scholarly journals House Officers’ Choice of Family Medicine Specialty amid the Implementation of the New Universal Health Insurance Law

2021 ◽  
Vol 12 ◽  
pp. 215013272110189
Author(s):  
Marwa Mostafa Ahmed ◽  
Samar Fares ◽  
Asmaa Ahmed Sayed ◽  
Inas Talat ElSayed ◽  
Saeed S. A. Soliman
Keyword(s):  
Health Insurance ◽  
Family Medicine ◽  
Cross Sectional Study ◽  
Universal Health Insurance ◽  
University Hospitals ◽  
Questionnaire Response ◽  
Cross Sectional ◽  
Insurance Law ◽  
Recent Graduates ◽  
Universal Health

Background The new Egyptian Universal Health Insurance Law is introduced through family-oriented primary health care. Increasing the number of recent graduates who specialized in family medicine is considered a national need to overcome family physicians’ shortage. Aim To explore the factors affecting the house officers’ choice of Family Medicine as a future career amid the implementation of the new Universal Health Insurance Law in Egypt. Methods This is a cross-sectional study conducted on house officers during their training in Cairo university hospitals from the first of March 2020 to February 2021. The researchers offered an anonymous self-administered questionnaire to all house officers at the beginning of their 2-week family medicine training (1170 house officers). Results A total of 1052 completed the questionnaire (response rate 90%). Family medicine as a specialty was considered by 53.6% (n = 564) of participants, while only 23.4% (n = 246) of participants had an obvious intention to choose family medicine. Multivariate (adjusted) logistic regression model revealed that factors significantly associated with intention to choose family medicine were marital status, knowledge about governmental advantages for family medicine offered to the specialized recent graduates, and previously encountered with family practice as customers. Conclusions The choice of family medicine specialty is increasing among house officers. This could be attributed to the growing interest in family medicine in Egypt, especially after implementing the new insurance law’s first phase in several Egyptian governorates.

scholarly journals Low acuity paediatric emergency visits under single-payer universal health insurance in Taiwan, 2000–2015: a population-based repeated cross-sectional design

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042084
Author(s):  
I-Anne Huang ◽  
Yiing-Jenq Chou ◽  
I-Jun Chou ◽  
Yu-Tung Huang ◽  
Jhen-Ling Huang ◽  
...  
Keyword(s):  
Health Insurance ◽  
Paediatric Population ◽  
Population Based ◽  
Universal Health Insurance ◽  
Cross Sectional ◽  
Single Payer ◽  
Insurance Programme ◽  
Ed Visits ◽  
Cross Sectional Design ◽  
Universal Health

ObjectivesEmergency services utilisation is a critical policy concern. The paediatric population is the main user of emergency department (ED) services, and the main contributor to low acuity (LA) ED visits. We aimed to describe the trends of ED and LA ED visits under a comprehensive, universal health insurance programme in Taiwan, and to explore factors associating with potentially unnecessary ED utilisation.Design and settingWe used a population-based, repeated cross-sectional design to analyse the full year of 2000, 2005, 2010 and 2015 National Health Insurance claims data individually for individuals aged 18 years and under.ParticipantsWe identified 5 538 197, 4 818 213, 4 401 677 and 3 841 174 children in 2000, 2005, 2010 and 2015, respectively.Primary and secondary outcome measuresWe adopted a diagnosis grouping system and severity classification system to define LA paediatric ED (PED) visits. Generalised estimating equation was applied to identify factors associated with LA PED visits.ResultsThe annual LA PED visits per 100 paediatric population decreased from 10.32 in 2000 to 9.04 in 2015 (12.40%). Infectious ears, nose and throat, dental and mouth diseases persistently ranked as the top reasons for LA visits (55.31% in 2000 vs 33.94% in 2015). Physical trauma-related LA PED visits increased most rapidly between 2000 and 2015 (0.91–2.56 visits per 100 population). The dose–response patterns were observed between the likelihood of incurring LA PED visit and either child’s age (OR 1.06–1.35 as age groups increase, p<0.0001) or family socioeconomic status (OR 1.02–1.21 as family income levels decrease, p<0.05).ConclusionDespite a comprehensive coverage of emergency care and low cost-sharing obligations under a single-payer universal health insurance programme in Taiwan, no significant increase in PED utilisation for LA conditions was observed between 2000 and 2015. Taiwan’s experience may serve as an important reference for countries considering healthcare system reforms.

Scientific publications in internal medicine and family medicine: a comparative cross-sectional study in Swiss university hospitals

2020 ◽  
Author(s):  
Paul Sebo ◽  
Sylvain de Lucia ◽  
Nathalie Vernaz
Keyword(s):  
Internal Medicine ◽  
Family Medicine ◽  
Median Number ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
University Hospitals ◽  
Cross Sectional ◽  
H Index ◽  
Number Of Publications ◽  
Number Of Citations

Abstract Background Family medicine is a relatively new academic medical discipline. We aimed to compare the main bibliometric indices of hospital-based senior physicians practicing internal medicine versus family medicine in Switzerland. Methods We conducted this cross-sectional study in March 2020. We selected all hospital-based senior physicians practicing internal medicine or family medicine in the six Swiss university hospitals. Using Web of Science, after removing from both groups of physicians the 5% with the highest number of publications, we extracted the number of publications, the number of publications per year, the number of citations, the number of citations per year, the number of citations per publication and the h-index. We compared the data between the two groups using negative binomial regressions and the proportion of physicians having at least one publication using chi-square tests. Results We included 349 physicians in the study (internal medicine: 51%, men: 51%). The median number of publications was three [interquartile range (IQR) = 18], the median number of citations was nine (IQR = 158) and the median h-index was one (IQR = 5). All bibliometric indices were similar in both groups, as was the proportion of physicians having at least one publication (family medicine: 87% versus 82%, P = 0.15). Conclusions We found no association between the bibliometric indices and the medical specialty. Further studies are needed to explore other important indicators of academic output, such as those more specifically assessing its quality and scientific importance.

