Comparing diagnostic delay in cancer: a cross-sectional study in three European countries with primary care-led health care systems

Abstract Objective There are no “gold standard” parameters to measure patient satisfaction regarding the health care system provided by the government. Most of the developed countries have well-structured health care systems, and they depend on patient satisfaction to evaluate and optimize performance and activities of such systems. The study was conducted to evaluate the Omani population’s satisfaction toward public and private health care systems existing in the country. Materials and Methods A cross-sectional study was conducted with a predesigned and pretested questionnaire that was sent to all regions of the Sultanate of Oman via an electronic link. The questionnaire included 22 questions divided into two sections: (1) public and private health care systems in Oman, and (2) abroad treatments. Results The response rate of the 11 Oman’s governorates was 73.9%. There was an association between gender, age, marital status, and the level of education with the preference for local private hospital’s treatment (p < 0.001). Both males (88.1%) and females (83.9%) preferred to be treated by Omani doctors. The association between gender and the preference to be treated by the Omani doctors was statistically significant (p = 0.016). There was a significant relationship between the overall patient satisfaction regarding the treatment that they received and all of the following parameters: well-trained nurses, competency of doctors, professional behavior, and skill level of the staff. On the other hand, 88% of the participants were unhappy about appointment waiting times to be seen in the tertiary-care hospital. Conclusion The study showed that most of the participants have preferred to be treated by Omani physicians and nurses, however, hospitals need to make operational and working changes in order to decrease the appointment waiting time, as this was found to be one of the most common reasons for population dissatisfaction.

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A NOVEL TOOL FOR THE EARLY IDENTIFICATION OF FRAILTY IN ELDERLY PEOPLE: THE APPLICATION IN PRIMARY CARE SETTINGS

Journal of Frailty & Aging ◽

10.14283/jfa.2019.41 ◽

2019 ◽

pp. 1-6

Author(s):

M. Maggio ◽

M. Barbolini ◽

Y. Longobucco ◽

L. Barbieri ◽

C. Benedetti ◽

...

Keyword(s):

Primary Care ◽

Construct Validity ◽

Predictive Value ◽

Community Health Centers ◽

Health Care Systems ◽

Cross Sectional Study ◽

Criterion Validity ◽

Cross Sectional ◽

Care Systems ◽

The One

Objectives: Frailty is a pre-disability condition in older persons providing a challenge to Health-Care Systems. Systematic reviews highlight the absence of a gold-standard for its identification. However, an approach based on initial screening by the General Practitioner (GP) seems particularly useful. On these premises, a 9-item Sunfrail Checklist (SC), was developed by a multidisciplinary group, in the context of European Sunfrail Project, and tested in the Community. Objectives: – to measure the concordance between the judgments of frailty (criterion-validity): the one formulated by the GP, using the SC, and the one subsequently expressed by a Comprehensive Geriatric Assessment Team (CGA-Team); – to determine the construct-validity through the correspondence between some checklist items related to the 3 domains (physical, cognitive and social) and the three tools used by the CGA-Team; – to measure the instrument’s performance in terms of positive predictive value (PPV) and negative predictive value (NPV). Design: Cross-sectional study, with a final sample-size of 95 subjects. Setting: Two Community-Health Centers of Parma, Italy. Participants: Subjects aged 75 years old or more, with no disability and living in the community. Measurements: We compared the screening capacity of the GP using the SC to that one of CGA-Team based on three tests: 4-meter Gait-Speed, Mini-Mental State Examination and Loneliness Scale. Results: 95 subjects (51 women), with a mean age of 81±4 years were enrolled. According to GPs 34 subjects were frail; the CGA-Team expressed a frailty judgment on 26 subjects. The criterion-validity presented a Cohen’s k of 0.353. Construct-validity was also low, with a maximum contingency-coefficient of 0.19. The analysis showed a PPV of 58.1% and a NPV equal to 84.6%. Conclusions: Our data showed a low agreement between the judgements of GP performed by SC and CGA-Team. However, the good NPV suggests the applicability of SC for screening activities in primary-care.

