scholarly journals Performance of new alternative providers of primary care services in England: an observational study

2015 ◽  
Vol 108 (5) ◽  
pp. 171-183 ◽  
Author(s):  
Felix Greaves ◽  
Anthony A Laverty ◽  
Utz Pape ◽  
Anenta Ratneswaren ◽  
Azeem Majeed ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Care Services ◽  
Primary Care Services

scholarly journals Diagnostic scope in out-of-hours primary care services in eight European countries: an observational study

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Linda AMJ Huibers ◽  
Grete Moth ◽  
Gunnar T Bondevik ◽  
Janko Kersnik ◽  
Carola A Huber ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
European Countries ◽  
Out Of Hours ◽  
Care Services ◽  
Primary Care Services

scholarly journals Assessing the safety of home oximetry for COVID-19: a multisite retrospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e049235
Author(s):  
Jonathan Clarke ◽  
Kelsey Flott ◽  
Roberto Fernandez Crespo ◽  
Hutan Ashrafian ◽  
Gianluca Fontana ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Vulnerable Groups ◽  
Care Services ◽  
Primary Care Services ◽  
National Implementation ◽  
Primary Care Patients ◽  
Discharge From Hospital ◽  
English National Health ◽  
Increases In Risk

ObjectivesTo determine the safety and effectiveness of home oximetry monitoring pathways for patients with COVID-19 in the English National Health Service.DesignRetrospective, multisite, observational study of home oximetry monitoring for patients with suspected or proven COVID-19.SettingThis study analysed patient data from four COVID-19 home oximetry pilot sites in England across primary and secondary care settings.ParticipantsA total of 1338 participants were enrolled in a home oximetry programme across four pilot sites. Participants were excluded if primary care data and oxygen saturations at rest at enrolment were not available. Data from 908 participants were included in the analysis.InterventionsHome oximetry monitoring was provided to participants with a known or suspected diagnosis of COVID-19. Participants were enrolled following attendance to emergency departments, hospital admission or referral through primary care services.ResultsOf 908 patients enrolled into four different COVID-19 home oximetry programmes in England, 771 (84.9%) had oxygen saturations at rest of 95% or more, and 320 (35.2%) were under 65 years of age and without comorbidities. 52 (5.7%) presented to hospital and 28 (3.1%) died following enrolment, of which 14 (50%) had COVID-19 as a named cause of death. All-cause mortality was significantly higher in patients enrolled after admission to hospital (OR 8.70 (2.53–29.89)), compared with those enrolled in primary care. Patients enrolled after hospital discharge (OR 0.31 (0.15–0.68)) or emergency department presentation (OR 0.42 (0.20–0.89)) were significantly less likely to present to hospital than those enrolled in primary care.ConclusionsThis study finds that home oximetry monitoring can be a safe pathway for patients with COVID-19; and indicates increases in risk to vulnerable groups and patients with oxygen saturations <95% at enrolment, and in those enrolled on discharge from hospital. Findings from this evaluation have contributed to the national implementation of home oximetry across England.

scholarly journals Screening Neurocognitive Disorders in Primary Care Services: The Quick Mild Cognitive Impairment Approach

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 158-158
Author(s):  
Constanca Paul ◽  
Susana Sousa ◽  
Pedro Santos ◽  
Rónán O’Caoimh ◽  
William Molloy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Community Sample ◽  
Neurocognitive Disorders ◽  
Cognitive Status ◽  
Health Concerns ◽  
Care Services ◽  
Primary Care Services ◽  
Mental Health Concerns

Abstract Neurocognitive Disorders (NCD) is an increasingly common condition in the community. The General Practitioner (GP) in Primary Care Services (PCS), have a crucial role in early detection of NCD and is usually the first professional to detect the signs of MCI. The objective of this study was to test the feasibility and utility of the cognitive screening instrument QMCI in Primary Care. A community sample of 436 people 65+ living in the community was randomly selected from a larger group of old people with mental health concerns (N=2734), referred by their GPs. The mean age of the sample was 75.2 years (sd 7.2), with 41.3% men and 58.7% women; 60.4% married followed by 28.7% widows. The education level was low with 21% illiterate and 69,8% people with 4 years education. The QMCI mean was 37.1/100 (sd 16.2). The amount of people screening positive for cognitive impairment QMCI (&lt;62/100) was 94.2%. In the distribution of people with cognitive impairment by Global Deterioration Scale (GDS) three recoded categories, of the 286 people 76,1% where classified as having very mild or mild impairment, 19,4% moderate or moderately serious and 4,5% severe or very severe impairment. These results confirm the perception of GPs about their clients having mental health concerns and the ability of QMCI accurately discriminate MCI. The QMCI is very brief (3-5mins) fitting the short time of GPs to assess cognitive status and timely refer clients to nonpharmacological interventions that could postpone NCD symptoms.

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