Monitoring the Dissemination of an Educational Protocol on Pediatric Asthma in Family Practice: A Test of Associations between Dissemination Variables

1999 ◽  
Vol 26 (1) ◽  
pp. 103-120 ◽  
Author(s):  
Ilse Mesters ◽  
Ree M. Meertens
Keyword(s):  
Primary Care ◽  
Diffusion Of Innovation ◽  
Family Practice ◽  
Family Physicians ◽  
Self Management ◽  
Education Programs ◽  
Cross Sectional ◽  
Diffusion Of Innovation Theory ◽  
Perceived Success ◽  
Continued Use

Many asthma education programs aim at reducing morbidity. Now that effective programs are available, the next step is the nationwide dissemination to achieve morbidity reduction. A dissemination of a tested program has been undertaken in Dutch primary care, guided by the Diffusion of Innovation theory. It was hypothesized that greater awareness and concern and/or receptivity about asthma self-management would make it more likely that family physicians would adopt the program. Family physicians were considered more likely to adopt the program if they saw it as an improvement on their current way of providing education, as easy to use, and as having observable outcomes. It was expected that once the program had been adopted, and as it was being implemented, it would increasingly be perceived by its users as successful. Finally, more perceived success of performance was expected to be related to continued use. Both longitudinal and cross-sectional data largely confirmed the hypotheses.

scholarly journals COPD patients need more information about self-management: a cross-sectional study in Swedish primary care

2019 ◽  
Vol 37 (4) ◽  
pp. 459-467 ◽  
Author(s):  
Hanna Sandelowsky ◽  
Ingvar Krakau ◽  
Sonja Modin ◽  
Björn Ställberg ◽  
Anna Nager
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Self Management ◽  
Sectional Study ◽  
Cross Sectional ◽  
Copd Patients

scholarly journals Effect of family practice contract services on the quality of primary care in Guangzhou, China: a cross-sectional study using PCAT-AE

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021317 ◽  
Author(s):  
Lina Li ◽  
Chenwen Zhong ◽  
Jie Mei ◽  
Yuan Liang ◽  
Li Li ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Practice ◽  
Assessment Tool ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Quality Of Primary Care ◽  
Care Assessment ◽  
First Contact

ObjectiveCurrent healthcare reform in China has an overall goal of strengthening primary care and establishing a family practice system based on contract services. The objective of this study was to determine whether contracting a general practitioner (GP) could improve quality of primary care.DesignA cross-sectional study using two-stage sampling conducted from June to September 2014. Propensity score matching (PSM) was employed to control for confounding between patients with and without contracted GP.SettingThree community health centres in Guangzhou, China.Participants698 patients aged 18–89 years.Main outcome measuresThe quality of primary care was measured using a validated Chinese version of primary care assessment tool (PCAT). Eight domains are included (first contact utilisation, accessibility, continuity, comprehensiveness, coordination, family-centredness, community orientation and cultural competence from patient’s perceptions).ResultsA total of 692 effective samples were included for data analysis. After PSM, 94 pairs of patients were matched between the patients with and without contracted GPs. The total PCAT score, continuity (3.12 vs 2.68, p<0.01), comprehensiveness (2.31 vs 2.04, p<0.01) and family-centredness (2.11 vs 1.79, p<0.01) were higher in patients who contracted GPs than those did not. However, the domains of first contact utilisation (2.74 vs 2.87, p=0.14) and coordination (1.76 vs 1.93, p<0.05) were lower among patients contracted with GPs than in those who did not.ConclusionOur findings demonstrated that patients who had a contracted GP tend to experience higher quality of primary care. Our study provided evidence for health policies aiming to promote the implementation of family practice contract services. Our results also highlight further emphases on the features of primary care, first contact services and coordination services in particular.

scholarly journals EVALUATION OF DIABETES SELF-MANAGEMENT EDUCATION IN PATIENTS WITH CONCOMITANT CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 73 (10) ◽  
pp. 2170-2174
Author(s):  
Oleksii M. Korzh
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Management Training ◽  
Cross Sectional Study ◽  
Self Management ◽  
Average Score ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Diabetes Educators

