scholarly journals The preferences of general practitioners regarding family physician contract in the underprivileged areas of Iran in using conjoint analysis

2019 ◽  
Author(s):  
Sima Rafiei ◽  
Rafat Mohebbifar ◽  
Mohammad Ranjbar ◽  
Fatemeh Akbarirad
Keyword(s):  
Logistic Regression ◽  
General Practitioners ◽  
Family Physician ◽  
Family Doctor ◽  
Medical Specialty ◽  
Cross Sectional Study ◽  
International Standards ◽  
Cross Sectional ◽  
Ordered Logistic Regression ◽  
The Family

Background: One of the most important methods for improving the fair access of people to health services is the family physician program, which is facing many challenges. One of these challenges is the lack of policymakers' understanding of physicians' preferences regarding the provisions of the family physician contract. Therefore, this study was aimed to investigate general practitioners' preferences regarding the type of family doctor contract in one of the underprivileged regions of Iran. Methods: An analytical-cross-sectional study was conducted among 150 general practitioners (GPs) who registered in Ministry of Health and Medical Education (MoHME) family physician plan and were working in the health network of deprived regions in Iran. A discrete choice experiment (DCE) questionnaire was developed by the researchers and then distributed to GPs. Results were analyzed using Ordered Logistic Regression. Data were collected using a questionnaire designed by orthogonal method in SPSS 20. Data analysis was performed using logistic regression model in Stata 13 software. Results: Findings revealed that “type of employer” had the most significant effect on GPs’ preferences (OR = 2.5), followed by “allocating quota for admission to medical specialty courses after 5 years” (OR = 2.25), being allowed to give medical services to population without geographical restriction (OR = 2.8), being allowed to provide services out of the defined service packet (OR =   1.4), and “decreased length of contract” (OR  =  0.93). Conclusion: The amendment of the provisions of the family physician contract in accordance with physicians' preferences increases the probability of their participation in and compliance with the family physician program. However, the compliance of the provisions of this contract with relevant international standards and upstream laws of the country should be maintained as much as possible.  

scholarly journals What do Iranian general practitioners expect from family physician contracts?

2019 ◽  
Vol 7 (3) ◽  
pp. e000038
Author(s):  
Rafat Mohebbifar ◽  
Fatemeh Akbarirad ◽  
Mohammad Ranjbar ◽  
Sima Rafiei
Keyword(s):  
Family Medicine ◽  
General Practitioners ◽  
Family Physician ◽  
Medical Specialty ◽  
Cross Sectional Study ◽  
Successful Implementation ◽  
Medical Council ◽  
Cross Sectional ◽  
Study Results ◽  
Ordinal Regression Model

BackgroundFamily medicine has become a main prerequisite of providing primary healthcare and a main reforming strategy to ensure the delivery of efficient and high-quality health services.AimThis study aimed to investigate general practitioners’ (GP) preferences regarding family physician contract.Design and settingCross-sectional study was conducted among GPs who registered in Ministry of Health and Medical Education (MoHME) family physician plan and were working in the health network of moderately developed regions in Iran. The sample size was calculated to be 150 GPs who were randomly selected from MoHME database.MethodDeveloped questionnaire was distributed to GPs. Results were analysed by ordinal regression model.ResultsStudy results confirmed that ‘type of employer’ had the most significant effect on GPs’ preferences (β=0.86). Then attributes including ‘allocating quota for being accepted in medical specialty’ (β=0.78), ‘increased length of contract’ (β=0.00.42) and ‘capitation payment+15% bonus’ had respectively the great effects on participants’ decision. Findings also revealed that a scenario of contracting with medical council was 2.4 times more likely to be chosen by GPs compared with a scenario of contracting with a medical university. Furthermore, a scenario that allocated a quota for admission to medical specialty courses was 2.18 times more probable to be preferred by them (p<0.001).ConclusionSuccessful implementation of family medicine requires development of suitable solutions for attracting and attaining GPs in the programme. It seems that using a variety of incentives and applying them in physicians’ work contract would be helpful in this regard.

scholarly journals Patients’ Perspectives about Lifestyle Behaviors and Health in the Context of Family Medicine: A Cross-Sectional Study in Portugal

