scholarly journals Pandemic trends in health care use: From the hospital bed to the general practitioner with COVID-19

2021 ◽  
Author(s):  
Fredrik Methi ◽  
Kjersti Helene Hernaes ◽  
Katrine Damgaard Skyrud ◽  
Karin Magnusson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Age Groups ◽  
Health Care Use ◽  
Specialist Care ◽  
Care Services ◽  
Primary Care Services ◽  
Hospital Bed ◽  
Bed Days ◽  
The Mean

Aim: To explore whether the acute 30-day burden of COVID-19 on health care use has changed from the beginning to the end of the pandemic. Methods: In all Norwegians (N=122 699) who tested positive for SARS-CoV-2 in three pandemic waves (March 1st-July 31st 2020 (1st wave), August 1st-December 31st 2020 (2nd wave), and January 1st-May 31st 2021 (3rd wave)), we studied the age- and sex-specific share of patients (by age groups 1-19, 20-67, and 68 or more) who had: 1) Relied on self-care, 2) used primary care, and 3) used specialist care. Results: We find that a remarkably high and stable share (70-80%) of patients with COVID-19 exclusively had contact with primary care in the acute phase, both in the 1st, 2nd and 3rd wave. The mean number of primary care visits ranged between 2 and 4. We also show that the use of specialist care in the acute 30-day phase of COVID-19 has decreased, from 14% being hospitalized at least once during spring 2020, to 4% during spring 2021. The mean number of hospital bed-days decreased significantly for men from the 1st to the 2nd wave (from 13 days, 95% CI=11.5-14.5 to 10 days (9-11) for men aged ≥68 years, and from 11 days (10-12) to 9 days (8-10) for men aged 20-67 years), but not for women. Conclusion: COVID-19 places a continued high demand on the primary care services, and a decreasing demand on the specialist care services.

scholarly journals Impacts of mild COVID-19 on elevated use of primary and specialist health care services: A nationwide register study from Norway

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257926
Author(s):  
Katrine Damgaard Skyrud ◽  
Kjersti Helene Hernæs ◽  
Kjetil Elias Telle ◽  
Karin Magnusson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Services ◽  
Age Groups ◽  
Relative Difference ◽  
Health Care Use ◽  
Positive Test ◽  
Specialist Care ◽  
Care Services ◽  
Specialist Health Care

Aim To explore the temporal impact of mild COVID-19 on need for primary and specialist health care services. Methods In all adults (≥20 years) tested for SARS-CoV-2 in Norway March 1st 2020 to February 1st 2021 (N = 1 401 922), we contrasted the monthly all-cause health care use before and up to 6 months after the test (% relative difference), for patients with a positive test for SARS-CoV-2 (non-hospitalization, i.e. mild COVID-19) and patients with a negative test (no COVID-19). Results We found a substantial short-term elevation in primary care use in all age groups, with men generally having a higher relative increase (men 20–44 years: 522%, 95%CI = 509–535, 45–69 years: 439%, 95%CI = 426–452, ≥70 years: 199%, 95%CI = 180–218) than women (20–44 years: 342, 95%CI = 334–350, 45–69 years = 375, 95%CI = 365–385, ≥70 years: 156%, 95%CI = 141–171) at 1 month following positive test. At 2 months, this sex difference was less pronounced, with a (20–44 years: 21%, 95%CI = 13–29, 45–69 years = 38%, 95%CI = 30–46, ≥70 years: 15%, 95%CI = 3–28) increase in primary care use for men, and a (20–44 years: 30%, 95%CI = 24–36, 45–69 years = 57%, 95%CI = 50–64, ≥70 years: 14%, 95%CI = 4–24) increase for women. At 3 months after test, only women aged 45–70 years still had an increased primary care use (14%, 95%CI = 7–20). The increase was due to respiratory- and general/unspecified conditions. We observed no long-term (4–6 months) elevation in primary care use, and no elevation in specialist care use. Conclusion Mild COVID-19 gives an elevated need for primary care that vanishes 2–3 months after positive test. Middle-aged women had the most prolonged increased primary care use.