The aim: Was to evaluate the quality of DSME provided by primary care physicians to people with diabetes mellitus. Materials and methods: A descriptive cross-sectional study was conducted among 120 primary care physicians. The quality of diabetes self-management training provided by physicians was assessed on a personal scale of 39 Likert questions obtained from the American Association of Diabetes Educators in seven areas of diabetes self-monitoring. The Cronbach’s reliability coefficient for each domain / subscale was ≥ 0.7. The data were analyzed using an independent selective t-test and one-way ANOVA. Results: More than half of the doctors provided “inadequate quality” of diabetes self-management in all areas. Doctors had the highest average score in the domain of “drug intake” (4.46 ± 0.61). Average scores in the “problem-solving domain” (3.52 ± 0.63) and “ being active domain” (3.46 ± 0.75) were low. The quality of DSME provided by physicians was not related to any of the characteristics of the physician. Conclusions: The quality of doctors’ communication on DSME in this study was suboptimal. Most adequately informed cases of diabetic behavior associated with self-management have been associated with reduced risk factors and an orientation towards disease. Thus, training of primary care physicians in diabetic self-management is recommended because of the key role that these doctors play in managing diabetes.

scholarly journals Geographical distribution of family physicians in Japan: A nationwide cross-sectional study

2019 ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results 519 JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p<0.001). Conclusions Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

scholarly journals Did the COVID-19 pandemic result in more family physicians stopping practice? Results from Ontario, Canada

2021 ◽  
Author(s):  
Tara Kiran ◽  
Michael E. Green ◽  
Fangyun C. Wu ◽  
Alexander Kopp ◽  
Lidija Latifovic ◽  
...  
Keyword(s):  
Primary Care ◽  
Practice Patterns ◽  
Family Physicians ◽  
Absolute Number ◽  
Physician Practice ◽  
Physician Practice Patterns ◽  
Fee For Service ◽  
Cross Sectional ◽  
The Impact ◽  
The Given

AbstractPurposeTo understand changes in family physician practice patterns and whether more family physicians stopped working during the COVID-19 pandemic compared to previous years.MethodsWe analyzed administrative data from Ontario, Canada two ways: cross-sectional and longitudinal. First, we identified the percentage and characteristics of all family physicians who had a minimum of 50 billing days in 2019 but no billings during the first six months of the pandemic. Second, for each year from 2010 to 2020, we calculated the percentage of physicians who billed for services in the first quarter of the calendar year but submitted no bills between April and September of the given year.ResultsWe found 3.1% of physicians working in 2019 (N=385/12,247) reported no billings in the first six months of the pandemic. Compared with other family physicians, a higher portion were age 75 or older (13.0% vs. 3.4%, p<0.001), had fee-for-service reimbursement (38% vs 25%, p<0.001), and had a panel size under 500 patients (40% vs 25%, p<0.001). Between 2010 and 2019, an average of 1.6% of physicians who practiced in the first quarter had no billings in each of the second and third quarters of the calendar year compared to 3.0% in 2020 (p<0.001).ConclusionsApproximately twice as many family physicians stopped work in Ontario, Canada during COVID-19 compared to previous years, but the absolute number was small and those who did had smaller patient panels. More research is needed to understand the impact on primary care attachment and access to care.

Primary care physicians’ attitudes toward research: a cross-sectional descriptive study

2019 ◽  
Vol 37 (3) ◽  
pp. 306-313
Author(s):  
Limor Adler ◽  
Linoy Gabay ◽  
Ilan Yehoshua
Keyword(s):  
Primary Care ◽  
Logistic Regression ◽  
Primary Care Physicians ◽  
Administrative Support ◽  
Research Training ◽  
Univariate Analysis ◽  
Family Physicians ◽  
Research Experience ◽  
Cross Sectional ◽  
Health Maintenance