2021 ◽  
Vol 18 (6) ◽  
pp. 2981
Author(s):  
Rosália Páscoa ◽  
Andreia Teixeira ◽  
Micaela Gregório ◽  
Rosa Carvalho ◽  
Carlos Martins
Keyword(s):  
Family Medicine ◽  
Family Doctor ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Future Research ◽  
Lifestyle Behaviors ◽  
Sectional Study ◽  
Self Assessment ◽  
Cross Sectional ◽  
The Family

Lifestyle interventions are recognized as essential in the prevention and treatment of non-communicable diseases. Previous studies have shown that Portuguese patients tend to give more importance to diagnostic and laboratory tests than to lifestyle measures, and seem unaware that behavioral risks are the main modifiable risk factors. The study aimed to analyze patients’ perspectives about lifestyle behaviors and health in the context of family medicine in Portugal. A population-based cross-sectional study was carried out in Portugal (the mainland). A total of 900 Portuguese patients aged ≥20 years, representative of the population, were surveyed using face-to-face questionnaires. Participants were selected by the random route method. Descriptive statistics and non-parametric tests were performed to evaluate differences between the personal beliefs and the personal behavior self-assessment, as well as between the level of importance given to the family doctor to address health behaviors and the reported approach implemented by the family doctor, and its association with bio-demographic variables. The results indicate that the vast majority of this Portuguese cohort has informed beliefs regarding lifestyle behaviors, tends to overestimate their own behavior self-assessment, and strongly agrees that it is important that their family doctor asks/advises on these lifestyle behaviors, although the proportion of those who totally agree that their family doctor usually does this is significantly lower. Differences concerning bio-demographic variables were found. Future research directions should focus on the politics, economics, and policy aspects that may have an impact in this area. It will also be important to understand more broadly the relationships between lifestyle behaviors and clinical, physical, and sociodemographic variables.

scholarly journals Awareness of Family Physician Residents of their Roles in Disaster Health Management: A Cross-Sectional Study in Saudi Arabia

2021 ◽  
pp. 254-261
Author(s):  
Fawaz Hassan Alamri ◽  
Faisal Dhahi Aldahash ◽  
Sa’ad Alqahtani
Keyword(s):  
Saudi Arabia ◽  
Disaster Management ◽  
Family Physician ◽  
Emergency Services ◽  
Health Management ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Disaster Medicine ◽  
Cross Sectional ◽  
The Family

Background: Family physicians have a pivotal role in responding to the medical community's needs and have a crucial role in disaster health management. Family physicians have several tasks and duties during and after the disaster, such as event detection, critical information’ collection and distribution, and rehabilitative activities. It is important to identify the level of awareness of the family physicians regarding their role in the management of disasters. Aim: To assess the awareness of family physician residents of their roles in disaster health management, Saudi Arabia. Methods: This study was cross-sectional; it was performed on Saudi family physician residents in family practice clinics and centers in Saudi Arabia. A self-administrated questionnaire has been sent electronically to the participants to investigate their awareness. IMB SPSS version 22 was used to analyze the collected data. Results: This study included 400 family physicians; more than one-half 52.75%were in the age of 28-30 years old. There were 61.5% worked previously at hospital emergency services. A few percentages reported receiving training on disaster medicine management in the clinic, 38.5%. 47.75% reported willingness to train on disaster management. There was 71% of physicians had high knowledge regarding their role in disaster management. Conclusion: There was high awareness among the family physicians regarding their role in the management of disaster with an acceptable attitude toward receiving training.

scholarly journals Gender and obesity interaction in quality of life in adults assisted by family doctor program in Niterói, Brazil

2016 ◽  
Vol 21 (5) ◽  
pp. 1617-1624 ◽  
Author(s):  
Karla Dala Paula Torres ◽  
Maria Luiza Garcia Rosa ◽  
Samuel Datum Moscavitch
Keyword(s):  
Quality Of Life ◽  
Family Doctor ◽  
Cross Sectional Study ◽  
Obese Women ◽  
Cross Sectional ◽  
Primary Care Settings ◽  
Sf 36 ◽  
The Family ◽  
The Impact

