scholarly journals Access to care for workers’ compensation patients in dense and sparse population centers

2021 ◽  
Vol 12 (3) ◽  
pp. 50-52
Author(s):  
Blair A Skylar M Rhode ◽  
Skylar M Rhode Skylar M Rhode
Keyword(s):  
Primary Care ◽  
Access To Care ◽  
Case Series ◽  
Cook County ◽  
Primary Care Doctor ◽  
Workers Compensation ◽  
Injured Worker ◽  
Claim Number ◽  
Orthopedic Care ◽  
Gain Access

Background: Workers’ compensation was originated to provide a no-fault, timely access to appropriate medical care. Unfortunately, we have found that the system fails the injured worker in certain environments. By implementing procedural roadblocks in the form of initial claim denial and delay methods, the injured worker finds himself/herself in a battle of attrition. By delaying treatment and compensation benefits, the injured workers are “starved out” of their access to care and often walk away from their claim or accept a payout without treatment. Methods: We performed a randomized, consecutive case-series where 300 hypothetical patients called medical offices to attempt to arrange a physician consultation. We analyzed the ability of a patient to gain access (an appointment) to a primary care (N=100), orthopedic (N=100) and neurology (N=100) physician after stating that they were injured at work. We analyzed two cohorts, one as an injured worker that was given a claim number (N=150) and the other that was injured at work but not yet given a claim number (N=150). Conclusion: This study demonstrates how difficult it is to gain access to care as an injured worker. An injured worker in a low densely populated area without a claim number was unable to gain access to a primary care doctor in our cohort (100% denial rate). Even a patient with an accepted claim number in densely populated Cook County, IL had a 52% chance of being denied access to care with an orthopedic surgeon while a patient without a claim number had an 84% chance of being denied access to orthopedic care.

scholarly journals Telemedicine-Based Tobacco Treatment Model in Primary Care from a Low-Resource Setting

2019 ◽  
Vol 10 (04) ◽  
pp. 690-692
Author(s):  
Kumar Thamaraiselvan Santhosh ◽  
Mani Bhushan Pant ◽  
Fareed Uzzafar ◽  
Narayana Manjunatha ◽  
C. Naveen Kumar ◽  
...  
Keyword(s):  
Primary Care ◽  
Case Series ◽  
Premature Mortality ◽  
Primary Care Doctor ◽  
Tobacco Treatment ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Tobacco Addiction ◽  
Video Consultation ◽  
Psychiatry Program

AbstractTobacco addiction is one of the leading causes of premature mortality. Early and effective intervention in primary care, though possible and feasible, is seldom done in India. This case series describes the diagnosis and management of three patients of tobacco addiction by a primary care doctor (PCD) who is being trained in digitally driven four modules based “Primary Care Psychiatry Program” of National Institute of Mental Health and Neurosciences, Bengaluru, India. This article discusses about the way in which two modules (telepsychiatric on-consultation training and collaborative video consultation) helped a primary care doctor (M.B.P.) working approximately 1,500 miles away from an academic institute to treat tobacco dependence at a rural primary health center of India.

scholarly journals Primary care doctor fostering and clinical research training in Sweden: Implications for Japan

2018 ◽  
Vol 20 (1) ◽  
pp. 4-8 ◽  
Author(s):  
Takashi Watari ◽  
Masahiro Hirose ◽  
Patrik Midlöv ◽  
Yasuharu Tokuda ◽  
Hideyuki Kanda ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Research ◽  
Research Training ◽  
Primary Care Doctor

scholarly journals Cardio-Pulmonary Sequelae in Recovered COVID-19 Patients: Considerations for Primary Care

2021 ◽  
Vol 12 ◽  
pp. 215013272110237
Author(s):  
Zouina Sarfraz ◽  
Azza Sarfraz ◽  
Alanna Barrios ◽  
Radhika Garimella ◽  
Asimina Dominari ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Infection ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Case Reports ◽  
Case Series ◽  
Infectious Complications ◽  
Care Physician ◽  
Cross Sectional ◽  
Infection Period

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care. Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords “COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication.” We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, while making healthcare considerations for primary care workers. Results: We identified 29 studies across 9 countries including 37.9% Chinese and 24.1% U.S. studies, comprising 655 patients (Mean Age = 45) with various ethnical backgrounds including Asian and European. Based on the WHO COVID-19 severity classification scale, initial disease severity was mild for 377 patients and severe for 52 patients. Treatments during primary infection included corticosteroids, oxygen support, and antivirals. The mean value (in days) for complication onset after acute recovery was 28 days. Complete blood counts and RT-PCR tests were the most common laboratory results described. In 22 of the studies, patients showed signs of clinical improvement and were prescribed medications such as anticoagulants or corticosteroids. Conclusion: Post-recovery infectious complications are common in long-COVID-19 patients ranging from mild infections to life-threatening conditions. International thoracic and cardiovascular societies need to develop guidelines for patients recovering from COVID-19 pneumonia, while focused patient care by the primary care physician is crucial to curb preventable adverse events. Recommendations for real-time and lab-quality diagnostic tests are warranted to establish point-of-care testing, detect early complications, and provide timely treatment.

