scholarly journals Keeping doors open: A cross-sectional survey of family physician practice patterns during COVID-19, needs, and intentions

2021 ◽  
Author(s):  
Tara Kiran ◽  
Ri Wang ◽  
Curtis Handford ◽  
Nadine Laraya ◽  
Azza Eissa ◽  
...  
Keyword(s):  
Family Physician ◽  
Practice Patterns ◽  
Clinical Care ◽  
Family Physicians ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Policy Makers ◽  
Family Doctors ◽  
Future Practice

Objective: To determine the extent to which family physicians closed their doors altogether or for in-person visits during the pandemic, their future practice intentions, and related factors. Methods: Between March and June 2021, we conducted a cross-sectional survey using email, fax, and phone of 1,186 family doctors practicing comprehensive family medicine in Toronto, Ontario. We asked about practice patterns in January 2021, use of virtual care, and practice intentions. Results: Of the 1,016 (86%) that responded to the survey, 99.7% (1001/1004) indicated their practice was open in January 2021 with 94.8% (928/979) seeing patients in-person and 30.8% (264/856) providing in-person care to patients reporting COVID-19 symptoms. Respondents estimated spending 58.2% of clinical care time on phone visits and an additional 5.8% on video and 7.5% on email. 17.2% (77/447) were planning to close their current practice in the next five years. There was a higher proportion of physicians who worked alone in a clinic among those who did not see patients in-person (27.6% no vs 12.4% yes, p<0.05), did not see symptomatic patients (15.6% no vs 6.5 % yes, p<0.001), and those who planned to close their practice in the next 5 years (28.9% yes vs 13.9% no, p<0.01). Interpretation: The vast majority of family physicians in Toronto were open to in-person care in January 2021 but almost one-fifth are considering closing their practice in the next five years. Policy-makers need to prepare for a growing family physician shortage and better understand factors that support recruitment and retention.

scholarly journals A cross-sectional survey on influencing factors of contracted services of Chinese family doctors : A quantitative and qualitative study

2019 ◽  
Author(s):  
Huanyan Wang ◽  
Lei Shi ◽  
Xuanye Han ◽  
Jinchan Zhang ◽  
Lihua Fan
Keyword(s):  
Health Service ◽  
Community Health ◽  
Influencing Factors ◽  
Service Providers ◽  
Family Doctor ◽  
Community Health Service ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Family Doctors

Abstract Background: The family doctor system has gained rapid ground worldwide. In recent years, China has been actively exploring family doctor-type contracted services. The purpose of this study was to explore the influencing factors of Contracted Family Doctors Services (CFDS) from the perspectives of community health service providers, administrators and medical staff, and it provides a strong basis for the development and promotion of CFDS. Methods: A combination of quantitative and qualitative methods was adopted in this study. A cross-sectional survey was conducted among community health service providers and administrators in 12 community health service centers across four provinces (Zhejiang, Anhui, Beijing, and Shanghai) of China. A total of 389 people took the survey. Ultimately, 320 questionnaires were valid. The effective response rate was 82.3%. A total of 36 consumers were interviewed through in-depth interviews. The total effective rate 100.0%. Exploratory factor analysis, confirmatory factor analysis, and expert consultation were used to analyze the influencing factors of CFDS. Results: The factors influencing CFDS from the perspectives of medical staff were divided into four dimensions, with the following weighting coefficients: national government (31.87%), community health service agency factors (24.73%), consumers-related factors (22.58%), and contracted doctor-related factors (20.82%). The factors influencing CFDS from the perspectives of patients/consumers were national policy factors, contracted team factor, and consumers-related factors. Conclusions: National governments, community health agencies, community health workers, and consumers play an important role in the advancement of CFDS. Therefore, the development of CFDS needs to consider the rights and interests of all stakeholders involved.