Abstract Obesity impacts the quality of life (HRQL). Studies about the effects of a possible interaction between gender and body mass are rare. The objective of the present paper is to estimate the biological interaction between gender and obesity on HRQL. This was a cross-sectional study based on data from CAMELIA study with population assisted by the Family Doctor Program of Niteroi visited between June 2006 and December 2007. HRQL was assessed by the SF-36. The exposure categories were: obese women, non-obese women, obese men and non-obese men, the reference category. Obese women showed higher percentages of low overall, physical and mental quality of life with the largest associations in the physical component. The excess risk due to interaction was statistically significant in physical dimension: RERI = 1.97 (0.40-3.52) and RERIa = 1,97 (0.40-1.7). Among the Brazilian population aged 20–64 years, obesity was independently associated with low HRQL. This association differed by gender, being significant for women. The possibility of the combined effect takes greater importance in the context of increasing incidence of obesity globally. Healthcare professionals in primary care settings should pay attention to gender differences in the impact of obesity on HRQL.

scholarly journals Utilization of Emergency Department Services by the Bedouin Population in Southern Israel

2007 ◽  
Vol 7 ◽  
pp. 330-335 ◽  
Author(s):  
Arnon Dov Cohen ◽  
Jacob Dreiher ◽  
Amir Sharf ◽  
Daniel Aharon Vardy
Keyword(s):  
Emergency Department ◽  
Family Physician ◽  
Jewish Population ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Primary Care Clinics ◽  
The Family ◽  
Ed Visits ◽  
Central Database ◽  
Age Adjusted Rates

Excessive use of the emergency department (ED) is associated with increased costs and workload in the ED, patients' inconvenience and disruption of the continuity of care. The study's goal was to describe trends in ED utilization among Bedouins living in southern Israel. A retrospective cross-sectional study was conducted in primary care clinics in southern Israel. Patients included Bedouin and Jewish patients insured by Clalit Health Services. Data was retrieved from a central database. The number of visits to the ED and age-adjusted rates of ED visits during 2000-2003 were determined in the Bedouin vs. Jewish population. All visits that ended in hospitalization were excluded. Data was stratified according to patients' residence (semi-nomadic vs. urban Bedouins) and referral origin. Age-adjusted rates of ED visits decreased from 42.9/1000 patients/month in 2000 to 38.3/1000 patients/month in 2003. There were more ED visits in the Bedouin as compared to Jewish population (38.3/1000 vs. 21.8/1000 patients/month). The decrease in ED utilization was more prominent among adult semi-nomadic Bedouins (from 60.8/1000 to 40.3/1000 patients/month). The proportion of referrals by the family physician to ED significantly decreased (among urban Bedouins: from 54.3% to 43.2%, p<0.001; among semi-nomadic Bedouins: from 53.9% to 39.9%, p<0.001), while the proportion of selfreferrals and referrals from physicians other than the family physician increased. A decrease in ED utilization by the Bedouin population during the last years was demonstrated. Utilization of ED services is still increased as compared to the non-Bedouin population. Interventions to control excessive use of ED services in the Bedouin population are currently underway.

scholarly journals Hubungan perilaku Keluarga Sadar Gizi (KADARZI) dan Perilaku Hidup Bersih Sehat (PHBS) pada tatanan rumah tangga dengan status gizi balita usia 24-59 bulan

2017 ◽  
Vol 5 (2) ◽  
pp. 88-97
Author(s):  
Hartono Hartono ◽  
Bagoes Widjanarko ◽  
Mexitalia Setiawati EM
Keyword(s):  
Logistic Regression ◽  
Nutritional Status ◽  
Significant Relationship ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Dominant Factor ◽  
Chi Square ◽  
Cross Sectional ◽  
The Family ◽  
Chi Square Test

