RE: “TIME TRENDS IN INCIDENCE RATES OF FIRST HIP FRACTURE IN THE UPPSALA HEALTH CARE REGION, SWEDEN, 1965–1983”

Abstract Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, talking therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving talking therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in talking therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in talking therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in talking therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.

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A comparison of hip fracture incidence rates among elderly in Sweden by latitude and sunlight exposure

Scandinavian Journal of Public Health ◽

10.1177/1403494813510794 ◽

2013 ◽

Vol 42 (2) ◽

pp. 201-206 ◽

Cited By ~ 7

Author(s):

Finn Nilson ◽

Syed Moniruzzaman ◽

Ragnar Andersson

Keyword(s):

Hip Fracture ◽

Incidence Rates ◽

Sunlight Exposure ◽

Fracture Incidence ◽

Hip Fracture Incidence

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Hip Fracture Incidence Rates in Singapore 1991–1998

Osteoporosis International ◽

10.1007/s001980170121 ◽

2001 ◽

Vol 12 (4) ◽

pp. 311-318 ◽

Cited By ~ 91

Author(s):

L. K. H. Koh ◽

◽

S.-M. Saw ◽

J. J. M. Lee ◽

K.-H. Leong ◽

...

Keyword(s):

Hip Fracture ◽

Incidence Rates ◽

Fracture Incidence ◽

Hip Fracture Incidence

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Health care services and costs after hip fracture, comparing conventional versus standardised care: A retrospective study with 12-month follow-up

Injury ◽

10.1016/j.injury.2021.01.034 ◽

2021 ◽

Author(s):

Kristin Haugan ◽

Vidar Halsteinli ◽

Øystein Døhl ◽

Trude Basso ◽

Lars G. Johnsen ◽

...

Keyword(s):

Health Care ◽

Retrospective Study ◽

Hip Fracture ◽

Health Care Services ◽

Care Services

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Elderly Patients with Pertrochanteric Hip Fracture: In Hospital Care

Journal of Orthopedics & Bone Disorders ◽

10.23880/jobd-16000190 ◽

2019 ◽

Vol 3 (4) ◽

pp. 1-8

Author(s):

Faour Martín O

Keyword(s):

Health Care ◽

Hip Fracture ◽

Elderly Patients ◽

Hip Fractures ◽

Cost Reduction ◽

Hospital Care ◽

Scientific Evidence ◽

Clinical Results ◽

Fracture Management ◽

Care Of Elderly

Objective: To evaluate the improvement in the care of elderly patients hospitalized due to pertrochanteric hip fractures. Methods: A comparative study of two cohorts of patients admitted due to pertrochanteric hip fractu re before (2010) and after the application of in hospital management protocols (2018). The intervention consisted in the implementation of multidisciplinary measures during hospitalization based on current scientific evidence. An evaluation of the clinical results was performed, as well as the health care impact. Results: The characteristics of patients admitted for hip fracture in 2010 (216 patients) and 2018 (205 patients) were similar in age, sex, Barthel index and the Charlson abbreviated index. In 2018 patients had more comorbidity. A significant reduction of preoperative stay and overall stay in the cohort of 2018 was achieved. Detection of delirium, malnutrition and anaemia was higher in 2018, and a reduced incidence of infection and a better function al efficiency was achieved in this period. Conclusion: The introduction of measures for the improvement of the pertrochanteric hip fracture management reduces hospitalization with consequent cost reduction. Unification of criteria among professionals may b e an opportunity for better clinical results and reduction of complications.

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Reduction in Diabetes-Related Major Amputation Rates After Implementation of a Multidisciplinary Model: An Evaluation in Alberta, Canada

Journal of the American Podiatric Medical Association ◽

10.7547/19-137 ◽

2019 ◽

pp. 0000-0000 ◽

Cited By ~ 2

Author(s):

Reza Basiri ◽

Brent D. Haverstock ◽

Paul F. Petrasek ◽

Karim Manji

Keyword(s):