QOLP-01. EXPERIENCES FROM PATIENT, CAREGIVER, AND PHYSICIAN SURVEYS ON DIAGNOSIS AND TREATMENT OF BRAIN METASTASES

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi182-vi182
Author(s):  
Albert Kim ◽  
Gi-Ming Wang ◽  
Kristin Waite ◽  
Scott Elder ◽  
Avery Fine ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Practice Patterns ◽  
Checkpoint Inhibitors ◽  
Clinical Care ◽  
Unmet Need ◽  
High Yield ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physician Recommendations

Abstract The development of brain metastases (BM) is one of the most feared complications of cancer due to the substantial neuro-cognitive morbidity and grim prognosis. In the past decade, targeted therapies and checkpoint inhibitors have demonstrated remarkable intracranial response rates for tumors of multiple histologies. As overall survival for these patients improves, there is a growing need to identify issues surrounding patient survivorship and to standardize physician practice patterns for these patients. To date, there has not been an adequate study to specifically explore these questions of survivorship and practice standardization for patients with advanced cancer and BM. Here, we present results from a cross-sectional survey in which we analyze responses from 237 patients, 209 caregivers, and 239 physicians to identify areas of improvement in the clinical care of BM. In comparing physician and patient/caregiver responses, we found a disparity in the perceived discussion of topics pertaining to important aspects of BM clinical care. We identified variability in practice patterns for this patient population between private practice and academic physicians. Many physicians continue to have patients with BM excluded from clinical trials. Finally, we obtained patient/physician recommendations on high-yield areas for federal funding to improve patient quality of life. Therefore, by identifying potential areas of unmet need, we anticipate this wealth of actionable information will translate into tangible benefits for both patients and caregivers. Future studies are needed to validate our findings.

scholarly journals Cross-sectional survey of patients, caregivers, and physicians on diagnosis and treatment of brain metastases

2021 ◽  
Author(s):  
Albert E Kim ◽  
Gi-Ming Wang ◽  
Kristin A Waite ◽  
Scott Elder ◽  
Avery Fine ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Practice Patterns ◽  
Checkpoint Inhibitors ◽  
Clinical Care ◽  
Unmet Need ◽  
High Yield ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physician Recommendations

Abstract Background The development of brain metastases (BM) is one of the most feared complications of cancer due to the substantial neuro-cognitive morbidity and grim prognosis. In the past decade, targeted therapies and checkpoint inhibitors have demonstrated promising intracranial response rates for tumors of multiple histologies. As overall survival for these patients improves, there is a growing need to identify issues surrounding patient survivorship and to standardize physician practice patterns for these patients. To date, there has not been an adequate study to specifically explore these questions of survivorship and practice standardization for patients with advanced cancer and BM. Methods Here, we present results from a cross-sectional survey in which we analyze responses from 237 patients, 209 caregivers, and 239 physicians to identify areas of improvement in the clinical care of BM. Results In comparing physician and patient/caregiver responses, we found a disparity in the perceived discussion of topics pertaining to important aspects of BM clinical care. We identified variability in practice patterns for this patient population between private practice and academic physicians. Many physicians continue to have patients with BM excluded from clinical trials. Finally, we obtained patient/physician recommendations on high-yield areas for federal funding to improve patient quality of life. Conclusion By identifying potential areas of unmet need, we anticipate this wealth of actionable information will translate into tangible benefits for both patients and caregivers. Future studies are needed to validate our findings.

Practice Patterns and Attitudes of Surgeons on the Use of Prophylactic Mesh to Prevent Parastomal Hernia: A Cross-sectional Survey

2019 ◽  
Vol 65 (9) ◽  
pp. 14-23 ◽  
Author(s):  
Manuel Lopez-Cano ◽  
Hobart W Harris ◽  
John P Fisher ◽  
Jose Antonio Pereira ◽  
Josep M Garcia-Alamino ◽  
...  
Keyword(s):  
Parastomal Hernia ◽  
Practice Patterns ◽  
Cross Sectional Survey ◽  
Prophylactic Mesh ◽  
Cross Sectional

scholarly journals The measurement performance of the EQ-5D-5L versus EQ-5D-3L in patients with hidradenitis suppurativa

