associated with comorbidity. Findings suggest providers should engage in integrated communication regarding weight and pain, targeting this multimorbidity using methods aligned with priorities discussed by patients.


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