Perceptions of Final Year Medical Students about Family Medicine as A Career Choice in Pakistan

2020 ◽  
Author(s):  
Dur-e- Nishat
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical Profession ◽  
Healthcare Services ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Chi Square Test

Background: Family medicine is a field in which complete and detailed set of healthcare services are provided to the patients and their families. In developed countries, freshly graduated students choose family medicine as a priority for their career. However, in Pakistan it is not the case. The present study is undertaken to determine the perceptions of final year medical students’ about Family Medicine as a viable career. Methods: A total number of 504 students participated in the study. This was a cross-sectional study. The study participants were in their final year of medical college. Data was collected using a preapproved questionnaire. Data was entered and analyzed via SPSS version 17 and Chi-Square test was used post-stratification. Results: Only 14.3% (n=72) medical students had heard about Family Medicine. Only 18% (n=92) would select family medicine as a profession. The most frequent rationale for choosing the field of Family Medicine was the variety of patients seen in general practice (55.4% n=51). Conclusion: There is a dire need to focus on increasing awareness about the field of family medicine among medical students. The students should be counseled on the advantages along with the disadvantages of choosing this field as a medical profession.

scholarly journals SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study

Thorax ◽  
2020 ◽  
Vol 75 (12) ◽  
pp. 1089-1094 ◽  
Author(s):  
Adrian Shields ◽  
Sian E Faustini ◽  
Marisol Perez-Toledo ◽  
Sian Jossi ◽  
Erin Aldera ◽  
...  
Keyword(s):  
Intensive Care ◽  
Healthcare Workers ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Nasopharyngeal Swab ◽  
Sectional Study ◽  
University Hospitals ◽  
Cross Sectional ◽  
General Internal ◽  
Increased Risk

ObjectiveTo determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.DesignA cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.SettingUniversity Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.Participants545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.InterventionParticipants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.Main outcome measureProportion of participants demonstrating infection and positive SARS-CoV-2 serology.ResultsThe point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).Conclusions and relevanceWe identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.

scholarly journals Difference in the general medicine in-training examination score between community-based hospitals and university hospitals: a cross-sectional study based on 15,188 Japanese resident physicians

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuji Nishizaki ◽  
Keigo Nozawa ◽  
Tomohiro Shinozaki ◽  
Taro Shimizu ◽  
Tomoya Okubo ◽  
...  
Keyword(s):  
Physical Examination ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Medical Interview ◽  
Sectional Study ◽  
University Hospitals ◽  
Community Based ◽  
Cross Sectional ◽  
Clinical Competencies ◽  
Clinical Procedures

Abstract Background The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. Methods We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge“. Specifically, “medical interview and professionalism,” “symptomatology and clinical reasoning,” “physical examination and clinical procedures,” and “disease knowledge” were assessed. Results We found no significant difference in “medical interview and professionalism” scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96–1.59) in “physical examination and clinical procedures” in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. Conclusions The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as “physical examination and clinical procedures.”

Observer Ratings of Shared Decision Making Do Not Match Patient Reports: An Observational Study in 5 Family Medicine Practices

2020 ◽  
Vol 41 (1) ◽  
pp. 51-59
Author(s):  
Gisèle Diendéré ◽  
Imen Farhat ◽  
Holly Witteman ◽  
Ruth Ndjaboue
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Risk Communication ◽  
Shared Decision Making ◽  
Cross Sectional Study ◽  
Clinical Encounter ◽  
Values Clarification ◽  
Shared Decision ◽  
Cross Sectional ◽  
Medical Consultations

Background Measuring shared decision making (SDM) in clinical practice is important to improve the quality of health care. Measurement can be done by trained observers and by people participating in the clinical encounter, namely, patients. This study aimed to describe the correlations between patients’ and observers’ ratings of SDM using 2 validated and 2 nonvalidated SDM measures in clinical consultations. Methods In this cross-sectional study, we recruited 238 complete dyads of health professionals and patients in 5 university-affiliated family medicine clinics in Canada. Participants completed self-administered questionnaires before and after audio-recorded medical consultations. Observers rated the occurrence of SDM during medical consultations using both the validated OPTION-5 (the 5-item “observing patient involvement” score) and binary questions on risk communication and values clarification (RCVC-observer). Patients rated SDM using both the 9-item Shared Decision-Making Questionnaire (SDM-Q9) and binary questions on risk communication and values clarification (RCVC-patient). Results Agreement was low between observers’ and patients’ ratings of SDM using validated OPTION-5 and SDM-Q9, respectively (ρ = 0.07; P = 0.38). Observers’ ratings using RCVC-observer were correlated to patients’ ratings using either SDM-Q9 ( rpb = −0.16; P = 0.01) or RCVC-patients ( rpb = 0.24; P = 0.03). Observers’ OPTION-5 scores and patients’ ratings using RCVC-questions were moderately correlated ( rφ = 0.33; P = 0.04). Conclusion There was moderate to no alignment between observers’ and patients’ ratings of SDM using both validated and nonvalidated measures. This lack of strong correlation emphasizes that observer and patient perspectives are not interchangeable. When assessing the presence, absence, or extent of SDM, it is important to clearly state whose perspectives are reflected.

Sign in / Sign up

Export Citation Format

Share Document