Women’s Health Informatics in the Primary Care Setting

2011 ◽  
pp. 1518-1529
Author(s):  
Gareth Parry
Keyword(s):  
Primary Care ◽  
Women’S Health ◽  
Women's Health ◽  
Health Informatics ◽  
Clinical Information ◽  
Improve Patient Care ◽  
Primary Care Doctor ◽  
Local Hospital ◽  
The Many

Women’s health in primary care is a large part of the generalist’s practice. Information technology (IT) is now an integral part of the generalist’s office, often more so than in secondary care and therefore this chapter is a key starting point in the book. Initially there is an introduction of the role of IT in primary health and the many areas it may encompass. We then move onto organizing clinical information and the ways that this maybe represented electronically in the “cradle to grave” electronic health record. In addition to recording information, can IT help the primary care doctor? The area of IT in screening, prevention and alerts is discussed. The role of the computer in the clinician’s office and the impact it has on the consultation is explored. Can computer help clinicians perform better? Areas of discussion include the role of computers in audit and systems using artificial intelligence to improve patient care. IT is increasingly important in scheduling both within the practice and at the local hospital. This can be done by the primary care doctor and in some instances by the patient his or herself. The ideal situation is the primary care doctor having a system which can “talk” to external systems (e.g. local hospital notes, with a secure portal). In some countries such as the United Kingdom, this is becoming a reality, though there are problems which are discussed.

Beginning

2021 ◽  
pp. 1-12
Author(s):  
Allan Hugh Cole
Keyword(s):  
Primary Care ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Movement Disorder ◽  
Clinical Diagnosis ◽  
Personal Narrative ◽  
Primary Care Doctor ◽  
Doctor Who ◽  
Brain Scan ◽  
Movement Disorder Specialist

Through personal narrative, this chapter details the author’s experience of first becoming aware that something was not right with his body. This experience leads to visiting his primary care doctor who tells him that she is concerned about the possibility of his having Parkinson’s disease and then refers the author to a neurologist who is a movement disorder specialist. He is examined by this neurologist, who says, “What worries me is that I think you are in the early stages of Parkinson’s disease,” but who wants the author to have a brain scan that will confirm the clinical diagnosis given his young age and subtle symptoms. The author leaves his office, drives home, and informs his wife that this doctor thinks he have Parkinson’s disease. Here begins his new life as a person with Parkinson’s (PwP).

scholarly journals Impact of the Programa Mais médicos (more doctors Programme) on primary care doctor supply and amenable mortality: quasi-experimental study of 5565 Brazilian municipalities

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Thomas Hone ◽  
Timothy Powell-Jackson ◽  
Leonor Maria Pacheco Santos ◽  
Ricardo de Sousa Soares ◽  
Felipe Proenço de Oliveira ◽  
...  
Keyword(s):  
Primary Care ◽  
Human Resources For Health ◽  
Primary Care Doctor ◽  
Substitution Effects ◽  
Programme Implementation ◽  
Potential Health ◽  
The Sustainable Development ◽  
Amenable Mortality ◽  
Quasi Experimental ◽  
Primary Care Doctors

Abstract Background Investing in human resources for health (HRH) is vital for achieving universal health care and the Sustainable Development Goals. The Programa Mais Médicos (PMM) (More Doctors Programme) provided 17,000 doctors, predominantly from Cuba, to work in Brazilian primary care. This study assesses whether PMM doctor allocation to municipalities was consistent with programme criteria and associated impacts on amenable mortality. Methods Difference-in-differences regression analysis, exploiting variation in PMM introduction across 5565 municipalities over the period 2008–2017, was employed to examine programme impacts on doctor density and mortality amenable to healthcare. Heterogeneity in effects was explored with respect to doctor allocation criteria and municipal doctor density prior to PMM introduction. Results After starting in 2013, PMM was associated with an increase in PMM-contracted primary care doctors of 15.1 per 100,000 population. However, largescale substitution of existing primary care doctors resulting in a net increase of only 5.7 per 100,000. Increases in both PMM and total primary care doctors were lower in priority municipalities due to lower allocation of PMM doctors and greater substitution effects. The PMM led to amenable mortality reductions of − 1.06 per 100,000 (95%CI: − 1.78 to − 0.34) annually – with greater benefits in municipalities prioritised for doctor allocation and where doctor density was low before programme implementation. Conclusions PMM potential health benefits were undermined due to widespread allocation of doctors to non-priority areas and local substitution effects. Policies seeking to strengthen HRH should develop and implement needs-based criteria for resource allocation.

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