scholarly journals Primary health institutions preference by hypertensive patients: effect of distance, trust and quality of management in the rural Heilongjiang province of China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingjing Liu ◽  
Hui Yin ◽  
Tong Zheng ◽  
Bykov Ilia ◽  
Xing Wang ◽  
...  
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Health Resources ◽  
Hypertension Management ◽  
Heilongjiang Province ◽  
Allocation Model ◽  
Hypertensive Patients ◽  
Primary Health ◽  
Health Institutions

Abstract Background Traditional “inverted triangle” healthcare resources allocation model in China has wasted a lot of health resources. The Chinese health reform began to strengthens the role of the primary health institutions in delivering primary health care especially in rural areas in the background of large development gap between urban-rural health and rapid growth in the incidence of chronic diseases in rural. We take hypertensive patients as an example, to verify the effect of policy implementation through distribution characteristics of rural primary health institutions preference of hypertensive patients and explore the influencing factor that promoting rationalized use of medical care for patients with chronic disease as well as rational allocation of health resources in rural areas. Methods A cross-sectional survey was conducted in Heilongjiang, a province in northeastern China by using a self-designed questionnaire. Stratified cluster sampling was used to choose 484 hypertensive patients from two villages in Heilongjiang province in 2010. Results About 88.4% of respondents reported preferred primary health institutions (83.5% preferred village clinics and 4.9% preferred township hospitals), 49.4% of respondents knew hypertension management administered by primary health institutions, 53.5% received hypertension education from primary care physicians, more than half of respondents reported that they didn’t receive telephone interviews and family visits from primary care physicians over the past 6 months. Residence closer to the primary health institutions (OR = 10.360), trust in village doctors (OR = 7.323), elders (OR = 3.001), and asked for return visits by primary health physicians (OR = 2.073) promote preferences for primary health institutions. Conclusions: Accessibility to primary healthcare and doctor-patient trust stimulate patients to choose the primary health institutions. Primary health institutions should improve general approach to hypertension management and enhance the ability of providing basic public health services.

scholarly journals Effect of trust in primary care physicians on patient satisfaction: a cross-sectional study among patients with hypertension in rural China

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenqin Chen ◽  
Yingchao Feng ◽  
Jiyuan Fang ◽  
Jin Wu ◽  
Xianhong Huang ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Rural China ◽  
Hypertension Management ◽  
Technical Competence ◽  
Patient Trust ◽  
Clinical Behavior ◽  
Organization Of Care

Abstract Background In rural areas of China, hypertension is on the rise and it is drawing the Chinese government’s attention. The health outcomes of hypertension management can be positively impacted by patient satisfaction with primary care physicians (PCPs), and the influence of patient trust on satisfaction cannot be ignored. This study aimed to analyze the effect of trust in PCPs on patient satisfaction among patients with hypertension in rural China, and the influence of patients’ socio-demographic characteristics and hypertension-management-related factors. Methods A multi-stage stratified random sampling method was adopted to investigate 2665 patients with hypertension in rural China. Patient trust and satisfaction were measured using the Chinese version of the Wake Forest Physician Trust Scale and the European Task Force on Patient Evaluation of General Practice. Multiple linear regression was used to analyze the factors influencing patient satisfaction, and structural equation modeling was conducted to clarify the relationships among patient trust and patient satisfaction with PCPs. Results Patients’ trust in their PCPs’ benevolence had a positive main effect on all three satisfaction dimensions (clinical behavior: β = 0.940, p <  0.01; continuity and cooperation: β = 0.910, p <  0.01; and organization of care: β = 0.879, p <  0.01). Patients’ trust in their PCPs’ technical competence had a small negative effect on all three satisfaction dimensions (clinical behavior: β = − 0.077, p <  0.01; continuity and cooperation: β = − 0.136, p <  0.01; and organization of care: β = − 0.064, p <  0.01). Patient satisfaction was also associated with region, gender, insurance status, distance from the nearest medical/health-service institution, and number of visits to PCPs in the past year. Conclusions Patients focused more on physicians’ benevolence than on their technical competence. Hence, medical humanities and communication skills education should be emphasized for PCPs. Regarding region-based and health-insurance-based differences, the inequities between eastern, central, and western provinces, as well as between urban and rural areas, must also be addressed.

