scholarly journals Experiences with Primary Care in the State of Utah for Gender Diverse People: Surveying the Difficulties in Accessing Healthcare

2021 ◽  
Author(s):  
Bita Tristani-Firouzi ◽  
Joanne Rolls ◽  
Nicole L Mihalopoulos ◽  
Cori A Agarwal
Keyword(s):  
Primary Care ◽  
Hormone Therapy ◽  
Online Survey ◽  
Primary Care Providers ◽  
Insurance Companies ◽  
Care Providers ◽  
University Of Utah ◽  
Trans Men ◽  
Healthcare Needs ◽  
Trans Women

Background: Transgender and non-binary communities continue to be underserved in healthcare. This study seeks to better understand the barriers and difficulties faced by transgender and non-binary patients in accessing primary care and hormone therapy in Utah. Methods: An online survey was developed for transgender and non-binary identifying adults and was advertised via social media and the University of Utah Hospital website. Results: There were 123 respondents from Utah including 39 trans women, 49 trans men, and 35 non-binary individuals. The age ranged from 18-67 (average 30 years), and 93% were Caucasian. The majority (84%) were insured, yet 67% of respondents reported difficulty accessing primary care. Fear of discrimination and being unable to find trans-friendly providers were reported as the two largest barriers. Non-binary respondents reported fear of discrimination as a barrier to primary care at the highest percentage (92%). Nearly 3 in 4 respondents who have hormone therapy reported difficulty paying for it. One in four trans women reported accessing hormones online or from a friend. Conclusion: Utah is currently drastically underequipped to provide for the healthcare needs of transgender and non-binary communities. There needs to be an increase in trans-friendly primary care providers to curb discrimination. More resources and efforts must go into training primary care providers with necessary knowledge to properly serve transgender and non-binary patients. Finally, clear anti-discrimination laws are needed for insurance companies to reduce the financial barrier to transgender health services in Utah.

A Comparison of Perceptions of Reassurance in Patients with Nontraumatic Neck Pain and Whiplash-Associated Disorders in Consultations with Primary Care Practitioners—An Online Survey

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3377-3386
Author(s):  
Alma Viviana Silva Guerrero ◽  
Jenny Setchell ◽  
Annick Maujean ◽  
Michele Sterling
Keyword(s):  
Primary Care ◽  
Neck Pain ◽  
Structural Damage ◽  
Online Survey ◽  
Detailed Comparison ◽  
Primary Care Providers ◽  
Care Providers ◽  
Convenience Sample ◽  
Primary Care Practitioners ◽  
Pain Symptoms

Abstract Objectives Neck pain remains highly prevalent and costly worldwide. Although reassurance has been recommended as a first line of treatment, specific advice on the best ways to provide reassurance has not been provided due to lack of evidence. Pain symptoms and experiences differ between patients with whiplash-associated disorder (WAD) and those with nontraumatic neck pain (NTNP). The aims of this study were to 1) identify and compare the concerns, fears, and worries of patients with WAD and NTNP; and 2) determine if patients believe their concerns are addressed by primary care providers. Methods These questions were investigated through an online survey, with a convenience sample of 30 participants with NTNP and 20 with WAD. Results A thematic analysis of survey responses resulted in the following seven themes related to common concerns, and two regarding how well concerns were addressed. Common concerns expressed by both groups shared four themes: 1) further structural damage, 2) psychological distress, 3) concerns about the future, and 4) hardships that eventuate. Theme 5), pain/disability is long term, was specific to WAD. Themes 6), pain is current or reoccurring, and 7), interference with daily life, were specific to NTNP. Regarding how well patient concerns were addressed, two overarching themes were common to both conditions: 1) concerns were addressed, with both groups sharing the subthemes “successful treatment,” “reassurance,” and “trust”; and 2) concerns were not addressed, where all subthemes were shared with the exception of two unique to NTNP. Conclusions This detailed comparison provides information about neck pain patients’ concerns and fears, while providing health practitioners support for selecting strategies to promote reassurance appropriately for individual patient needs. Our findings from patients’ perspectives enhance the understanding for providing reassurance for neck pain as proposed by our analysis.

scholarly journals Evaluation of an electronic consultation service for transgender care

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jatinderpreet Singh ◽  
Allison Lou ◽  
Michael Green ◽  
Erin Keely ◽  
Mary Greenaway ◽  
...  
Keyword(s):  
Primary Care ◽  
Response Time ◽  
Access To Care ◽  
Hormone Therapy ◽  
Primary Care Providers ◽  
Care Providers ◽  
Face To Face ◽  
Electronic Consultation ◽  
Clinical Questions ◽  
Insight Into