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Clinical information needs and access in primary health care: a comparative cross-sectional study of rural and non-rural primary care physicians

Health Information & Libraries Journal ◽

10.1111/hir.12121 ◽

2015 ◽

Vol 32 (4) ◽

pp. 287-299 ◽

Cited By ~ 10

Author(s):

Salman Bin Naeem ◽

Rubina Bhatti

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Care Physicians ◽

Information Needs ◽

Clinical Information ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Rural Primary Care ◽

Primary Health

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VA Video Connect for Clinical Care in Older Adults in a Rural State During the COVID-19 Pandemic: Cross-Sectional Study (Preprint)

10.2196/preprints.21561 ◽

2020 ◽

Author(s):

Kalpana P Padala ◽

Kerrie B Wilson ◽

C Heath Gauss ◽

Jessica D Stovall ◽

Prasad R Padala

Keyword(s):

Older Adults ◽

Health Care ◽

Rural Areas ◽

Electronic Device ◽

Health Care Systems ◽

Clinical Care ◽

Cross Sectional Study ◽

Willingness To Participate ◽

Sectional Study ◽

Cross Sectional

BACKGROUND The COVID-19 pandemic has accelerated the need for telehealth at home. Although the Department of Veterans Affairs is a leading provider of telehealth, disparities may exist in reaching older veterans living in rural areas. VA Video Connect (VVC) is a video conferencing app that enables veterans to connect with their health care provider via a secure and private session. OBJECTIVE The aim of this study was to examine the capability and willingness of older veterans to participate in a VVC visit during the COVID-19 pandemic. METHODS A cross-sectional study was conducted on older veterans (N=118) at the Central Arkansas Veterans Healthcare System. Participants were interviewed over the phone and responses to the following items were recorded: availability of internet, email, and an electronic device with a camera; veterans’ willingness to complete an appointment via a VVC visit; and availability of assistance from a caregiver for those who were unable to participate in a VVC visit alone. RESULTS Participants’ mean age was 72.6 (SD 8.3) years, 92% (n=108) were male, 69% (n=81) were Caucasian, 30% (n=35) were African Americans, and 36% (n=42) lived in a rural location. The majority reported having access to the internet (n=93, 77%) and email service (n=83, 70%), but only 56% (n=67) had a camera-equipped device. Overall, 53% (n=63) were willing and capable of participating in a VVC visit. The availability of internet access was significantly lower in rural compared to nonrural participants (P=.045) and in those with or less than a high school education compared to those who pursued higher education (P=.02). Willingness to participate in the VVC visit was significantly lower in rural compared to nonrural participants (P=.03). Of the participants who reported they were able and willing to partake in a VVC visit (n=54), 65% (n=35) opted for VVC and 35% (n=19) preferred a phone visit. In total, 77% (n=27) of the scheduled VVC visits were successful. CONCLUSIONS Despite advances in technology, and willingness on the part of health care systems, there are some lingering issues with capability and willingness to participate in video telehealth visits, particularly among older adults residing in rural areas.

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Partisan Differences in Twitter Language Among US Legislators During the COVID-19 Pandemic: Cross-sectional Study (Preprint)

10.2196/preprints.27300 ◽

2021 ◽

Author(s):

Sharath Chandra Guntuku ◽

Jonathan Purtle ◽

Zachary F Meisel ◽

Raina M Merchant ◽

Anish Agarwal

Keyword(s):

