scholarly journals Recognising potential for preventing hospitalisation

2010 ◽  
Vol 34 (1) ◽  
pp. 116 ◽  
Author(s):  
David Banham ◽  
Tony Woollacott ◽  
John Gray ◽  
Brett Humphrys ◽  
Angel Mihnev ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Public Hospital ◽  
Hospital Admissions ◽  
South Australia ◽  
Local Area ◽  
Care Plan ◽  
Older Individuals ◽  
Preventable Hospitalisation ◽  
Access To Primary Care

To identify the incidence and distribution of public hospital admissions in South Australia that could potentially be prevented with appropriate use of primary care services, analysis was completed of all public hospital separations from July 2006 to June 2008 in SA. This included those classified as potentially preventable using the Australian Institute of Health and Welfare criteria for selected potentially preventable hospitalisations (SPPH), by events and by individual, with statistical local area geocoding and allocation of relative socioeconomic disadvantage quintile. A total of 744 723 public hospital separations were recorded, of which 79 424 (10.7%) were classified as potentially preventable. Of these, 59% were for chronic conditions, and 29% were derived from the bottom socioeconomic status (SES) quintile. Individuals in the lowest SES quintile were 2.5 times more likely to be admitted for a potentially preventable condition than those from the top SES quintile. Older individuals, males, those in the most disadvantaged quintiles, non-metropolitan areas and Indigenous people were more likely to have more than one preventable admission. People living in more disadvantaged areas in SA appear to have poorer utilisation of effective primary care, resulting in preventable hospital admissions, than those in higher SES groups. The SA Health Care Plan, 2007–2016 is aimed at investing in improved access to primary care in those areas of most disadvantage. The inclusion of SPPHs in future routine reporting should identify if this has occurred. What is known about the topic?Ambulatory care sensitive conditions, or selected potentially preventable hospitalisation separations (SPPH), are an indicator of the availability and effectiveness of primary health care. SPPHs are increasingly reported by area level disadvantage. What does this paper add?This paper offers analysis by individuals. It shows around three-quarters of individuals had one potentially preventable public hospital separation. The rate among those living in the most disadvantaged areas was more than twice that of lowest disadvantage areas. What are the implications for practitioners?Realising the potential for preventing potentially avoidable hospitalisation may involve focus on particular target areas and subpopulations. Potentially preventable separations by area of disadvantage can assist with monitoring performance and evaluating policy and program initiatives. Analysis by numbers of individuals will enhance this further.

Access to Primary Care for Patients with Diabetes at an Urban Public Hospital Walk-in Clinic

1998 ◽  
Vol 9 (2) ◽  
pp. 170-183 ◽  
Author(s):  
Robert L. Schiff ◽  
David Ansell ◽  
David Goldberg ◽  
Stuart Dick ◽  
Corinne Peterson
Keyword(s):  
Primary Care ◽  
Public Hospital ◽  
Patients With Diabetes ◽  
Access To Primary Care

scholarly journals Access to primary care and other health care use among western Canadians with chronic conditions: a population-based survey

CMAJ Open ◽  
2014 ◽  
Vol 2 (1) ◽  
pp. E27-E34 ◽  
Author(s):  
R. G. Weaver ◽  
B. J. Manns ◽  
M. Tonelli ◽  
C. Sanmartin ◽  
D. J. T. Campbell ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Chronic Conditions ◽  
Population Based ◽  
Health Care Use ◽  
Access To Primary Care ◽  
Population Based Survey

scholarly journals Access to primary care and cognitive impairment: results from a national community study of aging Americans

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Megan A. Mullins ◽  
Julie P. W. Bynum ◽  
Suzanne E. Judd ◽  
Philippa J. Clarke
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Emergency Department ◽  
Cognitive Impairment ◽  
Racial Differences ◽  
Care Service ◽  
Emergency Department Utilization ◽  
Care Utilization ◽  
Access To Primary Care ◽  
Primary Care Supply