scholarly journals Health care use up to 6 months after COVID-19 in 700.000 children and adolescents: a pre-post study

2021 ◽  
Author(s):  
Karin Magnusson ◽  
Katrine Damgaard Skyrud ◽  
Pal Suren ◽  
Margrethe Greve-Isdahl ◽  
Ketil Stordal ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Services ◽  
Age Groups ◽  
Health Care Use ◽  
School Age ◽  
Older Children ◽  
Specialist Care ◽  
Before And After ◽  
Specialist Health Care

Objectives: To explore whether, and for how long COVID-19 among children gives an increase in use of health care services, when compared to children with no COVID-19. Methods: Studying all Norwegian residents aged 1-5, 6-15 and 16-19 years from August 1st 2020 to February 1st 2021 (N= 768 560), we contrasted rates of monthly all-cause primary and specialist health care use before and after testing for SARS-CoV-2 (% relative change), for children testing positive (non-hospitalized in the acute phase) (N=10 306) vs children with no COVID-19 (N=758 254). Results: We found a substantial elevation in short-term primary care use for children testing positive for SARS-CoV-2 during the first month following positive test when compared to children testing negative (relative elevation 1-5 years: 325%, 95%CI=296-354; 6-15 years: 434%, 95%CI=415-453; 16-19 years: 360%, 95%CI=342-379). There was still elevated primary care use at 2 months (1-5 years: 21%, 95%CI= 4-38; 6-15 years: 13%, 95%CI=2-25) and at 3 months (1-5 years: 26%, 95%CI=7-45, 6-15 years: 15%, 95%CI=3-26) for young children, but not at 2 or 3 months for the older children (16-19 years: 10%, 95%CI=-1-22 and 6%, 95%CI=-5-18, respectively). The 1-5-year-olds also had a long-term (up to 6 months) increase of primary care (14%, 95%CI=1-26) that was not observed for older age groups, when compared to same-aged children testing negative. We observed no elevated use of specialist care. Conclusion: Children in pre-school age used health services for a longer time (3-6 months) after COVID-19 than children in primary and secondary school age (1-3 months).

scholarly journals Health-Care Waste: Knowledge of Primary Care nurses

2018 ◽  
Vol 71 (5) ◽  
pp. 2367-2375 ◽  
Author(s):  
Ana Paula Mhirdaui Sanches ◽  
Karen Sayuri Mekaro ◽  
Rosely Moralez de Figueiredo ◽  
Silvia Carla da Silva André
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Family Health ◽  
Chemical Waste ◽  
Know How ◽  
Paulo State ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Nurses ◽  
Health Care Waste

ABSTRACT Objective: to describe the knowledge of nurses on Health-Care Waste Management (HCW) in Family Health Units (FHU) of São Carlos city, São Paulo State. Method: exploratory, descriptive and quantitative approach. The research was carried out with nurses of 16 FHU of the municipality of São Carlos-SP. Data were collected through an interview using a tool validated and analyzed using descriptive statistics. Results: it is noteworthy that 68.7% (11) of the nurses did not know how to describe how chemical waste was sorted. In addition, regarding the treatment of HCW, 50.0% (8) of the nurses did not know if the general waste were subjected to some type of treatment. Conclusion: the HCW management can be considered a challenge in the nurses' agenda inserted in the Primary Care services, which refers to the need to implement periodic training on the management of this waste.

scholarly journals Assessing the quality of maternal health care in Indigenous primary care services

2010 ◽  
Vol 192 (10) ◽  
pp. 597-598 ◽  
Author(s):  
Alice R Rumbold ◽  
Ross S Bailie ◽  
Damin Si ◽  
Michelle C Dowden ◽  
Catherine M Kennedy ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Maternal Health ◽  
Maternal Health Care ◽  
Care Services ◽  
Primary Care Services

scholarly journals UNDERSTANDING DEMENTIA PREVALENCE AND HEALTH CARE USE PATTERNS IN RURAL NORTH CAROLINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S904-S905
Author(s):  
Amanda N Grant ◽  
Tsai-Ling Liu ◽  
Nigel L Rozario ◽  
Deanna A Mangieri ◽  
Jennifer M Woodward ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
North Carolina ◽  
Health Care Use ◽  
Health Care Needs ◽  
Care Needs ◽  
Dementia Prevalence ◽  
Care Services ◽  
Dementia Patients ◽  
Acute Care Services