Abstract Background Access to transgender care in Canada is poor. Although primary care providers are ideally positioned to initiate care, many feel uncomfortable providing transgender care. This study aimed to explore the impact of an electronic consultation (eConsult) service between primary care providers and transgender care specialists on access to care and to explore the content of clinical questions that were asked. Methods This was a retrospective mixed methods analysis of 62 eConsults submitted between January 2017 and December 2018 by primary care providers to specialists in transgender care in a health region in eastern Ontario, Canada. A descriptive analysis was conducted to assess the average response time and the total time spent by the specialist for the eConsults. An inductive and deductive content analysis was carried out to identify common themes of clinical questions being asked to transgender specialists. A post-eConsult survey completed by primary care providers was assessed to gain insight into avoided face-to-face referrals and overall provider satisfaction. Results The median specialist response time was 1.2 days (range: 1 h to 5 days) and the average time spent by specialists per eConsult was 18 min (range: 10 to 40 min). The qualitative analysis identified six major themes: 1) interpretation/management of abnormal bloodwork, 2) change in management due to lack of desired effect/hormone levels not a target, 3) initiation of hormone therapy/initial work up, 4) management of adverse effects of hormone therapy, 5) transition related surgery counseling and post-op complications, and 6) management of patients with comorbidities. Approximately one-third of eConsults resulted in an avoided face-to-face referral and 95% of primary care providers rated the value of their eConsult as a 5 (excellent value) or 4. Conclusions This study demonstrated that a transgender eConsult service has potential to significantly improve access to care for transgender patients. Given the importance that timely access has on improving mental health and reducing suicide attempts, eConsult has the potential to make a substantial clinical impact on this population. Identified themes of eConsult questions provides insight into potential gaps in knowledge amongst primary care providers that could help inform future continuing education events.

scholarly journals Strategies in Primary Care to Face the SARS-CoV-2 / COVID-19 Pandemic: An Online Survey

2021 ◽  
Vol 8 ◽  
Author(s):  
Marion Eisele ◽  
Nadine Janis Pohontsch ◽  
Martin Scherer
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Health Care Providers ◽  
Online Survey ◽  
Qualitative Content Analysis ◽  
Primary Care Providers ◽  
Care Providers ◽  
Sources Of Information ◽  
Pandemic Preparedness ◽  
Team Meetings

Background: Primary care plays a key role in pandemics like the SARS-CoV-2 pandemic in 2020. We aimed to investigate the challenges faced and the solutions implemented in primary care.Methods: One hundred and twenty-one general practitioners in Germany completed the online survey. We used open questions to examine challenges experienced and solutions implemented during the early pandemic and chose qualitative content analysis to extract and describe the meaning of the answers. We derived deductive categories from the research questions and formed inductive categories during the material reviews.Results: Main challenges were: insufficient information, lack of protective equipment, need to restructure practice procedures and insufficient individual and structural pandemic preparedness, resulting in secondary challenges: fear of infection, impaired patient care, aggravated steering of patients, difficult cooperation with external entities and a not viable hygiene concept advised by authorities. Strategies to address these challenges included establishing regular team-meetings to develop new solutions, focusing on few reliable sources of information, working in alternating shifts, increasing telemedicine, establishing window and open-air practices and building networks with other health care providers. Respondents criticized the lack of consideration of their experiences in planning pandemic measures within primary care.Conclusions: General practitioners successfully applied pragmatic and creative strategies in their practices during the early phase of the pandemic. Among these, communication within and between practices emerged as a key strategy. These strategies should be provided with pandemic preparedness plans. The lacking consideration of the primary care providers' experiences in planning and implementing pandemic measures needs to be addressed by stakeholders.

scholarly journals Personal Sun Protection and Counseling Patterns among Primary Care Providers

2019 ◽  
Author(s):  
Daniel Alexander Nadelman ◽  
Joel J. Heidelbaugh
Keyword(s):  
Primary Care ◽  
Online Survey ◽  
Formal Education ◽  
Medical Training ◽  
Primary Care Providers ◽  
Sun Protection ◽  
Training Methods ◽  
Care Providers ◽  
Patient Counseling ◽  
The Relationship

Abstract Background: Personal sun protection and patient counseling patterns among primary care providers is an important topic that has not previously been studied in great detail. Our report evaluates the relationship between sun protection habits among providers, patterns in discussions with patients about sun protection, and prior education on this topic during medical training. Methods: An online survey was sent to family medicine faculty and house officers. Four survey questions about personal sun protection and patient counseling habits were provided. Participants were then asked whether they had received formal education concerning sun protection during their medical training. Results: Our results suggest that providers who received formal education on sun protection during their medical training were more likely to personally use adequate protection and counsel their patients on this topic. Conclusions: This study highlights the importance of sun protection education among primary care providers. Our findings suggest that improving education on this topic among physicians may lead to increased awareness among both patients and providers. Productive discussions about sun protection in the primary care setting has the potential to improve sun protective habits among patients, which can in turn decrease the incidence of skin cancer.