Abstract Background Clinical research in family medicine can improve health outcomes and increase physicians’ professionalism, yet is modest compared to other disciplines and receives little funding. Objectives To identify factors that promote and impede engagement of family physicians in research and to compare characteristics of family physicians who do and do not engage in research. Methods During September to October 2018, e-mail questionnaires were sent to 1424 primary care physicians of one health maintenance organization. Respondents were classified as researchers and non-researchers based on their research experience. Responses were analysed using univariate analysis, principal component analysis and multivariate logistic regression. Results Of 235 respondents, 48 (20.4%) were categorized as researchers. The respondents generally agreed that research in primary care improves medical services and provides professional prestige; and that workload, bureaucracy and lack of dedicated time hinder engagement in research. Logistic regression analysis identified several factors associated with being a researcher, including advanced research training (P = 0.001, AOR = 8.49, 95% CI [2.49–29.14]), reading more research articles (P = 0.013, AOR = 14.16, 95% CI [1.76–113.5] and self-employment (P = 0.005, AOR = 5.92, 95% CI [1.71–20.44]). In a factor analysis, only ‘importance of research’ was associated with being a researcher (P = 0.039, AOR = 1.89, 95% CI [1.03–3.48]). Compared to non-researchers, researchers were older (83.3% versus 51.3% aged &gt;40 years, P &lt; 0.001), more often men (60.4% versus 37.4%, P = 0.02) and worked more (41.7% versus 16.7% worked &gt;41 hours weekly, P = 0.02). Conclusions Providing time dedicated to research, administrative support, research training and education about the importance of research could increase participation in research by primary care physicians.

scholarly journals Factors associated with knowledge of self-management of worsening asthma in primary care patients: a cross-sectional study

2020 ◽  
pp. 1-7
Author(s):  
Philip Wireklint ◽  
Mikael Hasselgren ◽  
Scott Montgomery ◽  
Karin Lisspers ◽  
Björn Ställberg ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Self Management ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Primary Care Patients

scholarly journals Potential for Integrating Mental Health Specialist Video Consultations in Office-Based Routine Primary Care: Cross-Sectional Qualitative Study Among Family Physicians

10.2196/13382 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e13382 ◽  
Author(s):  
Mariell Hoffmann ◽  
Mechthild Hartmann ◽  
Michel Wensing ◽  
Hans-Christoph Friederich ◽  
Markus W Haun
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Qualitative Study ◽  
Primary Care Practice ◽  
Family Physicians ◽  
Health Conditions ◽  
Care Practice ◽  
Cross Sectional ◽  
Mental Health Specialist ◽  
Health Specialist

Background Although real-time mental health specialist video consultations have been proposed as an effective care model for treating patients with mental health conditions in primary care, little is known about their integration into routine practice from the perspective of family physicians. Objective This study aimed to determine the degree to which family physicians advocate that mental health specialist video consultations can be integrated into routine primary care, where most patients with mental health conditions receive treatment. Methods In a cross-sectional qualitative study, we conducted 4 semistructured focus groups and 3 telephonic interviews in a sample of 19 family physicians from urban and rural districts. We conducted a qualitative content analysis applying the Tailored Implementation in Chronic Diseases framework in a combined bottom-up (data-driven) and top-down strategy for deriving key domains. Results Family physicians indicated that mental health specialist video consultations are a promising and practical way to address the most pressing challenges in current practice, that is, to increase the accessibility and co-ordination of specialized care. Individual health professional factors were the most frequently discussed topics. Specifically, family physicians valued the anticipated clinical outcomes for patients and the anticipated resources set for the primary care practice as major facilitators (16/19, 84%). However, family physicians raised a concern regarding a lack of facial expressions and physical interaction (19/19, 100%), especially in emergency situations. Therefore, most family physicians considered a viable emergency plan for mental health specialist video consultations that clearly delineates the responsibilities and tasks of both family physicians and mental health specialists to be essential (11/19, 58%). Social, political, and legal factors, as well as guideline factors, were hardly discussed as prerequisites for individual family physicians to integrate mental health specialist video consultations into routine care. To facilitate the implementation of future mental health specialist video consultation models, we compiled a checklist of recommendations that covers (1) buy-in from practices (eg, emphasizing logistical and psychological relief for the practice), (2) the engagement of patients (eg, establishing a trusted patient-provider relationship), (3) the setup and conduct of consultations (eg, reliable emergency plans), and (4) the fostering of collaboration between family physicians and mental health specialists (eg, kick-off meetings to build trust). Conclusions By leveraging the primary care practice as a familiar environment for patients, mental health specialist video consultations provide timely specialist support and potentially lead to benefits for patients and more efficient processes of care. Integration should account for the determinants of practice as described by the family physicians. Trial Registration German Clinical Trials Register DRKS00012487; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00012487

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