Health Care ◽

Health Care System ◽

Pearson Correlation ◽

Significant Negative Correlation ◽

Major Amputation ◽

Incidence Rates ◽

Positive Sign ◽

Supporting Evidence ◽

The Impact ◽

Care System

BACKGROUND: Lower limb amputations (LLAs) are a major debilitating complication of diabetes. The toe and flow model (TFM) describes the framework for multidisciplinary centers aiming to reduce this complication. In this study, we investigate the efficacy of the TFM to reduce diabetes-related major LLAs in comparison with the standard of care (SOC) in the Canadian health care system. METHODS: We retrospectively reviewed the anonymized diabetes-related LLA reports in two similar metropolitan health zones in Alberta, Canada from 2007 to 2017. Although both zones have the same provincial health care system and similar demographics, Calgary, our first zone operates on the basis of the TFM while the Edmonton zone operates in accordance with the provincial SOC. LLAs were divided into minor and major amputation cohorts. We used the chi-square test, linear regression, and Pearson correlation for analysis. The lower proportion of major LLAs was denoted as a positive sign for the efficacy of the TFM. RESULTS: Although the number of LLAs remained relatively comparable (Calgary zone: 2238 and Edmonton zone: 2410), the Calgary zone had both significantly lower major (45%) and higher minor (42%) amputation incidence rates compared to the Edmonton zone. The increasing trend in minor LLAs and decreasing trend in major LLAs in the Calgary zone were negatively and significantly correlated (r = -0.730, p = 0.011). No significant correlation was found in the Edmonton zone. CONCLUSIONS: A significant reduction in the incidence rate, decreasing trend of diabetes-related major LLAs and the significant negative correlation of minor and major LLAs rates in the Calgary zone (TFM) compared to its sister zone Edmonton (SOC), provides supporting evidence for the impact of the TFM. This investigation provides support for a modernization of the diabetes-related limb preservation practice in Canada through the implementation of TFMs across the country to combat major LLAs.

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Good Medicine and Good Health-care Demand Good Information (Systems)

Methods of Information in Medicine ◽

10.3414/me15-05-1001 ◽

2015 ◽

Vol 54 (05) ◽

pp. 385-387

Author(s):

R. -D. Hilgers ◽

R. Hofestädt ◽

U. Hübner ◽

P. Knaup-Gregori ◽

C. Ose ◽

...

Keyword(s):

Health Care ◽

Information Systems ◽

Medical Informatics ◽

Health Informatics ◽

German Journal ◽

Good Health ◽

Incidence Rates ◽

Annual Conference ◽

Good Information ◽

Patient Registries

SummaryThe demand for evidence-based health informatics and benchmarking of ‘good’ information systems in health care gives an opportunity to continue reporting on recent papers in the German journal GMS Medical Informatics, Biometry and Epidemiology (MIBE) here. The publications in focus deal with a comparison of benchmarking initiatives in German-speaking countries, use of communication standards in telemonitoring scenarios, the estimation of national cancer incidence rates and modifications of parametric tests. Furthermore papers in this issue of MIM are introduced which originally have been presented at the Annual Conference of the German Society of Medical Informatics, Biometry and Epidemiology. They deal as well with evidence and evaluation of ‘good’ information systems but also with data harmonization, surveillance in obstetrics, adaptive designs and parametrical testing in statistical analysis, patient registries and signal processing.

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Trends in cancer incidence and survival in the Augsburg study region—results from the Augsburg cancer registry

BMJ Open ◽

10.1136/bmjopen-2019-036176 ◽

2020 ◽

Vol 10 (8) ◽

pp. e036176

Author(s):

Nina Grundmann ◽

Christa Meisinger ◽

Martin Trepel ◽

Jacqueline Müller-Nordhorn ◽

Gerhard Schenkirsch ◽

...

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Pancreatic Cancer ◽

Cancer Incidence ◽

Oropharyngeal Cancer ◽

Time Trends ◽

Cancer Survival ◽

Relative Survival ◽

Incidence Rates ◽

Study Region

ObjectivesKnowledge about time trends of cancer incidence and cancer survival in a defined region is an essential prerequisite for the planning of regional healthcare infrastructure. The aim of the study was to provide population-based analyses of all common tumour sites to assess the cancer burden in the Augsburg study region.SettingTotal population of the study region of Augsburg (668 522 residents), Southern Germany.ParticipantsThe data obtained from the Cancer Registry Augsburg comprised 37 487 incident cases of malignant tumours (19 313 men and 18 174 women) diagnosed between 2005 and 2016 in the Augsburg region’s resident population.Primary and secondary outcome measuresWe calculated sex-specific, age-standardised incidence rates and annual percent change to assess time trends. In men and in women, 3-year and 5-year relative survival was calculated and results were compared with the latest German estimates. Survival trends were presented for the most common cancers only.ResultsDecreasing age-standardised incidence rates were observed for prostate cancer and for colorectal cancer in men. For oropharyngeal cancer, rates declined in men, but significantly increased in women. Incidence for female breast cancer remained stable. Five-year relative survival ranged between 6.4% (95% CI: 4.1% to 10.1%) for pancreatic cancer and 97.7% (95% CI: 96.0% to 99.4%) for prostate cancer in men and between 10.2% (95% CI: 7.1% to 14.6%) for pancreatic cancer and 96.6% (95% CI: 93.6% to 99.6%) for malignant melanoma in women. Trends in 3-year survival of the five most common tumour sites in men showed a significant increase for lung and oropharyngeal cancer. In women, continuously rising survival trends were observed for breast cancer.ConclusionsSurvival of cancer patients in the Augsburg study region was largely concordant with the situation in Germany as a whole, while incidence showed slight deviations in some cancer sites. Regional evaluations on cancer survival are a valuable instrument for identifying deficits and determining advances in oncological health management.

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