scholarly journals Provider payment to primary care physicians in China: background, challenges, and a reform framework

2018 ◽  
Vol 20 ◽  
Author(s):  
Xiaoying Pu ◽  
Yaming Gu ◽  
Xiaohe Wang
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Mixed System ◽  
System Reform ◽  
Payment Reform ◽  
Primary Health ◽  
Provider Payment ◽  
Equity And Efficiency ◽  
Health Institutions ◽  
The Government

AbstractAim: To provide a framework for provider payment reform for primary care physicians in China. Background: Primary health care is central to health system reform and payment incentives have significant consequences for the equity and efficiency of it. Methods: This paper describes the special payments system for public primary health institutions and the subsequent internal salary remuneration to primary care physicians in China. Based on an analysis of the major challenges, we suggest a reform framework including the pattern of governance, and payments to primary health institutions and employed physicians. Findings: A mixed system of input-based and output-based payments to institutions would probably be appropriate under a long-term and relational contract with the government. It was also advised that internal remuneration is provided by a basic salary plus a bonus based on performance, and an extra-regional allowance. We hope that the results can be used to shift the passive budgeting of in-house staff within the public primary health institutions toward strategic purchasing.

EVALUASI RASIONALITAS PENGGUNAAN DAN PEMBERIAN OBAT PADA PASIEN HIPERTENSI GERIATRI DI PUSKESMAS TAJINAN PERIODE JANUARI – DESEMBER 2019

2020 ◽  
Vol 5 (2) ◽  
pp. 268-277
Author(s):  
Luluk Anisyah ◽  
◽  
Wibowo Wibowo
Keyword(s):  
Correlation Analysis ◽  
Medical Record ◽  
Significant Relationship ◽  
Antihypertensive Drugs ◽  
Hypertension Management ◽  
Hypertensive Patients ◽  
Primary Health ◽  
Data Collection Sheet ◽  
Dose Accuracy ◽  
Accuracy Data

Increasing the number of elderly causes an increase in health problems one of which is associated with hypertension which can cause complications and death. The purpose of this study was to determine the description and accuracy of the use of antihypertensive drugs in geriatric patients who were diagnosed with hypertension at the Tajinan Primary Health in Malang in the period January-December 2019. This study was an observational or non-experimental study conducted using retrospective medical record data. The measuring instrument used was the data collection sheet from the medical record, the Consensus for Hypertension Management 2019 to see the accuracy of indications, patient accuracy, drug accuracy, and dose accuracy. Data analysis using Correlation Test. The results of the correlation analysis showed that the resulting Standardize estimates were 0.002 (p <0.05) which showed that there was a significant relationship between sexes with the occurrence of hypertension. The results of the correlation analysis showed that the resulting Standardize estimates were 0.001 (p <0.05) which means that there was a significant relationship between the accuracy of the types of antihypertensive drugs used in hypertensive patients. The conclusion is that the rationality evaluation of the use and administration of drugs in hypertensive patients at the Tajinan Primary Health in Malang based on the 2019 Hypertension Management Consensus guidelines shows the accuracy both in terms of indication, drug, patient and dose.

scholarly journals Do electronic reminders alter recorded diagnoses in primary care office-hours practices of health centers: A register-based study in a Finnish city

2021 ◽  
Vol 9 ◽  
pp. 205031212110361
Author(s):  
Mika Lehto ◽  
Kaisu Pitkälä ◽  
Ossi Rahkonen ◽  
Merja K Laine ◽  
Marko Raina ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Health Centers ◽  
Health Record ◽  
Record System ◽  
Electronic Reminder ◽  
Primary Health ◽  
Primary Care Health ◽  
Before And After ◽  
Care Health

