NURSES LOOK TO HEALTH-CARE REFORMS TO FLEX MUSCLE. DOCTORS FIGHT BACK

PEDIATRICS ◽  
1994 ◽  
Vol 94 (3) ◽  
pp. A48-A48
Author(s):  
J. F. L.
Keyword(s):  
Primary Care ◽  
Health Care ◽  
American Medical Association ◽  
Care Physician ◽  
First Line ◽  
Health Care Reforms ◽  
White House ◽  
The Public ◽  
Primary Care Doctors

Nurses press the White House for a bigger role in primary care, including diagnosing patients and determining treatment, a move they say would save money. Due to the shortage of primary-care doctors, "a person who would see a nurse as a first-line provider would get better care," argues Virginia Trotter Betts, president of the American Nurses Association. But the American Medical Association wants to keep nurses in supporting roles. "This is a quality of care issue," says AMA Chairman Raymond Scalettar. "We're not looking down on nurses at all, but this push is wrong and could be harmful to the public." Instead, the doctors' group wants to assure that all Americans have a primary-care physician.

scholarly journals The role of social media in primary care

2021 ◽  
Vol 16 (2) ◽  
pp. 14-18
Author(s):  
Aneesa Abdul Rashid ◽  
Ahmed Kamarulzaman ◽  
Sakinah Sulong ◽  
Suhazeli Abdullah
Keyword(s):  
Primary Care ◽  
Social Media ◽  
Healthcare Professionals ◽  
Daily Life ◽  
First Line ◽  
The Public ◽  
Business Meetings ◽  
New Information ◽  
Primary Care Doctors

Online activities have become the norm. From searching for new information to conducting business meetings, social media’s role in daily life continues to grow in prominence. It is estimated that the majority of the population uses social media, and users include doctors and other healthcare professionals. It is critical for primary care doctors to note how social media can substantially influence one’s healthcare behaviour and decision making. Because primary care doctors are usually the first line of contact for patients, they are the most easily accessible and most instrumental in using social media to steer the public toward proper information on healthcare.

Better Health—But Not for All: The Swedish Public Health Report, 1987

1989 ◽  
Vol 19 (2) ◽  
pp. 221-255 ◽  
Author(s):  
Finn Diderichsen ◽  
Gudrun Lindberg
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Living Standards ◽  
Health Care Spending ◽  
Public Health Report ◽  
The Public ◽  
Health Report ◽  
Social And Economic Development

This article is a summary of the Public Health Report submitted to the Swedish Parliament in 1987. Health development, especially that of underprivileged groups, is regarded as an indicator of the quality of social and economic development of the country. Sweden is a very egalitarian country, but in spite of decreasing inequalities in living standards, the Report shows increasing inequalities in health. At the same time, the state has put restraints on health care spending, and the shift in the health care budget toward more primary care has stopped. This development seriously impairs the ability of the health and medical services to cope with inequities described in this Report.

scholarly journals Quality of Primary Health Care models for brazilian children

2021 ◽  
Vol 10 (8) ◽  
pp. e48610817584
Author(s):  
Beatriz Díaz-Fabregat ◽  
Wilmer Ramírez-Carmona ◽  
Eliane Cristina Gava Pizi ◽  
Juliane Avansini Marsicano ◽  
Rosana Leal do Prado
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Statistical Tests ◽  
Family Health ◽  
The Public ◽  
Primary Health ◽  
Care Assessment ◽  
Brazilian Children

Aim. To evaluate the quality of Primary Health Care (PHC) models for Brazilian children. Methods. A cross-sectional study was performed with 516 parents or guardian of children in the public preschools from a city in São Paulo State, Brazil. The participants completed the questionnaires on the perception of the quality of the PHC (Primary Care Assessment Tool-PCATool), and the socioeconomic conditions in their families. The data were analyzed by statistical tests (95% confidence level). Results. Private services, Family Health Strategies (FHS), and Conventional Health Care (CHC) were the modalities of PHC used by children. Among the three modalities, in all groups were observed statistically significant differences (p<0.001), the best quality of care was provided by FHS (8.22±1.69). The CHC (5.69±1.34) and the private service (6.65±0.99) need improvement in accessibility, continuity of care, integrality, family, and community orientation. The socioeconomic class of the families was associated with modalities of PHC (p<0.001).  Conclusions. The quality of primary care for children in the public health system still requires much improvement, primarily in conventional model. However, the Family Health Strategies was the model that presented the best quality of primary health care for children.  

