scholarly journals Does a policy that requires adherence to a regular primary care physician improve the actual adherence of patients?

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
A. Golan-Cohen ◽  
G. Blumberg ◽  
E. Merzon ◽  
E. Kitai ◽  
Y. Fogelman ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Continuity Of Care ◽  
Economic Status ◽  
Care Physician ◽  
Policy Implications ◽  
Cross Sectional ◽  
Physician Visits ◽  
Personal Physician ◽  
Adherence Group

Abstract Background Continuity of care by the same personal physician is a key factor in an effective and efficient health care system. Studies that support the association between high adherence and better outcomes were done in settings where allocation to the same physician was a long-term policy. Objectives To evaluate the influence that changing organizational policy from the free choice of a primary care physician to a mandatory continuity of care by the same physician has on adherence to a personal physician. Methods A cross-sectional study based on electronic databases; comparison of adherence and demographic characteristics (sex, age, and socio-economic status) of 208,286 Leumit enrollees who met the inclusion criteria, according to change in the adherence to a personal physician. To evaluate adherence, we used the Usual Provider of Care (UPC) index, which measures the number of visits made to the personal doctor out of the total primary care physician visits over the same period. The patients were divided into groups according to their UPC level. Results The data shows that 54.5% of the patients were high adherers even before the organizational change; these rates are similar to those published by various organizations worldwide, years after mandating continuity of care by the same physician. In the year following the intervention, only 34.5% of the patients changed the level of their adherence group. Of these, 64% made a shift to a higher adherence group. Before the intervention, the high adherers were older (mean age 57.8 vs. 49.3 years in the low adherers group) and from a higher SES (mean SES status 9.32 vs. 8.71). After the intervention, a higher proportion of older patients and patients from a higher SES changed their adherence to a higher group. Sex distribution was similar over all the adherence level groups and did not change after the intervention. Conclusions and policy implications A policy change that encouraged adherence to an allocated primary care physician managed to improve adherence only in specific groups. Health organizations need to examine the potential for change and the groups they want to influence and direct their investment wisely. Trial registration retrospectively registered.

Primary care and suicidality among psychiatric outpatients: The patient-doctor relationship matters

2020 ◽  
pp. 009121742097799
Author(s):  
Krista Schultz ◽  
Sharan Sandhu ◽  
David Kealy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Primary Care Physician ◽  
Population Based ◽  
Borderline Personality ◽  
Care Physician ◽  
Cross Sectional

Objective The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Method Cross-sectional population-based study in Greater Vancouver, Canada. One-hundred ninety-seven participants were recruited from three Mental Health Clinics who reported having a primary care physician. Participants completed a survey containing questions regarding items assessing quality of Patient-Doctor Relationship, general psychiatric distress (K10), borderline personality disorder, and suicidality (Suicidal Behaviours Questionnaire-Revised-SBQ-R). Zero-order correlations were computed to evaluate relationships between study variables. Hierarchical regression analysis was used to control for confounding variables. Results The quality of the patient doctor relationship was significantly negatively associated with suicidality. The association between the quality of the patient-doctor relationship and suicidality remained significant even after controlling for the effects of psychiatric symptom distress and borderline personality disorder features. Conclusions The degree to which patients’ perceive their primary care physician as understanding, reliable, and dedicated, is associated with a reduction in suicidal behaviors. Further research is needed to better explicate the mechanisms of this relationship over time.

scholarly journals Relation between primary care physician supply and diabetes care and outcomes: a cross-sectional study

CMAJ Open ◽  
2016 ◽  
Vol 4 (1) ◽  
pp. E80-E87 ◽  
Author(s):  
T. Kiran ◽  
R. H. Glazier ◽  
M. A. Campitelli ◽  
A. Calzavara ◽  
T. A. Stukel
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Diabetes Care ◽  
Cross Sectional Study ◽  
Care Physician ◽  
Physician Supply ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Direct phone communication to primary care physician to plan discharge from hospital: feasibility and benefits

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lukas Enzinger ◽  
Perrine Dumanoir ◽  
Bastien Boussat ◽  
Pascal Couturier ◽  
Patrice Francois
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Interprofessional Collaboration ◽  
Improve Patient Safety ◽  
Discharge Summary ◽  
Care Physician ◽  
University Hospital ◽  
Phone Call ◽  
Cross Sectional ◽  
Telephone Contact