Public Health ◽

Health Care ◽

Vaccine Development ◽

Health Care Systems ◽

Cross Sectional Study ◽

Party Affiliation ◽

Cross Sectional ◽

Health Crisis ◽

Care Systems ◽

Town Halls

BACKGROUND As policy makers continue to shape the national and local responses to the COVID-19 pandemic, the information they choose to share and how they frame their content provide key insights into the public and health care systems. OBJECTIVE We examined the language used by the members of the US House and Senate during the first 10 months of the COVID-19 pandemic and measured content and sentiment based on the tweets that they shared. METHODS We used Quorum (Quorum Analytics Inc) to access more than 300,000 tweets posted by US legislators from January 1 to October 10, 2020. We used differential language analyses to compare the content and sentiment of tweets posted by legislators based on their party affiliation. RESULTS We found that health care–related themes in Democratic legislators’ tweets focused on racial disparities in care (odds ratio [OR] 2.24, 95% CI 2.22-2.27; P<.001), health care and insurance (OR 1.74, 95% CI 1.7-1.77; P<.001), COVID-19 testing (OR 1.15, 95% CI 1.12-1.19; P<.001), and public health guidelines (OR 1.25, 95% CI 1.22-1.29; P<.001). The dominant themes in the Republican legislators’ discourse included vaccine development (OR 1.51, 95% CI 1.47-1.55; P<.001) and hospital resources and equipment (OR 1.22, 95% CI 1.18-1.25). Nonhealth care–related topics associated with a Democratic affiliation included protections for essential workers (OR 1.55, 95% CI 1.52-1.59), the 2020 election and voting (OR 1.31, 95% CI 1.27-1.35), unemployment and housing (OR 1.27, 95% CI 1.24-1.31), crime and racism (OR 1.22, 95% CI 1.18-1.26), public town halls (OR 1.2, 95% CI 1.16-1.23), the Trump Administration (OR 1.22, 95% CI 1.19-1.26), immigration (OR 1.16, 95% CI 1.12-1.19), and the loss of life (OR 1.38, 95% CI 1.35-1.42). The themes associated with the Republican affiliation included China (OR 1.89, 95% CI 1.85-1.92), small business assistance (OR 1.27, 95% CI 1.23-1.3), congressional relief bills (OR 1.23, 95% CI 1.2-1.27), press briefings (OR 1.22, 95% CI 1.19-1.26), and economic recovery (OR 1.2, 95% CI 1.16-1.23). CONCLUSIONS Divergent language use on social media corresponds to the partisan divide in the first several months of the course of the COVID-19 public health crisis.

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VA Video Connect for Clinical Care in Older Adults in a Rural State During the COVID-19 Pandemic: Cross-Sectional Study

Journal of Medical Internet Research ◽

10.2196/21561 ◽

2020 ◽

Vol 22 (9) ◽

pp. e21561

Author(s):

Kalpana P Padala ◽

Kerrie B Wilson ◽

C Heath Gauss ◽

Jessica D Stovall ◽

Prasad R Padala

Keyword(s):

Older Adults ◽

Health Care ◽

Rural Areas ◽

Electronic Device ◽

Health Care Systems ◽

Clinical Care ◽

Cross Sectional Study ◽

Willingness To Participate ◽

Sectional Study ◽

Cross Sectional

Background The COVID-19 pandemic has accelerated the need for telehealth at home. Although the Department of Veterans Affairs is a leading provider of telehealth, disparities may exist in reaching older veterans living in rural areas. VA Video Connect (VVC) is a video conferencing app that enables veterans to connect with their health care provider via a secure and private session. Objective The aim of this study was to examine the capability and willingness of older veterans to participate in a VVC visit during the COVID-19 pandemic. Methods A cross-sectional study was conducted on older veterans (N=118) at the Central Arkansas Veterans Healthcare System. Participants were interviewed over the phone and responses to the following items were recorded: availability of internet, email, and an electronic device with a camera; veterans’ willingness to complete an appointment via a VVC visit; and availability of assistance from a caregiver for those who were unable to participate in a VVC visit alone. Results Participants’ mean age was 72.6 (SD 8.3) years, 92% (n=108) were male, 69% (n=81) were Caucasian, 30% (n=35) were African Americans, and 36% (n=42) lived in a rural location. The majority reported having access to the internet (n=93, 77%) and email service (n=83, 70%), but only 56% (n=67) had a camera-equipped device. Overall, 53% (n=63) were willing and capable of participating in a VVC visit. The availability of internet access was significantly lower in rural compared to nonrural participants (P=.045) and in those with or less than a high school education compared to those who pursued higher education (P=.02). Willingness to participate in the VVC visit was significantly lower in rural compared to nonrural participants (P=.03). Of the participants who reported they were able and willing to partake in a VVC visit (n=54), 65% (n=35) opted for VVC and 35% (n=19) preferred a phone visit. In total, 77% (n=27) of the scheduled VVC visits were successful. Conclusions Despite advances in technology, and willingness on the part of health care systems, there are some lingering issues with capability and willingness to participate in video telehealth visits, particularly among older adults residing in rural areas.