Patient’s and Doctor’s Delay in the Diagnosis of Multiple Myeloma and Waldenströms Macroglobulinemia: The Results of An Inventarisation and Follow-up Study by the CKP the Dutch Advocacy Group for Patients in the Netherlands

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5182-5182
Author(s):  
P. Wijermans ◽  
N. van der Linden ◽  
C. Uyl ◽  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Multiple Myeloma ◽  
Care Physician ◽  
Medical Specialist ◽  
First Line ◽  
The Mean ◽  
To Come ◽  
Mean Time ◽  
Do So

Abstract Introduction. In 1998 the Dutch organisation for patients with Multiple Myeloma (MM) and Waldenstrom’s macroglobulinemia (WM) the CKP (Dutch Contact Group for patients with Multiple Myeloma and Waldenströms Macroglobulinemia), performed a study among their members to the time from first complains to diagnosis. This study was initiated after signals from the members that there was a substantial patients and doctor’s delay in the diagnostic procedures. As results of the outcome of this study the CKP took several initiatives to improve the awareness of these rare diseases among those active in the first line health care such as primary care physicians, physiotherapists, oncology nurses etc. Ten years later a similar questionnaire was send to the members in order to evaluate if there was an improvement in the time to diagnosis. Methode: A questionnaire was send to all the patient members of the CKP in 1998. Thereafter the CKP made several information booklets for first line health care workers, for patients and was present with information booth at many symposia and meetings for the those people who might come in contact with MM and WM patients. Ten years later we repeated the same questionnaire in order to evaluate the results of these iniatives. Results. It is estimated that based upon the prevalence the CKP did represented in 1998 about one third of the MM and WM patients of The Netherlands and in 2008 about 45%. The response to the questionnaire was n= 443 (79%) and n=580 (58%) respectively for 1998 and 2008. 60% vs 67% of the patients were 60 years or older. The diagnosis was made by the first physician or after one referral in 40% vs 31%. 19% vs 21% of the patients were at least 3 times referred to another health care worker. The patient’s delay was less than 2 months in 75% vs 58% in 1998 and 2008 respectively. For MM patients the other results were as follows: mean time from first complain to diagnosis in 1998 vs 2008 was 13 months vs 15 month. First visit to a physician to diagnosis was 10 month vs 11months. In 47% vs 51% the diagnosis was made within 6 months whereas in 28% it took more than 1 year to do so in the two study years. Within one month 41% vs 38% were referred by the first (primary care) physician to a medical specialist For WM the mean time from first disease signal to diagnosis was 19 months vs 24 months. First visit to physician and diagnosis 14 vs 13 months. In 42% vs 44% the diagnosis was made within 6 months whereas in 37% vs 38% it took more than 1 year to do so in the two study years. Within one month 18% vs 35% were referred by the first (primary care) physician to a medical specialist Conclusions: Both in 1998 and 2008 the mean time from first complain to diagnosis was more than one year. The doctor’s delay did not improve in this decennium but there was a slight improvement of the patient’s delay. The way the CKP has organised its activities has not led to any improvement in the time needed to come to a diagnosis. We have to contact our sister organisations in other countries to compare these data and do more research how we must organise our activities to come to an improvement of the patient’s and doctor’s delay that is now unacceptable long in a substantial number of patients.

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 Patient Suffering in Chronic Digestive Diseases: Will Primary Care-Specialist Collaboration With Effective Interactive Communication and Integrative Medicine in the Plan of Care Improve Quality of Life?

2020 ◽  
Vol 7 (6) ◽  
pp. 989-993
Author(s):  
Andrew Thomas ◽  
Annie Thomas
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
The United States ◽  
Care Providers ◽  
Physician Visits ◽  
Digestive Diseases ◽  
Care Specialist

Acute and chronic digestive diseases are causing increased burden to patients and are increasing the United States health care spending. The purpose of this case report was to present how nonconfirmatory and conflicting diagnoses led to increased burden and suffering for a patient thus affecting quality of life. There were many physician visits and multiple tests performed on the patient. However, the primary care physician and specialists could not reach a confirmatory diagnosis. The treatment plans did not offer relief of symptoms, and the patient continues to experience digestive symptoms, enduring this burden for over 2 years. The central theme of this paper is to inform health care providers the importance of utilizing evidence-based primary care specialist collaboration models for better digestive disease outcomes. Consistent with patient’s experience, the authors propose to pilot/adopt the integrative health care approaches that are proven effective for treating digestive diseases.

scholarly journals Factors related to perceived continuity of care in hospitalized cardiac patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Safstrom ◽  
T.J Jaarsma ◽  
L.N Nordgren ◽  
M.L Liljeroos ◽  
A.S Stomberg
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Care ◽  
Continuity Of Care ◽  
Perceived Control ◽  
Care Utilization ◽  
Funding Source ◽  
Patient Reported