Objectives: One purpose of electronic reminders is improvement of the quality of documentation in office-hours primary care. The aim of this study was to evaluate how implementation of electronic reminders alters the rate and/or content of diagnostic data recorded by primary care physicians in office-hours practices in primary care health centers. Methods: The present work is a register-based longitudinal follow-up study with a before-and-after design. An electronic reminder was installed in the electronic health record system of the primary health care of a Finnish city to remind physicians to include the diagnosis code of the visit in the health record. The report generator of the electronic health record system provided monthly figures for the number of various recorded diagnoses by using the International Classification of Diseases, 10th edition, and the total number of visits to primary care physicians, thus allowing the calculation of the recording rate of diagnoses on a monthly basis. The distribution of diagnoses before and after implementing ERs was also compared. Results: After the introduction of the electronic reminder, the rate of diagnosis recording by primary care physicians increased clearly from 39.7% to 87.2% (p < 0.001). The intervention enhanced the recording rate of symptomatic diagnoses (group R) and some chronic diseases such as hypertension, type 2 diabetes and other soft tissue disorders. Recording rate of diagnoses related to diseases of the respiratory system (group J), injuries, poisoning and certain other consequences of external causes (group S), and diseases of single body region of the musculoskeletal system and connective tissue (group M) decreased after the implementation of electronic reminders. Conclusion: Electronic reminders may alter the contents and extent of recorded diagnosis data in office-hours practices of the primary care health centers. They were found to have an influence on the recording rates of diagnoses related to chronic diseases. Electronic reminders may be a useful tool in primary health care when attempting to change the behavior of primary care physicians.

Abstract P136: Healthier Personal Habits Of Primary Care Physicians Increase The Likelihood Of Their Recommending Lifestyle Modifications For Their Hypertensive Patients That Are Consistent With The National Guidelines

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Olivia Y Hung ◽  
Nora L Keenan ◽  
Jing Fang
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
High Blood Pressure ◽  
Primary Care Physicians ◽  
Lifestyle Modification ◽  
Lifestyle Interventions ◽  
Lifestyle Modifications ◽  
Hypertensive Patients ◽  
Attitudes And Behaviors ◽  
And Behaviors

Introduction: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) recommended lifestyle interventions, either with or without pharmacologic treatment, for all patients with high blood pressure. The objective of this study is to determine the association of physicians’ personal habits with their attitudes and behaviors regarding JNC VII lifestyle modification guidelines. Hypothesis: Primary care physicians who have healthier habits, as defined by eating more cups of fruits and/or vegetables, exercising more frequently, and/or not smoking, would be more likely to recommend lifestyle interventions consistent with JNC VII than their counterparts who have less healthy habits. Methods: One thousand primary care physicians completed DocStyles 2010, a voluntary web-based survey designed to provide insight into physician attitudes and behaviors regarding various health issues. Results: The respondents’ average age was 45.3 years and 68.5% (685 of 1000) were male. In regards to physician behavior, 4.0% (40 of 1000) smoked at least once a week, 38.6% (386 of 1000) ate ≥5 cups of fruits and/or vegetables ≥5 days/week, and 27.4% (274 of 1000) exercised ≥5 days/week. When asked about specific types of advice offered to their hypertensive patients, physicians reported recommending that their patients eat a healthy diet (922 of 1000), or cut down on salt (961 of 1000), or attain or maintain a healthy weight (948 of 1000), or limit the use of alcohol (754 of 1000), or be physically active (944 of 1000). Collectively, 66.5% (665 of 1000) made all 5 lifestyle modification recommendations. Physicians who were between 40 - 49 years old were 1.6 times as likely of making all 5 lifestyle recommendations compared with those who were under 40 years. Additionally, those who exercised at least once per week or did not actively smoke were approximately twice as likely to recommend these interventions. Conclusions: The probability of recommending all five lifestyle modifications increased with both the physician exercising at least once per week and not having smoked.