Abstract Rural and remote communities have limited access to high quality dementia care, prompting a need for innovative solutions to meet the health care needs of affected older adults. As part of a study aimed at implementing a telehealth intervention for primary care patients with dementia in two rural North Carolina counties, we examined baseline dementia prevalence and compared health care use between patients with and without dementia. Electronic health records from January 2018 to December 2018 were examined for 2,288 patients aged 65 or older. A zero-inflated Poisson regression model was used to compare healthcare use between patients with and without dementia adjusting for patients’ demographic and clinical characteristics. Dementia prevalence was 8.7% based on diagnosis codes. Most patients with dementia were women (70%), not married (55%), Medicare-insured (78%), and had more comorbidities (mean: 2±2) than non-dementia patients. Dementia patients had a significantly higher number of primary care visits, emergency department visits, inpatient visits, and preventable hospitalizations than patients without dementia (risk ratio = 1.1, 1.8, 2.18, and 1.3, respectively; all P< 0.05). Dementia burden was higher among women and use of acute care services by patients with dementia in this rural setting was higher than patients without the disease, similar to urban settings. These findings suggest opportunities to improve care coordination and access to resources to help reduce the need for acute care services among patients with dementia and can help tailor interventions to address the health care needs of this group.

scholarly journals Factors for Supporting Primary Care Physician Engagement With Patient Apps for Type 2 Diabetes Self-Management That Link to Primary Care: Interview Study (Preprint)

2018 ◽  
Author(s):  
Julie Ayre ◽  
Carissa Bonner ◽  
Sian Bramwell ◽  
Sharon McClelland ◽  
Rajini Jayaballa ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Care Physician ◽  
Self Management ◽  
Clinical Tool ◽  
Face To Face ◽  
Care Services ◽  
Primary Care Services ◽  
Potential Benefits

BACKGROUND The health burden of type 2 diabetes can be mitigated by engaging patients in two key aspects of diabetes care: self-management and regular contact with health professionals. There is a clear benefit to integrating these aspects of care into a single clinical tool, and as mobile phone ownership increases, apps become a more feasible platform. However, the effectiveness of online health interventions is contingent on uptake by health care providers, which is typically low. There has been little research that focuses specifically on barriers and facilitators to health care provider uptake for interventions that link self-management apps to the user’s primary care physician (PCP). OBJECTIVE This study aimed to explore PCP perspectives on proposed features for a self-management app for patients with diabetes that would link to primary care services. METHODS Researchers conducted 25 semistructured interviews. The interviewer discussed potential features that would link in with the patient’s primary care services. Interviews were audio-recorded, transcribed, and coded. Framework analysis and the Consolidated Criteria for Reporting Qualitative Research checklist were employed to ensure rigor. RESULTS Our analysis indicated that PCP attitudes toward proposed features for an app were underpinned by perceived roles of (1) diabetes self-management, (2) face-to-face care, and (3) the anticipated burden of new technologies on their practice. Theme 1 explored PCP perceptions about how an app could foster patient independence for self-management behaviors but could also increase responsibility and liability for the PCP. Theme 2 identified beliefs underpinning a commonly expressed preference for face-to-face care. PCPs perceived information was more motivating, better understood, and presented with greater empathy when delivered face to face rather than online. Theme 3 described how most PCPs anticipated an initial increase in workload while they learned to use a new clinical tool. Some PCPs accepted this burden on the basis that the change was inevitable as health care became more integrated. Others reported potential benefits were outweighed by effort to implement an app. This study also identified how app features can be positively framed, highlighting potential benefits for PCPs to maximize PCP engagement, buy-in, and uptake. For example, PCPs were more positive when they perceived that an app could facilitate communication and motivation between consultations, focus on building capacity for patient independence, and reinforce rather than replace in-person care. They were also more positive about app features that were automated, integrated with existing software, flexible for different patients, and included secondary benefits such as improved documentation. CONCLUSIONS This study provided insight into PCP perspectives on a diabetes app integrated with primary care services. This was observed as more than a technological change; PCPs were concerned about changes in workload, their role in self-management, and the nature of consultations. Our research highlighted potential facilitators and barriers to engaging PCPs in the implementation process.