Abstract Background The discharge summary is the main vector of communication at the time of hospital discharge, but it is known to be insufficient. Direct phone contact between hospitalist and primary care physician (PCP) at discharge could ensure rapid transmission of information, improve patient safety and promote interprofessional collaboration. The objective of this study was to evaluate the feasibility and benefit of a phone call from hospitalist to PCP to plan discharge. Methods This study was a prospective, single-center, cross-sectional observational study. It took place in an acute medicine unit of a French university hospital. The hospitalist had to contact the PCP by telephone within 72 h prior discharge, making a maximum of 3 call attempts. The primary endpoint was the proportion of patients whose primary care physician could be reached by telephone at the time of discharge. The other criteria were the physicians’ opinions on the benefits of this contact and its effect on readmission rates. Results 275 patients were eligible. 8 hospitalists and 130 PCPs gave their opinion. Calls attempts were made for 71% of eligible patients. Call attempts resulted in successful contact with the PCP 157 times, representing 80% of call attempts and 57% of eligible patients. The average call completion rate was 47%. The telephone contact was perceived by hospitalist as useful and providing security. The PCPs were satisfied and wanted this intervention to become systematic. Telephone contact did not reduce the readmission rate. Conclusions Despite the implementation of a standardized process, the feasibility of the intervention was modest. The main obstacle was hospitalists lacking time and facing difficulties in reaching the PCPs. However, physicians showed desire to communicate directly by telephone at the time of discharge. Trial registration French C.N.I.L. registration number 2108852. Registration date October 12, 2017.

scholarly journals Author Correction: A cluster-randomized trial of the effectiveness of a triple-faceted intervention promoting adherence to primary care physician visits by diabetes patients: J-DOIT2 large-scale trial (J-DOIT2-LT)

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mitsuhiko Noda ◽  
Yasuaki Hayashino ◽  
Katsuya Yamazaki ◽  
Hikari Suzuki ◽  
Atsushi Goto ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Trial ◽  
Primary Care Physician ◽  
Large Scale ◽  
Cluster Randomized Trial ◽  
Care Physician ◽  
Physician Visits ◽  
Cluster Randomized ◽  
Diabetes Patients

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

scholarly journals Continuity of Care with a Primary Care Physician and Mortality in Older Adults

2009 ◽  
Vol 65A (4) ◽  
pp. 421-428 ◽  
Author(s):  
F. D. Wolinsky ◽  
S. E. Bentler ◽  
L. Liu ◽  
J. F. Geweke ◽  
E. A. Cook ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Primary Care Physician ◽  
Continuity Of Care ◽  
Care Physician

scholarly journals Direct Phone Communication To Primary Care Physician To Plan Discharge From Hospital: Feasibility and Benefits

2021 ◽  
Author(s):  
Lukas ENZINGER ◽  
Perrine DUMANOIR ◽  
Bastien BOUSSAT ◽  
Pascal COUTURIER ◽  
Patrice FRANCOIS
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Interprofessional Collaboration ◽  
Improve Patient Safety ◽  
Discharge Summary ◽  
Care Physician ◽  
University Hospital ◽  
Phone Call ◽  
Cross Sectional ◽  
Telephone Contact

Abstract Background The discharge summary is the main vector of communication at the time of hospital discharge, but it is known to be insufficient. Direct phone contact between hospitalist and primary care physician (PCP) at discharge could ensure rapid transmission of information, improve patient safety and promote interprofessional collaboration. The objective of this study was to evaluate the feasibility and benefit of a phone call from hospitalist to PCP to plan discharge. Methods This study was a prospective, single-center, cross-sectional observational study. It took place in an acute medicine unit of a French university hospital. The hospitalist had to contact the PCP by telephone within 72 hours prior discharge, making a maximum of 3 call attempts. The primary endpoint was the proportion of patients whose primary care physician could be reached by telephone at the time of discharge. The other criteria were the physicians' opinions on the benefits of this contact and its effect on readmission rates. Results 275 patients were eligible. 8 hospitalists and 130 PCPs gave their opinion. Calls attempts were made for 71% of eligible patients. Call attempts resulted in successful contact with the PCP 157 times, representing 80% of call attempts and 57% of eligible patients. The average success rate for calls was 47%. The telephone contact was perceived by hospitalist as useful and providing security. The PCPs were satisfied and wanted this intervention to become systematic. Telephone contact did not reduce the readmission rate. Conclusions Despite the implementation of a standardized process, the feasibility of the intervention was modest. The main obstacle was hospitalists lacking time and facing difficulties in reaching the PCPs. However, physicians showed desire to communicate directly by telephone at the time of discharge. Trial registration French C.N.I.L. registration number 2108852. Registration date October 12, 2017.

scholarly journals Primary Care Physician Recognition and Documentation of Depressive Symptoms Among Chinese and Latinx Patients During Routine Visits: A Cross-Sectional Study

Health Equity ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 236-244
Author(s):  
Maria E. Garcia ◽  
Ladson Hinton ◽  
Steven E. Gregorich ◽  
Jennifer Livaudais-Toman ◽  
Celia P. Kaplan ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Primary Care Physician ◽  
Cross Sectional Study ◽  
Care Physician ◽  
Sectional Study ◽  
Cross Sectional
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