2021 ◽  
Author(s):  
Alex Bató ◽  
Valentin Brodszky ◽  
L. Hunor Gergely ◽  
Krisztián Gáspár ◽  
Norbert Wikonkál ◽  
...  
Keyword(s):  
Convergent Validity ◽  
Hidradenitis Suppurativa ◽  
Clinical Care ◽  
Intraclass Correlation ◽  
Life Quality ◽  
Measurement Properties ◽  
Economic Evaluations ◽  
Health State ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Purpose Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects up to 1% of the population in Europe. The EQ-5D is the most commonly used generic instrument for measuring health-related quality of life among HS patients. This study aims to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with HS. Methods We recruited 200 consecutive patients with HS (mean age 37 years, 38% severe or very severe HS) to participate in a multicentre cross-sectional survey. Patients completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16 questionnaires. Results More than twice as many different health state profiles occurred in the EQ-5D-5L compared to the EQ-5D-3L (101 vs. 43). A significant reduction in ceiling effect was found for the mobility, self-care and usual activities dimensions. A good agreement was established between the EQ-5D-3L and EQ-5D-5L with an intraclass correlation coefficient of 0.872 (95% CI 0.830–0.903; p < 0.001) that was confirmed by a Bland-Altman plot. EQ-5D-5L improved both the absolute and relative informativity in all dimensions except for anxiety/depression. EQ-5D-3L and EQ-5D-5L demonstrated similar convergent validity with DLQI and Skindex-16. EQ-5D-5L was able to better discriminate between known groups of patients based on the number of comorbidities and disease severity (HS-Physician's Global Assessment). Conclusion In patients with HS, the EQ-5D-5L outperformed the EQ-5D-3L in feasibility, ceiling effects, informativity and known-groups validity for many important clinical characteristics. We recommend using the EQ-5D-5L in HS patients across various settings, including clinical care, research and economic evaluations.

scholarly journals 31. Influenza Vaccination During Pregnancy: A Descriptive Cross-sectional Survey of the Knowledge, Beliefs, and Attitudes of Mexican Gynecologists and Family Physicians

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S39-S39
Author(s):  
Erika Z Lopatynsky-Reyes ◽  
Sue Ann Costa-Clemens ◽  
Enrique Chacon-Cruz ◽  
Michael Greenberg
Keyword(s):  
Influenza Vaccination ◽  
Pregnant Women ◽  
Latin American ◽  
Vaccine Coverage ◽  
Family Physicians ◽  
Morbidity And Mortality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Beliefs And Attitudes ◽  
In Pregnancy

Abstract Background Influenza in pregnancy is associated with elevated morbidity and mortality. Influenza vaccines are both safe and effective in pregnancy, supporting routine use in this population. Even though influenza vaccination in Mexico is recommended for pregnant women, there are no publications of influenza vaccine coverage in pregnancy. This is the first Latin American survey done only in physicians aiming to assess the knowledge, beliefs, and attitudes that Mexican Obstetrics-Gynecologists (OBG) and Family Physicians (FP) have towards influenza and influenza immunization during pregnancy. Methods A cross-sectional survey was conducted, both paper-based and online. The questionnaire was composed of 35 questions, which addressed general knowledge of influenza, recommendations for vaccination during pregnancy, and beliefs and attitudes concerning the acceptability of the vaccine in pregnant women. Results A total of 206 completed surveys were available, 98 (47.6%) from OBG, 108 (52.4%) from FP. Regarding current practicing medical institutions, 76 (37%), 69 (34%), 31 (14.5%), 30 (14.5%) reported working for the Mexican Institute of Social Security, Private Sector, Secretariat of Health, or a combination of all respectively, representing an estimated 2,472 daily pregnancy consultations. About a quarter (26.2%) reported not having a notion that influenza is more severe among pregnant women. More than half (51.5%) ignored the potential side effects of influenza infection on the fetus. The majority (56.8%) did not know when vaccination during pregnancy should occur. Pregnancy as a risk factor for developing influenza complications was known only in 48.1%. Also, 46.1 % believed that vaccination only confers protection to the mother, but not to the fetus. Nevertheless, 96.1% considered that immunization against influenza during pregnancy is a safe and effective preventive intervention. A results’ summary is shown in Figure-1. Conclusion Based on this survey, current knowledge of OBG and FP for influenza morbidity and mortality during pregnancy, and the importance of influenza vaccination in pregnant women, is poor. Mandatory recommendations to educate medical providers regarding influenza vaccination during pregnancy in Mexico are necessary, even as imperative for CME credits. Disclosures All Authors: No reported disclosures

scholarly journals Patient-reported experience and outcomes from orthodontic treatment