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Evaluation of communication between physicians and patients in Astana City Hospital №1

Central Asian Journal of Global Health ◽

10.5195/cajgh.2013.82 ◽

2014 ◽

Vol 2 ◽

Cited By ~ 1

Author(s):

Anara Zhumadilova ◽

Brett J. Craig ◽

Alexey Tsoy ◽

Alla Gabdrakhmanova ◽

Martin Bobak

Keyword(s):

Job Satisfaction ◽

Health Care ◽

Health Care Providers ◽

Healthcare Professionals ◽

Health Care Systems ◽

Cross Sectional Study ◽

City Hospital ◽

Care Providers ◽

Cross Sectional ◽

Care Systems

Introduction: Communication between patients and health care providers is important for the effective functioning of health care systems. Miscommunication often stems from discrepancies in expectations of both healthcare professionals and patients due to cultural and historical influences. We investigated the degree to which health care providers (doctors and nurses) and patients in Kazakhstan believe that interaction between doctors and patients should be doctor- or patient-oriented.Material and methods: We conducted a cross-sectional study of 163 patients and 176 health care providers (71 doctors and 105 nurses) in a general hospital in Astana, Kazakhstan. The subjects completed a structured questionnaire containing the Patient-Practitioner Orientation Scale (PPOS), and scales assessing life and job satisfaction, effort-reward balance of healthcare professionals, and the patients’ perceptions of communication practices.Results: An overwhelming majority of doctors (81.7%), nurses (88.1%), and patients (92.3%) were doctor-oriented. Among health care providers, PPOS was not associated with age, sex, life and job satisfaction, or effort-reward imbalance. Among patients, PPOS was not associated with age, sex, or specialty of health care provider. However, higher PPOS among patients (indicating preference for patient-oriented interaction) was associated with higher satisfaction with communication with health care providers and, less strongly, with their life satisfaction.Conclusion: The main finding of this study is the very small proportion of doctors, nurses and patients who believe that interaction should be patient-oriented. These results highlight the necessity of improvement of communication among health care providers towards patient-oriented approach in order to decrease miscommunication with patients. The fact that most patients prefer doctor-oriented interaction may reflect historical stereotypes; educational/information interventions among patients may also be needed.

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Prevalence of Chronic Illness and Risk Factors for Chronic Illness Among Patients With Venous Leg Ulceration: A Cross-Sectional Study

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734619850444 ◽

2019 ◽

Vol 18 (3) ◽

pp. 301-308 ◽

Cited By ~ 6

Author(s):

Maria Kelly ◽

Georgina Gethin

Keyword(s):