Primary Care: The Future for Pediatric Education

PEDIATRICS ◽  
1990 ◽  
Vol 86 (5) ◽  
pp. 653-659
Author(s):  
Joel J. Alpert
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Geographic Location ◽  
Pediatric Care ◽  
Past Century ◽  
Inner Cities ◽  
Critical Issues ◽  
Definition Of ◽  
Care Problems

There is a continuing crisis in primary care, characterized by inadequate numbers of appropriately trained primary care physicians and the failure to mount an effective and consistent graduate educational program for primary care. This paper reviews the history of the primary care crisis; revisits the definition of primary care; and, through identification of critical issues, presents a primary care educational agenda for the 1990s. Pediatrics is at a crossroads regarding primary care, as powerful social and economic forces are impacting on today's major pediatric care problems. Before the second World War there were more than 300 primary care physicians available for each 100 000 of our population. Today the ratio is 75 for 100 000. This is despite the fact that a shortage of 50 000 physicians 10 years ago no longer exists. The majority view is that a physician surplus of 70 000 will be present by the early 1990s.1 Whether there is a surplus is subject to interpretation and the surplus may end up as nonexistent. Moreover, the availability of primary care physicians varies with geographic location, and even a single figure for this nation provides a distorted picture. The shortage is especially serious in inner cities and in many rural areas. In addition, the use of overall numbers assumes that all primary care physicians are appropriately trained in the general disciplines. For the past century, physicians have cared for patients usually as family physicians. Today, however, the generalist has been replaced by the specialist. Is this a function of financial rewards and society's needs and values or the educational experience?

scholarly journals The Differences in the Prevalence of Cardiovascular Disease, Its Risk Factors, and Achievement of Therapeutic Goals among Urban and Rural Primary Care Patients in Poland: Results from the LIPIDOGRAM 2015 Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5656
Author(s):  
Krzysztof Studziński ◽  
Tomasz Tomasik ◽  
Adam Windak ◽  
Maciej Banach ◽  
Ewa Wójtowicz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Primary Care Physicians ◽  
Primary Care Patient ◽  
Care Patient ◽  
Cross Sectional ◽  
Therapeutic Goals ◽  
Rural Primary Care

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs.

PO261 Need of Capacity Building In Hypertension Management of Primary Care Physicians In India

Global Heart ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. 437
Author(s):  
P. Kumar ◽  
A. Jose ◽  
A. Sharma ◽  
V. Bagre ◽  
S. Bhalla
Keyword(s):  
Primary Care ◽  
Capacity Building ◽  
Primary Care Physicians ◽  
Hypertension Management

Induced Delusional Disorder in Rural Areas: A Case of Folie a Quatre

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
V. Peritogiannis ◽  
M. Lekka ◽  
N. Papavassiliou ◽  
C. Mantas ◽  
V. Mavreas ◽  
...  
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Psychiatric Service ◽  
Delusional Disorder ◽  
Appropriate Treatment ◽  
Psychiatric Units ◽  
Close Relationship ◽  
Psychotic Exacerbation ◽  
Three Sisters

Background and aim:Induced delusional disorder or folie a deux is characterized by the presence of similar delusional ideas in two or more individuals. The delusional system develops as a result of a close relationship with a person with an established psychotic disorder. Most commonly the affected persons are members of a family.Methods:An unusual case of folie a famille involving four siblings, brother and three sisters, (folie a quatre) is presented. This case was detected in the context of a community-based psychiatric service in Greece, the Mobile Psychiatric Unit of the prefectures of Ioannina and Thesprotia.Results:A 46-year-old woman was referred from primary care physicians for the management of a psychotic exacerbation. On the examination it was revealed that she and her three older siblings were sharing the delusional idea of being affected by their neighbors with magic. These siblings had been living in social isolation for long and have been querulant and aggressive toward their neighbors, against whom they had undertaken a succession of lawsuits. None of the rest siblings accepted to be examined so it could not be determined who the inducer was or what the diagnoses were for each of the affected persons. The patient did not receive the prescribed medication and did not engage in follow-up.Conclusions:Cases of induced delusional disorder may be difficult to be detected and treated. Mobile psychiatric units in co-operation with primary care physicians may have an opportunity to provide appropriate treatment for such patients in rural areas.

Sign in / Sign up

Export Citation Format

Share Document