Background: The prevalence of malnutrition among toddler in Kotabaru district was still high at 20,86 %. The family implemented Kadarzi was 56,24 % while the family who implemented PHBS was 42,48 %, this prevalence was still low. Objective: The purpose was analyzed the relationship between Kadarzi and PHBS behavior of households with nutritional status of toddler of 24-59 months.  Methods: The design was cross sectional study conducted in Puskesmas Dirgahayu. Subjects were children aged 24-59 months who lived in Puskesmas Dirgahayu area, who coverese with inclusion and exclusion criteria twose, subjects are 90 respondens. Sampling technical by simple random sampling. Analysis tests used chi square test and logistic regression with 95% confidence level. Questionnaire was used as tools research, energy and protein intake was measured by recall method.Results: The results showed 27,8 % children was categorized as malnutrition status, 72,2 % family implemented Kadarzi and 70,0 % Kadarzi behave uncategorised healthy home. Analysis of the data showed no significant relationship between Kadarzi behavior with nutritional status (p=0,000, OR=31,13). There was a significant relationship between clean and healthy behavior with nutritional status (p=0,000, OR=22,56). Analysis of multiple logistic regression test obtained dominant factor associated with nutritional status is Kadarzi behavior (p=0,000, OR=0,08). Conclusion: There was a significant relationship between Kadarzi and PHBS behavior of households with nutritional status of toddler 24-59 months.

scholarly journals What attributes do patients prefer in a family physician? A cross-sectional study in a northern region of Portugal

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e035130
Author(s):  
Joana Nuno ◽  
Susana Fernandes ◽  
Teresa Rei Silva ◽  
Ana Catarina Guimarães ◽  
Bernardo Morais Pereira ◽  
...  
Keyword(s):  
Family Physician ◽  
Multinomial Logistic Regression ◽  
Cross Sectional Study ◽  
Northern Region ◽  
White Coat ◽  
Sectional Study ◽  
Male Physician ◽  
Cross Sectional ◽  
The Family ◽  
The City

ObjectivesTo determine which modifiable and non-modifiable attributes patients prefer in a family physician, as well as to analyse participants’ characteristics associated with their choices.DesignCross-sectional study.SettingFamily healthcare units (FHU) in the city of Braga and Barcelos (Northern Portugal).ParticipantsAdults aged 18 years or more, enrolled in the selected FHU.Main outcome measuresThe preferred attributes were assessed with a questionnaire delivered in the FHU. These attributes included gender, age and nationality and the importance of being Portuguese, of greeting with a handshake, of welcoming in the waiting area, of using an identification badge and of wearing a white coat.ResultsA total of 556 questionnaires were included in the analysis; 66% and 58% of the participants had no preference for the gender or age of the family physician, respectively. Using a multinomial logistic regression, male participants were 3.8 times more likely to have a preference for a male physician than having no preference, in comparison to female participants (OR 3.864, 95% CI 1.96 to 7.61). More than 69% of the participants considered greeting with a handshake, using an identification badge and wearing a white coat important or very important. There was a statistically significant association between being Portuguese and the major importance given to the use of an identification badge (β=0.68, 95% CI 0.23 to 1.12).ConclusionsOur data show that modifiable attributes of the family physician (greeting, presence of an identification badge and wearing a white coat) are important for patients. Potential changes in family physician attitude in consultation could ultimately affect patient–physician relationship.

scholarly journals Family characteristics associated with rural households’ willingness to renew the family doctor contract services: a cross-sectional study in Shandong, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenjuan Li ◽  
Jie Li ◽  
Peipei Fu ◽  
Yan Chen ◽  
Yemin Yuan ◽  
...  
Keyword(s):  
Labor Force ◽  
Descriptive Analysis ◽  
Rural Households ◽  
Family Doctor ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Family Characteristics ◽  
Binary Logistic Regression Model ◽  
Cross Sectional ◽  
The Family