Abstract Background Despite a growing burden of Alzheimer’s Disease and related dementias (ADRD) in the US, the relationship between health care and cognitive impairment prevention is unclear. Primary care manages risk causing conditions and risk reducing behaviors for dementia, so we examine the association between individual and area-level access to primary care and cognitive impairment in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Methods REGARDS participants with a cognitive assessment and vascular measurements at their baseline visit were included in this cross-sectional analysis. Cognitive impairment was defined as a Six-Item Screener (SIS) score < 5. Primary care supply, primary care utilization and emergency department (ED) utilization were measured at the primary care service area (PCSA) level based on participant’s address. Individual access to care was self-reported. Models were adjusted for confounding by demographics, socioeconomic status and behavioral risk factors. Results Among 25,563 adults, living in a PCSA with low primary care supply was associated with 25% higher odds of cognitive impairment (OR 1.25 CI 1.07-1.45). Not having a regular source of medical care was associated with 14% higher odds of cognitive impairment (OR 1.14 CI 1.02-1.28), and living in a PCSA with high emergency department utilization was associated with 12% higher odds of cognitive impairment (OR 1.12 CI 1.02-1.23). Conclusions Our results are an important first step in understanding how health care may prevent cognitive impairment. They highlight the importance of primary care and suggest future work clarifying its role in preventing cognitive decline is imperative.

scholarly journals Health Care Costs Associated to Type of Feeding in the First Year of Life

2020 ◽  
Vol 17 (13) ◽  
pp. 4719
Author(s):  
Carolina Lechosa-Muñiz ◽  
María Paz-Zulueta ◽  
María Sáez de Adana Herrero ◽  
Elsa Cornejo del Rio ◽  
Sonia Mateo Sota ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Infectious Diseases ◽  
Emergency Room ◽  
Health Care Costs ◽  
Medical Records ◽  
Hospital Admissions ◽  
First Year ◽  
First Year Of Life ◽  
Care Costs

Background: Breastfeeding is associated with lower risk of infectious diseases, leading to fewer hospital admissions and pediatrician consultations. It is cost saving for the health care system, however, it is not usually estimated from actual cohorts but via simulation studies. Methods: A cohort of 970 children was followed-up for twelve months. Data on mother characteristics, pregnancy, delivery and neonate characteristics were obtained from medical records. The type of neonate feeding at discharge, 2, 4, 6, 9 and 12 months of life was reported by the mothers. Infectious diseases diagnosed in the first year of life, hospital admissions, primary care and emergency room consultations and drug treatments were obtained from neonate medical records. Health care costs were attributed using public prices and All Patients Refined–Diagnosis Related Groups (APR–DRG) classification. Results: Health care costs in the first year of life were higher in children artificially fed than in those breastfed (1339.5€, 95% confidence interval (CI): 903.0–1775.0 for artificially fed vs. 443.5€, 95% CI: 193.7–694.0 for breastfed). The breakdown of costs also shows differences in primary care consultations (295.7€ for formula fed children vs. 197.9€ for breastfed children), emergency room consultations (260.1€ for artificially fed children vs. 196.2€ for breastfed children) and hospital admissions (791.6€ for artificially fed children vs. 86.9€ for breastfed children). Conclusions: Children artificially fed brought about more health care costs related to infectious diseases than those exclusively breastfed or mixed breastfed. Excess costs were caused in hospital admissions, primary care consultations, emergency room consultations and drug consumption.

scholarly journals Giving Asthma Support to Patients (GASP): a novel online asthma education, monitoring, assessment and management tool

2014 ◽  
Vol 6 (3) ◽  
pp. 238 ◽  
Author(s):  
Felix Ram ◽  
Wendy McNaughton
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Health Care Professionals ◽  
Retrospective Cohort ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Management Tool ◽  
Asthma Education

BACKGROUND AND CONTEXT: Giving Asthma Support to Patients (GASP) is a unique online tool developed to provide asthma education at point of care, and to provide health care professionals in primary care with skills and knowledge to undertake a structured asthma assessment. ASSESSMENT OF PROBLEM: A retrospective cohort study was undertaken to evaluate the effectiveness of GASP. Data for patients aged 5–64 years seen in primary care (Waitemata region of Auckland) with uncontrolled asthma who had completed a minimum of two GASP assessments between 1 November 2008 and 17 April 2011 were extracted from a secure, self-populating database. Outcome measures were compared between each patient’s visit 1 and 2 assessments. RESULTS: A total of 761 patients provided data using GASP. There was a significant reduction between GASP assessments in the risk of exacerbations, hospital admissions, emergency department presentations, requirement for corticosteroids, and bronchodilator reliance. STRATEGIES FOR IMPROVEMENT: Results from this retrospective cohort study are promising. A randomised controlled trial of the use of GASP in primary care is warranted to confirm these findings. The effectiveness of the GASP tool also needs to be further investigated in Maori and Pacific populations. LESSONS: The findings of this study of GASP show its potential and support its use in the primary care setting. KEYWORDS: Asthma; decision support techniques; primary health care, retrospective study

scholarly journals Evaluation of the impacts of a district-level mental health care plan on contact coverage, detection and individual outcomes in rural Uganda: a mixed methods approach