Abstract Background Since healthcare systems are increasingly complex and often fragmented, continuity of care after hospitalization is a priority to increase patient safety and satisfaction. Aim Describe factors related to continuity of care in patients hospitalized due to cardiac conditions. Methods This cross-sectional multicenter study enrolled patients 6 weeks after hospitalization due to cardiac conditions. A total of 993 patients were included (mean age 72.2 (SD 10.4), males 66%) with AMI (35%), AF (25%), angina (21%) and HF (17.3%). Patients completed the Patient Continuity of Care Questionnaire, a questionnaire based on the definition that continuity of care is “the extent to which a series of health care services is experienced as connected and coherent and is consistent with a patient's health needs and personal circumstances”. The total score of the questionnaire ranges from 6 to 30, higher score indicating higher continuity and a score &lt;24 indicating insufficient continuity. Cronbach's alpha on the total PCCQ was 0.94. Correlations between PCCQ and quality of life, depression, anxiety, perceived control and health care utilization were estimated using spearman rang correlation. Results Insufficient continuity of care ranged between 47% to 59% in the different diagnosis groups, which the highest continuity in the AMI group and lowest in patients with atrial fibrillation. In patients hospitalized due to AMI (n=355, mean age 71 (± 11), 70% men), continuity of care was related to higher perceived control, higher quality of life, a good financial situation, being a man, no symptoms of anxiety or depression (ᚹ range 0.17–0.26 p≤0.002). A low score on the PCCQ were associated with follow-up visit to a nurse in primary care after hospitalization (ᚹ −0.12 p=0.033). In patients hospitalized due to angina (n=210, mean age 73 (± 9), 74% men), continuity of care was related to higher perceived control, higher quality of life and no depressive symptoms (ᚹ range between 0.20 and 0.26 p=0.005). In patients with AF, (n=255, mean age 71 (± 10.), 58% men), continuity of care was related to having had contact by telephone with a nurse-led AF clinic, higher perceived control, higher quality of life and not being depressed (ᚹ range between 0.14–0.25 p=0.03). In patients with HF, (n=173, mean age 77 (±8) 59% men), continuity was related to male ender, younger age, follow-up in a nurse-led HF clinic and not being anxious (ᚹ range between 0.16 and 0.22 p=0.004–0.047). Low total score on PCCQ correlated to having had telephone contact with nurse in primary care (ᚹ −0.24 p=0.002). Conclusion Almost half of all patient reported insufficient continuity of care. Perceived control, quality of life, and symptoms of depression were related to higher continuity of care in all diagnose groups except heart failure. Further, there was a correlation between continuity and follow-up visits or contact by telephone with nurse-led clinics in all diagnose groups except angina. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Medical Research Council of Southeast Sweden, Centre for Clinical Research Sörmland

scholarly journals Coordinated Management of COVID-19 Response: Lessons From Whole-of-Society and Whole-of-Health Strategies in Wuhan, China

2021 ◽  
Vol 9 ◽  
Author(s):  
Shanquan Chen ◽  
Pan Zhang ◽  
Yun Zhang ◽  
Hong Fung ◽  
Yong Han ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Delivery ◽  
Prevention And Control ◽  
Care Delivery ◽  
Control Strategies ◽  
Control Period ◽  
Targeted Prevention ◽  
First Line ◽  
And Control

Background: The outbreak of novel coronavirus disease 2019 (COVID-19) has been challenging globally following the scarcity of medical resources after a surge in demand. As the pandemic continues, the question remains on how to accomplish more with the existing resources and improve the efficiency of existing health care delivery systems worldwide. In this study, we reviewed the experience from Wuhan - the first city to experience a COVID-19 outbreak – that has presently shown evidence for efficient and effective local control of the epidemic.Material and Methods: We performed a retrospective qualitative study based on the document analysis of COVID-19-related materials and interviews with first-line people in Wuhan.Results: We extracted two themes (the evolution of Wuhan's prevention and control strategies on COVID-19 and corresponding effectiveness) and four sub-themes (routine prevention and control period, exploration period of targeted prevention and control strategies, mature period of prevention and control strategies, and recovery period). How Wuhan combatted COVID-19 through multi-tiered and multi-sectoral collaboration, overcoming its fragmented, hospital-centered, and treatment-dominated healthcare system, was illustrated and summarized.Conclusion: Four lessons for COVID-19 prevention and control were summarized: (a) Engage the communities and primary care not only in supporting but also in screening and controlling, and retain community and primary care as among the first line of COVID-19 defense; (b) Extend and stratify the existing health care delivery system; (c) Integrate person-centered integrated care into the whole coordination; and (d) Delink the revenue relationship between doctors and patients and safeguard the free-will of physicians when treating patients.

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