2020 ◽  
Vol 47 (2) ◽  
pp. 107-115
Author(s):  
Elizabeth Bradley ◽  
Andrew Shelton ◽  
Trevor Hodge ◽  
David Morris ◽  
Hilary Bekker ◽  
...  
Keyword(s):  
Secondary Care ◽  
Orthodontic Treatment ◽  
Clinical Care ◽  
Patient Treatment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Fixed Appliance ◽  
Treatment Experience ◽  
Patient Reported ◽  
Pre Treatment

Objective: To measure patient-reported impact of orthodontic treatment in terms of pre-treatment concerns, treatment experience and treatment outcome. Setting: Four sites in Yorkshire, including two secondary care settings (Leeds Dental Institute and St Luke’s Hospital, Bradford) and two specialist orthodontic practices. Design: Cross-sectional survey. Participants: NHS orthodontic patients (aged 12+ years) who have completed comprehensive orthodontic treatment, excluding orthognathic surgery and craniofacial anomalies. Methods: Participants were opportunistically identified by the direct clinical care team during scheduled appointments and those eligible were invited to participate. Data were collected using the Orthodontic Patient Treatment Impact Questionnaire (OPTIQ), a validated 12-item measure with questions relating to pre-treatment experience, impact of treatment and outcome from treatment. Results: Completed questionnaires for analysis included 120 from primary care and 83 from secondary care. The most common pre-treatment concerns were alignment (89%) and being embarrassed to smile (63%). The most common expectations from orthodontic treatment were improved confidence to eat (87%) and smile (72%) in front of others, improved appearance of teeth (85%) and reduced teasing/bullying (63%). Only 67% respondents recalled receiving written information and the lowest recall related to retainer type and length of retention. The most commonly reported complications were sore mouth (68%), fixed appliance breakage (61%) and gingivitis (39%). Treatment caused greatest impact in relation to pain, limitations in eating and effect on speech. Overall satisfaction with orthodontic treatment was reported by 96% of respondents, 87% would have orthodontic treatment again (if needed) and 91% would recommend treatment to a friend. Conclusions: The OPTIQ is a useful patient-reported tool to identify pre-treatment concerns and expectations, treatment experience and outcome. Orthodontic treatment leads to high levels of satisfaction.

The battle over employers’ demand for “more flexibility”

2016 ◽  
Vol 38 (6) ◽  
pp. 886-906 ◽  
Author(s):  
Erling Rasmussen ◽  
Barry Foster ◽  
Deirdre Farr
Keyword(s):  
New Zealand ◽  
Survey Design ◽  
Postal Questionnaire ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Policy Makers ◽  
Content Type ◽  
Employer Attitudes ◽  
Legislative Changes ◽  
Employment Legislation

Purpose The purpose of this paper is to place empirical research on New Zealand employers’ attitudes to collective bargaining and legislative change within the context of the long running debate of flexibility. Design/methodology/approach A cross-sectional survey design using a self-administered postal questionnaire, covering private sector employers with ten or more staff and including employers within all 17 standard industry classification. To explore particular issues, an additional in-depth interviews were conducted of 25 employers participating in the survey. Findings It is found that employers support overwhelmingly recent legislative changes though there are variations across industries and firm sizes. There is also considerable variation in terms of which legislative changes are applied in the workplace. Despite fewer constraints on employer-determined flexibility, there was a rather puzzling finding that most employers still think that employment legislation is even balanced or favouring employees. Originality/value Cross-sectional survey findings of New Zealand employer attitudes to legislative changes are few and provide valuable data for policy makers, unions, employers and employment relations researchers. The paper also contributes to a more comprehensive understanding of pressures to increase employer-determined flexibility in many western countries.

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