scholarly journals Utilisation of primary care before a childhood cancer diagnosis: do socioeconomic factors matter?: A Danish nationwide population-based matched cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e023569 ◽  
Author(s):  
Christina Friis Abrahamsen ◽  
Jette Møller Ahrensberg ◽  
Peter Vedsted
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Childhood Cancer ◽  
Socioeconomic Factors ◽  
Cancer Diagnosis ◽  
Low Income ◽  
Diagnostic Tests ◽  
Population Based ◽  
Matched Cohort ◽  
Frequent Use

ObjectivesEarly diagnosis of childhood cancer is critical. Nevertheless, little is known about the potential role of inequality. This study aims to describe the use of primary care 2 years before a childhood cancer diagnosis and to investigate whether socioeconomic factors influence the use of consultations and diagnostic tests in primary care.DesignA national population-based matched cohort study.Setting and participantsThis study uses observational data from four Danish nationwide registers. All children aged 0–15 diagnosed with cancer during 2008–2015 were included (n=1386). Each case was matched based on gender and age with 10 references (n=13 860).Primary and secondary outcome measuresThe primary outcome was additional rates for consultations and for invoiced diagnostic tests for children with cancer according to parental socioeconomic factors. Furthermore, we estimated the association between socioeconomic factors and frequent use of consultations, defined as at least four consultations, and the odds of receiving a diagnostic test within 3 months of diagnosis.ResultsChildren with cancer from families with high income had 1.46 (95% CI 1.23 to 1.69) additional consultations 3 months before diagnosis, whereas children from families with low income had 1.85 (95% CI 1.60 to 2.11) additional consultations. The highest odds of frequent use of consultations was observed among children from low-income families (OR: 1.94, 95% CI 1.24 to 3.03). A higher odds of receiving an invoiced diagnostic test was seen for children from families with mid-educational level (OR: 1.46, 95% CI 1.09 to 1.95).ConclusionWe found a socioeconomic gradient in the use of general practice before a childhood cancer diagnosis. This suggests that social inequalities exist in the pattern of healthcare utilisation in general practice.

scholarly journals Advanced Access scheduling in general practice and use of primary care: a Danish population-based matched cohort study

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101091
Author(s):  
Maria Bang ◽  
Henrik Schou Pedersen ◽  
Bodil Hammer Bech ◽  
Claus Høstrup Vestergaard ◽  
Jannik Falhof ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cohort Study ◽  
Population Based ◽  
Matched Cohort ◽  
Face To Face ◽  
Matched Cohort Study ◽  
Adjusted Incidence Rate ◽  
Advanced Access ◽  
The Impact

BackgroundAdvanced access scheduling (AAS) allows patients to receive care from their GP at the time chosen by the patient. AAS has shown to increase the accessibility to general practice, but little is known about how AAS implementation affects the use of in-hours and out-of-hours (OOH) services.AimTo describe the impact of AAS on the use of in-hours and OOH services in primary care.Design & settingA population-based matched cohort study using Danish register data.MethodA total of 161 901 patients listed in 33 general practices with AAS were matched with 287 837 reference patients listed in 66 reference practices without AAS. Outcomes of interest were use of daytime face-to-face consultations, and use of OOH face-to-face and phone consultations in a 2-year period preceding and following AAS implementation.ResultsNo significant differences were seen between AAS practices and reference practices. During the year following AAS implementation, the number of daytime face-to-face consultations was 3% (adjusted incidence rate ratio [aIRR] = 1.03; 95% confidence interval [CI] = 0.99 to 1.07) higher in the AAS practices compared with the number in the reference practices. Patients listed with an AAS practice had 2% (aIRR = 0.98; 95% CI = 0.92 to 1.04) fewer OOH phone consultations and 6% (aIRR = 0.94; 95% CI = 0.86 to 1.02) fewer OOH face-to-face consultations compared with patients listed with a reference practice.ConclusionThis study showed no significant differences following AAS implementation. However, a trend was seen towards slightly higher use of daytime primary care and lower use of OOH primary care.

scholarly journals Features of childhood cancer in primary care: a population-based nested case-control study

2012 ◽  
Vol 97 (Suppl 1) ◽  
pp. A5.1-A5
Author(s):  
RM Dommett ◽  
TR Redaniel ◽  
MCG Stevens ◽  
W Hamilton ◽  
RM Martin
Keyword(s):  
Primary Care ◽  
Childhood Cancer ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Nested Case Control ◽  
Control Study

scholarly journals The association between unexpected weight loss and cancer diagnosis in primary care: a matched cohort analysis of 65,000 presentations

2020 ◽  
Vol 122 (12) ◽  
pp. 1848-1856 ◽  
Author(s):  
Brian D. Nicholson ◽  
Willie Hamilton ◽  
Constantinos Koshiaris ◽  
Jason L. Oke ◽  
F. D. Richard Hobbs ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Cancer Diagnosis ◽  
Cohort Analysis ◽  
Matched Cohort

scholarly journals Impact of parental socioeconomic factors on childhood cancer mortality: a population-based registry study

2018 ◽  
Vol 57 (11) ◽  
pp. 1547-1555 ◽  
Author(s):  
Anniina Tolkkinen ◽  
Laura Madanat-Harjuoja ◽  
Mervi Taskinen ◽  
Matti Rantanen ◽  
Nea Malila ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Socioeconomic Factors ◽  
Cancer Mortality ◽  
Population Based ◽  
Registry Study ◽  
Population Based Registry

scholarly journals Cluster randomised controlled trial of a guided self-help mental health intervention in primary care

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023481 ◽  
Author(s):  
Fiona Mathieson ◽  
James Stanley ◽  
Catherine (Sunny) Collings ◽  
Rachel Tester ◽  
Anthony Dowell
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practice ◽  
Randomised Controlled Trial ◽  
Low Income ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Cluster Randomised ◽  
Study Results ◽  
Randomised Controlled

ObjectivesTo ascertain whether an ultrabrief intervention (UBI) improves mental health outcomes for patients in general practice with mild-to-moderate mental health concerns.Trial designTwo-arm cluster randomised controlled trial.MethodsParticipants: general practitioners (GPs) were invited based on working in a participating general practice. Patients were eligible to participate if aged 18–65 years, scored ≤35 on the Kessler-10 (K10) and if meeting local mental health access criteria (based on age, low income or ethnic group).Interventions: intervention arm GPs were trained on the UBI approach, with participating patients receiving three structured appointments over 5 weeks. GPs randomised to practice as usual (PAU) did not receive training, and delivered support following their existing practice approaches.Outcome measures: primary outcome was patient-level K10 score at 6 months postrecruitment.Randomisation: GP practices were randomised to UBI training or PAU at the start of the study.Blinding: GPs were not blinded to group assignment.ResultsNumbers randomised: 62 GPs (recruiting 85 patients) were randomised to UBI, and 50 to PAU (recruiting 75 patients).Numbers analysed: 31 GPs recruited at least one patient in the UBI arm (70 patients analysed), and 21 GPs recruited at least one patient in the PAU arm (69 patients analysed).Outcome: K10 scores from an intention-to-treat analysis were similar in UBI and PAU arms, with a wide CI (mean adjusted K10 difference=1.68 points higher in UBI arm, 95% CI −1.18 to 4.55; p=0.255). Secondary outcomes were also similar in the two groups.Conclusions: the UBI intervention did not lead to better outcomes than practice as usual, although the study had lower than planned power due to poor recruitment. The study results can still contribute to the continuing debate about brief psychological therapy options for primary care and their development.Trial registration numberACTRN12613000041752; Pre-results.

Sign in / Sign up

Export Citation Format

Share Document