Risk Factors ◽

Chronic Illness ◽

Health Care Systems ◽

Cross Sectional Study ◽

Sectional Study ◽

Community Nurse ◽

High Cholesterol ◽

Cross Sectional ◽

Care Systems ◽

Cross Sectional Design

Introduction. Chronic illness and risk factors for chronic illness are rising public health concerns for individuals and health care systems. Individuals with venous leg ulceration (VLU) have at least one chronic illness. As there is a projected increase in VLU prevalence there is a need to determine concurrent prevalence of risk factors for chronic illness among this population. Methods. A cross-sectional design conducted in 8 community, nurse-led, leg ulcer clinics. Results. Fifty patients (58%, n = 29 females) were enrolled. Seventy percent were >65 years old; 90% had at least one chronic illness; 60% had hypertension; 30% had atrial fibrillation; 18% had diabetes; 18% heart failure; and 28.6% musculoskeletal conditions. All had at least one risk factors for chronic illness (mean = 2.26), the most frequent being overweight (30%), obesity (30%), high cholesterol (22.2%), and restricted physical activity (22%). Participants took a mean 5.2 medications daily and 26% were on current oral antibiotics. Conclusions. Comprehensive, holistic assessment and regular reassessment with a preventative focus needs to consider chronic illness and risk factors for chronic illness. Patients with VLU are in frequent contact with their multidisciplinary team. This is an opportunity to improve care and make every encounter count.

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Primary Care Networks and Eritrean Immigrants’ Experiences with Health Care Professionals in Switzerland: A Qualitative Approach

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16142614 ◽

2019 ◽

Vol 16 (14) ◽

pp. 2614 ◽

Cited By ~ 1

Author(s):

Carla Wallimann ◽

Andreas Balthasar

Keyword(s):

Primary Care ◽

Health Care ◽

Health Professionals ◽

Health Care Professionals ◽

Access To Health Care ◽

Health Care Systems ◽

European Countries ◽

Care Providers ◽

Swiss Health ◽

Care Systems

Growing migration in European countries has simultaneously increased cultural diversity in health care. Migrants’ equal access to health care systems and migrant friendly health care have therefore become relevant topics. Findings gathered in recent years have mainly focussed on the perspective of care providers, whereas this study includes migrant perspectives. It explores the primary care network of Eritrean immigrants in Switzerland as well as their experiences of interacting with health professionals. Semi-structured face-to-face interviews with intercultural interpreters from Eritrea were conducted. On the basis of a thematic analysis, the study identified the important informal and formal contacts in these Eritrean immigrants’ primary care networks and the specific forms of support each actor provides. In this network, encounters with health professionals were predominately expressed positively. The main barriers reported were language difficulties and intercultural understanding. On the basis of the participants’ statements, six key lessons for practice have been derived. These lessons are specifically important for facilitating Eritrean immigrants’ access to the Swiss health care system. Nevertheless, they are also relevant for other groups of migrants in European countries.

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Diabetes, pre-diabetes and their risk factors in Malta: a study profile of national cross-sectional prevalence study

Global Health Epidemiology and Genomics ◽

10.1017/gheg.2016.18 ◽

2016 ◽

Vol 1 ◽

Cited By ~ 8

Author(s):

S. Cuschieri ◽

J. Vassallo ◽

N. Calleja ◽

N. Pace ◽

J. Mamo

Keyword(s):

Risk Factors ◽

Health Care Systems ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Effective Prevention ◽

Global Epidemic ◽

Population Sampling ◽

Care Systems ◽

Nationally Representative

BackgroundType 2 diabetes mellitus constitutes a global epidemic and a major burden on health care systems across the world. Prevention of this disease is essential, and the development of effective prevention strategies requires validated information on the disease burden and the risk factors. Embarking on a nationally representative cross-sectional study is challenging and costly. Few countries undertake this process regularly, if at all.MethodThis paper sets out the evidence-based protocol of a recent cross-sectional study that was conducted in Malta. Data collection took place from November 2014 to January 2016.ResultsThis study presents up-to-date national data on diabetes and its risk factors (such as obesity, smoking, physical activity and alcohol intake) that will soon be publicly available.ConclusionThis protocol was compiled so that the study can be replicated in other countries. The protocol contains step-by-step descriptions of the study design, including details on the population sampling, the permissions required and the validated measurement tools used.

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