scholarly journals Exploring the implementation and delivery of primary care services for transgender individuals in Ontario: case study protocol

2020 ◽  
Vol 21 ◽  
Author(s):  
Erin Ziegler ◽  
Ruta Valaitis ◽  
Nancy Carter ◽  
Cathy Risdon ◽  
Jennifer Yost
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Access To Health Care ◽  
Care Providers ◽  
Case Study Methodology ◽  
Care Services ◽  
Services Delivery ◽  
Primary Care Services ◽  
Care Models

Abstract Background: Historically transgender adults have experienced barriers in accessing primary care services. In Ontario, Canada, health care for transgender adults is accessed through primary care; however, a limited number of practitioners provide care, and patients are often waiting and/or traveling great distances to receive care. The purpose of this protocol is to understand how primary care is implemented and delivered for transgender adults. The paper presents how the case study method can be applied to explore implementation of health services delivery for the transgender population in primary care. Methods: Case study methodology will be used to explore this phenomenon in different primary care contexts. Normalization Process Theory is used as a guide. Three cases known to provide transgender primary care and represent different Ontario primary care models have been identified. Comparing transgender care implementation and delivery across different models is vital to understanding how care provision to this population can be supported. Qualitative interviews will be conducted. Participants will also complete the NoMAD (NOrmalization MeAsure Development) survey, a tool measuring implementation processes. The tool will be modified to explore the implementation of primary care services for transgender individuals. Documentary evidence will be collected. Cross-case synthesis will be completed to compare the cases. Discussion: Findings will provide an Ontario perspective on the implementation and delivery of primary care for transgender adults in different primary care models. Results may be applicable to other primary care settings in Canada and other nations with similar systems. Barriers and facilitators in delivery and implementation will be identified. Providing an understanding and increasing awareness of the implementation and delivery of primary care may help to reduce the invisibility and disparities transgender individuals experience when accessing primary care services. Understanding delivery of care could allow care providers to implement primary care services for transgender individuals, improving access to health care for this vulnerable population.

FACTORS ASSOCIATED WITH THE ASSESSMENT ON HEALTH CARE QUALITY AT COMMUNE HEALTH CENTERS IN THUA THIEN HUE PROVINCE

2017 ◽  
pp. 53-61
Author(s):  
Minh Tam Nguyen ◽  
Thi Hoa Nguyen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Patient Satisfaction ◽  
Health Status ◽  
Care Quality ◽  
Health Care Facilities ◽  
Health Centers ◽  
Important Indicator ◽  
Care Services ◽  
Primary Care Services

Background: Patient satisfaction is an important indicator of healthcare quality. Better satisfaction is associated with greater adherence to treatment and better health outcomes. Primary care is considered the basic structure of many healthcare systems. Evaluation of healthcare provision is essential in the ongoing assessment and consequent quality improvement of healthcare services. Objective: To describe and analyze the determinants associated with patient assessment and satisfaction in primary care. Methods: The survey was conducted with 519 households and 209 patients at 18 commune health centers. The questionnaire included sociodemographic variables, health status, and use and satisfaction with primary care services. We undertook descriptive analyses, bivariate correlations to study the relationship between levels of satisfaction and the explanatory variables for demographics, health status and health services for households and patients. Results: The majority of households and patients were satisfied with the health care services at primary health care facilities. Satisfaction of waiting time, communication and counseling by healthcare providers was high. We found significant associations between the level of satisfaction and owning health insurance card, the first contact point assigned at CHCs, the severity of illness episodes, and health condition of participants. Conclusions: The results provide evidence on factors that should be taken into account in the planning and development of health policies with respect to the quality and delivery of primary care services in order to enhancing the satisfaction of clients. Key words: consumer satisfaction, patient satisfaction, primary care, quality indicators

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