scholarly journals Perceptions of primary care providers on TB care for migrants: a mixed methods study in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A M Tavares ◽  
A C Garcia ◽  
A Gama ◽  
A B Abecasis ◽  
M Viveiros ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Online Survey ◽  
Social Protection ◽  
Close Contact ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Foreign Born ◽  
Structured Interviews

Abstract Background Tuberculosis (TB) is one of the main causes of death worldwide. In 2017, the proportion of TB cases among foreign-born individuals in Portugal was of 19%, and this proportion has been increasing. TB control among migrant populations largely depends on the role of the healthcare providers and their close contact with the patients. We aimed to explore the perspectives of primary care providers on the provision of TB care for migrant patients in Portugal. Methods An online survey and semi-structured interviews were conducted with healthcare providers from primary care settings in Portugal. Overall, 120 participated in the survey, and 17 were interviewed. Data from the survey and interviews were analysed using descriptive statistics and thematic analysis, respectively. Results Many participants (36.9%) considered that migrants arrive at an advanced stage of TB disease, and the main reason referred was migrants’ unawareness of the disease and its symptoms. Moreover, half (50.0%) of the providers considered that migrants frequently interrupt treatment, mainly due to their mobility, which causes difficulties in follow-up, and their social isolation that hampers social support. Overall, three main barriers for migrants’ access and use of TB care were mentioned: migrants’ low socioeconomic status, great bureaucracy required to register at services, and obstacles to benefit from social protection. Providers also suggested more training to improve their cultural competence and updating training on TB care. Conclusions Our study have shown social and economic factors that must be addressed to improve migrants’ access and use of TB care. In addition, increased health literacy for migrants and more training initiatives for providers can also contribute to improve TB care for migrants. Key messages Perspectives from primary care providers in Portugal highlighted social, economic, and administrative obstacles hampering the provision of TB care for migrants. With this work we expected to contribute with evidence to improve TB care for migrant patients in Portugal.

The Other Parent: An Exploratory Survey of Providers’ Engagement of Fathers in Pediatric Primary Care

2019 ◽  
Vol 58 (5) ◽  
pp. 555-563 ◽  
Author(s):  
Brandon S. Allport ◽  
Barry S. Solomon ◽  
Sara B. Johnson
Keyword(s):  
Primary Care ◽  
American Academy ◽  
Online Survey ◽  
Primary Care Providers ◽  
Pediatric Care ◽  
Pediatric Primary Care ◽  
Care Providers ◽  
Father Engagement ◽  
Effective Strategies ◽  
American Academy Of Pediatrics

Although father engagement in pediatric care is associated with positive child health outcomes, pediatric primary care providers (PCPs) often focus on the mother-child dyad. This study sought to characterize pediatric PCPs’ engagement of fathers in care. Pediatric PCPs affiliated with an academic health system were invited to complete an online survey. The primary outcome was the proportion of providers who routinely implement American Academy of Pediatrics recommendations for father engagement. There were 100 respondents. Of the 23 recommended practices for engaging fathers, 18 were routinely implemented by <50% of respondents. The least routinely implemented practices were parenting skills support (4%) and perinatal depression screening (5%). The most commonly endorsed barriers included lack of father attendance at visits (91%) and time constraints (75%). Despite the American Academy of Pediatrics recommendations, pediatric PCPs do not routinely engage fathers in care. Effective strategies are needed to reduce barriers and improve father engagement among pediatric providers.

Differences in unmet healthcare needs between public and private primary care providers: A population-based study

2018 ◽  
Vol 46 (4) ◽  
pp. 488-494 ◽  
Author(s):  
Christine Lindström ◽  
Maria Rosvall ◽  
Martin Lindström
Keyword(s):  
Primary Care ◽  
Care Provider ◽  
Primary Care Provider ◽  
Primary Care Providers ◽  
Time Interval ◽  
Care Providers ◽  
Public And Private ◽  
Private Providers ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