Abstract Background In China, some previous studies have investigated the signing rate and willingness of residents to sign the family doctor contract services (FDCS). Few studies have explored residents’ willingness to renew the FDCS. This study is designed to understand the family characteristics difference towards rural households’ willingness of maintaining the FDCS. Methods A total of 823 rural households were included in the analysis. A descriptive analysis was conducted to describe the sample characteristics. The binary logistic regression model was used to explore the family characteristics that influence the renewal willingness for FDCS among rural households in Shandong province, China. Results Our study found that about 95.5% rural households had willingness to maintain the FDCS in Shandong, China. Those households with catastrophic health expenditures (CHE) (OR = 0.328, 95%CI = 0.153–0.703), with highest level of education at graduate or above (OR = 0.303, 95%CI = 0.123–0.747) were less willing to maintain the FDCS. Those whose households have more than half of the labor force (OR = 0.403, 95%CI = 0.173–0.941) and those households living in economically higher condition were less willing to maintain the FDCS. Conclusions This study demonstrates a significant association between family characteristics (CHE, highest education in households, proportion of the household labor force) and willingness to maintain FDCS among rural households in Shandong, China. Targeted policies should be made for rural residents of identified at-risk families.

scholarly journals Influencing factors on the tendency of general practitioners to join in Urban Family Physician Program in Iran

2020 ◽  
Author(s):  
Mohsen Bayati ◽  
Arash Rashidian ◽  
Sajad Delavari ◽  
Vahid Yazdi-Feyzabadi
Keyword(s):  
General Practitioners ◽  
Family Physician ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Study Data ◽  
Self Report ◽  
Main Question ◽  
Cross Sectional ◽  
Positive Tendency ◽  
Urban Family

Abstract Background Urban family physician program (UFPP) is initiated as pilot by policy makers as a main reform in future of primary health care in Iran. Despite an ongoing pilot implementation of this program from 2012, it remains a main question about providing sufficient number of general practitioners (GPs). This study aimed to investigate the factors which affect GPs' decision to join in the UFPP.Methods In this national cross-sectional study, data were gathered by a self-report questionnaire from 601 GPs. The multivariate logistic regression was applied to explore the demographic, practice and views determinants of the tendency of GPs to join in the UFPP.Results More than half of GPs (58.6%) participated in the study had a positive tendency to join in the UFPP. Older GPs (adjusted OR=3.72; 95%CI: 1.05-13.09), working in public sector (adjusted OR=2.26; 95%CI: 1.43-3.58), lower income level (adjusted OR=6.69; 95%CI:2.95-15.16), higher economic expectations (adjusted OR=2.08; 95%CI: 1.19-3.63), and higher satisfaction from medicine profession (adjusted OR=2.00; 95%CI: 1.14-3.51) were the main factors which increased the GPs tendency to join UFPP.Conclusions decision for joining in the program is mainly affected by GPs' economic status. This clarifies that if the program can make them closer to their target income, they would be more likely to decide for joining in the program.

scholarly journals Influencing factors on the tendency of general practitioners to join in Urban Family Physician Program in Iran

2020 ◽  
Author(s):  
Mohsen Bayati ◽  
Arash Rashidian ◽  
Sajad Delavari ◽  
Vahid Yazdi-Feyzabadi
Keyword(s):  
General Practitioners ◽  
Family Physician ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Study Data ◽  
Self Report ◽  
Main Question ◽  
Cross Sectional ◽  
Positive Tendency ◽  
Urban Family

Abstract Background Urban family physician program (UFPP) is initiated as pilot by policy makers as a main reform in future of primary health care in Iran. Despite an ongoing pilot implementation of this program from 2012, it remains a main question about providing sufficient number of general practitioners (GPs). This study aimed to investigate the factors which affect GPs' decision to join in the UFPP.Methods In this national cross-sectional study, data were gathered by a self-report questionnaire from 601 GPs. The multivariate logistic regression was applied to explore the demographic, practice and views determinants of the tendency of GPs to join in the UFPP.Results More than half of GPs (58.6%) participated in the study had a positive tendency to join in the UFPP. Older GPs (adjusted OR=3.72; 95%CI: 1.05-13.09), working in public sector (adjusted OR=2.26; 95%CI: 1.43-3.58), lower income level (adjusted OR=6.69; 95%CI:2.95-15.16), higher economic expectations (adjusted OR=2.08; 95%CI: 1.19-3.63), and higher satisfaction from medicine profession (adjusted OR=2.00; 95%CI: 1.14-3.51) were the main factors which increased the GPs tendency to join UFPP.Conclusions decision for joining in the program is mainly affected by GPs' economic status. This clarifies that if the program can make them closer to their target income, they would be more likely to decide for joining in the program.

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