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
J. E. M. Nakku ◽  
S. D. Rathod ◽  
E. C. Garman ◽  
J. Ssebunnya ◽  
S. Kangere ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Symptom Severity ◽  
Population Level ◽  
Care Plan ◽  
Health Care Plan ◽  
The Impact

Abstract Background The burden of mental disorders in low- and middle-income countries is large. Yet there is a major treatment gap for these disorders which can be reduced by integrating the care of mental disorders in primary care. Aim We aimed to evaluate the impact of a district mental health care plan (MHCP) on contact coverage for and detection of mental disorders, as well as impact on mental health symptom severity and individual functioning in rural Uganda. Results For adults who attended primary care facilities, there was an immediate positive effect of the MHCP on clinical detection at 3 months although this was not sustained at 12 months. Those who were treated in primary care experienced significant reductions in symptom severity and functional impairment over 12 months. There was negligible change in population-level contact coverage for depression and alcohol use disorder. Conclusion The study found that it is possible to integrate mental health care into primary care in rural Uganda. Treatment by trained primary care workers improves clinical and functioning outcomes for depression, psychosis and epilepsy. Challenges remain in accessing the men for care, sustaining the improvement in detection over time, and creating demand for services among those with presumed need.

Hospital admissions from residential aged care facilities to a major public hospital in South Australia (1999-2005)

2010 ◽  
Vol 30 (4) ◽  
pp. 202-207 ◽  
Author(s):  
Jodie B Hillen ◽  
Richard L Reed ◽  
Richard J Woodman ◽  
Deborah Law ◽  
Paul H Hakendorf ◽  
...  
Keyword(s):  
Public Hospital ◽  
Hospital Admissions ◽  
South Australia ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

scholarly journals Sarcopenia screening in elderly in primary health care: nurse knowledge and practices

2020 ◽  
Vol 73 (suppl 3) ◽  
Author(s):  
Rutielle Ferreira Silva ◽  
Maria do Livramento Fortes Figueiredo ◽  
Juan José Tirado Darder ◽  
Ana Maria Ribeiro dos Santos ◽  
Maria Antonieta Rubio Tyrrell
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
The Elderly ◽  
Care Plan ◽  
Structured Interviews ◽  
Care Nurse ◽  
Primary Health ◽  
Primary Health Care Nurses ◽  
Nurse Knowledge

ABSTRACT Objective: Describe the knowledge and practices of the Primary Health Care nurse on sarcopenia screening in the elderly. Methods: Qualitative study conducted with 24 Primary Health Care nurses. The data was collected through semi-structured interviews, recorded and later transcribed. The speeches were grouped in thematic categories, later analyzed, supported by Paulo Freire’s reference. Results: The findings showed that the primary care nurses’ knowledge of sarcopenia screening in the elderly was incipient and fragile. This reality is reflected in a gap in practice, although some instruments already require the registration of characteristics indicative of sarcopenia, such as the evaluation of the calf circumference. Final Considerations: The need to train nurses to perform sarcopenia screening and to implement a promotional and preventive care plan, which will result in improving the quality of life of the elderly assisted in Primary Care, was highlighted.

scholarly journals Physical therapy in avoidable hospitalizations for primary care-sensitive conditions

2016 ◽  
Vol 29 (1) ◽  
pp. 183-192
Author(s):  
Alessandra Bombarda Müller ◽  
Nadia Cristina Valentini ◽  
Maria Eugênia Bresolin Pinto
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Physical Therapy ◽  
Health Care Services ◽  
Hospital Admissions ◽  
Physical Therapists ◽  
The Public ◽  
Avoidable Hospitalizations ◽  
Care Services ◽  
Sensitive Conditions

Abstract Avoidable hospitalizations for primary care-sensitive conditions have been used as indicators of access to timely and appropriate care because hospital admissions for many conditions could be prevented by interventions in primary care. Physical therapists play an important role in health promotion, disease prevention, and the pursuit of fairness and improvements in the effectiveness of health care services, which are the goals of the public policies proposed by the Brazilian unified health care system. We used MEDLINE and SciELO to search the literature for articles concerning the association between physical therapy and the reduction of avoidable hospitalizations for primary care-sensitive conditions. The literature on the topic is still in its infancy and confined to relatively few studies. Although the available literature associates access to quality primary care with reduced hospitalizations for primary care-sensitive conditions, there is a need for original studies investigating whether there is an association between physical therapy and decreased hospital admissions for primary care-sensitive conditions.

Sign in / Sign up

Export Citation Format

Share Document