Aims: To investigate if any differences in unmet healthcare needs between persons registered at public and private primary care providers exist in Skåne (southernmost Sweden). Methods: The 2012 public health survey in Skåne was conducted with a postal questionnaire and included 28,029 respondents aged between 18 and 80 years. The study was cross-sectional. If the responder in the last three months had perceived oneself to be in need of medical care by a physician but did not seek it, this was used as a measure of unmet healthcare needs. Differences in unmet healthcare needs in relation to the primary care provider were investigated while adjusting for socioeconomic status and self-rated health in a logistic regression. Results: Differences in unmet healthcare needs were small and non-significant when comparing public and private healthcare providers. Non-manual workers were to a somewhat higher extent using private providers while manual workers showed a reverse pattern. Unmet healthcare needs had decreased slightly since 2008, but so had the response rate. Conclusions: With the current primary care system, no significant differences in unmet healthcare needs seem to exist when comparing public and private providers. It is likely that the providers are similar in their organizational setup, accessibility and doctor-patient continuity. Still more studies need to be done, preferably in a way so that uncertainty about what type of primary care provider the respondent is listed at can be avoided and perhaps using a longer time interval for unmet needs so that more subjects could be included.

scholarly journals Changes to telehealth practices in primary care in New Brunswick (Canada): A comparative study pre and during the COVID-19 pandemic

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258839
Author(s):  
Claire Johnson ◽  
Jérémie B. Dupuis ◽  
Pierre Goguen ◽  
Gabrielle Grenier
Keyword(s):  
Primary Care ◽  
Comparative Study ◽  
New Brunswick ◽  
Nurse Practitioners ◽  
Online Survey ◽  
Primary Care Providers ◽  
Care Providers ◽  
Timely Access ◽  
Access To Primary Care

Background During the COVID-19 pandemic, telehealth technologies were used in the primary health care setting in New Brunswick as a means to continue providing care to patients while following public health guidelines. This study aimed to measure these changes and examine if they improved timely access to primary care. A secondary goal was to identify which telehealth technologies were deemed sustainable by primary care providers. Methods This was a comparative study on the use of telehealth technology before and during the COVID-19 pandemic. Between April 2020 and November 2020, 114 active primary care providers (family physicians or nurse practitioners) responded to the online survey. Results The findings illustrated an increase in the use of telehealth technologies. The use of phone consultations increased by 122%, from 43.9% pre-pandemic to 97.6% during the pandemic (p < 0.001). The use of virtual consultation (19.3% pre-pandemic vs. 41.2% during the pandemic, p < 0.001), emails and texts also increased during the pandemic. Whereas the more structural organizational tools (electronic medical charts and reservation systems) remained stable. However, those changes did not coincide with a significant improvement to timely access to care during the pandemic. Many participants (40.1%) wanted to keep phone consultations, and 21.9% of participants wanted to keep virtual consultations as part of their long-term practice. Interpretation The observed increase in the use of telehealth technologies may be sustainable, but it has not significantly improved timely access to primary care in New Brunswick.

scholarly journals Aging through the time of COVID-19: a survey of self-reported healthcare access

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Allie Peckham ◽  
Keenan A. Pituch ◽  
Molly Maxfield ◽  
M. Aaron Guest ◽  
Shalini Sivanandam ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare Provider ◽  
Chronic Conditions ◽  
Online Survey ◽  
Healthcare Access ◽  
Primary Care Providers ◽  
Care Providers ◽  
Snowball Sampling ◽  
Health Seeking ◽  
The Impact

Abstract Background Chronic conditions are common and require ongoing continuous management and preventive measures. The COVID-19 pandemic may have affected the management of chronic conditions by delaying care. We sought to understand the impact of personal characteristics (i.e., age) and healthcare factors (i.e., access to a provider) on healthcare access in a sample of Americans 50 years of age or older during COVID-19. Method Participants completed an online survey at the start of the COVID-19 pandemic – the Aging in the Time of COVID Survey. Questions focused on health status, health care access, COVID-19 fear, and social connectedness. Participants were recruited through social media advertisements, list serves, and snowball sampling. Data collection started in early April 2020 and concluded in late May 2020. Logistic regression models examined the results of two key access points: healthcare provider/doctor (n = 481) and medication (n = 765), with 56 and 93% of participants reporting access to a provider and medications, respectively. Results Individuals with an established primary care provider were much more likely to obtain access to a healthcare provider, OR = 3.81 (95% CI: 1.69, 8.77), and to receive medication, OR = 4.48 (95% CI: 1.61, 11.48), during the time of COVID-19. In addition, access to medication was (a) higher for those who were older, OR = 1.05 (95% CI: 1.01, 1.09), had a higher income (greater than 100 k compared to less than 50 k, OR = 3.04 (95% CI: 1.11, 8.98), and (b) lower for those having caregiving responsibilities, OR = 0.41 (95% CI: 0.21, 0.78), or greater social isolation, OR = 0.93 (95% CI: 0.87, 0.98). Conclusions Although most participants had access to medication, just over half had access to a healthcare provider when needed. Notably, health-seeking behaviors for individuals who do not have an established primary care providers as well as those who provide unpaid care, are socially isolated, and younger may require more proactive approaches to care monitoring, management, and maintenance.

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