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 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.

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 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

scholarly journals MO241TELEMEDICINE : COVID -19 PANDEMIC AND THE RISE OF THE VIRTUAL CARE IN NEPHROLOGY IN SPAIN

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Javier De Teresa Alguacil ◽  
Elisa Pereira Pérez ◽  
José Manuel Osorio Moratalla ◽  
Antonio Osuna Ortega
Keyword(s):  
Primary Care ◽  
Real Time ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Care Physician ◽  
University Hospital ◽  
Healthcare Personnel ◽  
Clinical Activity ◽  
The Cost

Abstract Background and Aims The coronavirus disease 2019 (COVID-19) pandemic, has required a rapid and drastic transformation of health systems worldwide, and consequently also of Spanish Nephrology Units, to respond to the critical situation. The adaptation and transformation of nephrology services during the COVID-19 pandemic in Spain was a urgent need. During this period is worth noting that outpatient nephrology consultations were carried out largely virtually. In conclusion, the pandemic has clearly impacted clinical activity in Spanish Nephrology departments including ours at Virgen de las Nieves University hospital (Granada), reducing elective activity. Method At the beginning of the pandemic, we quickly adapted by designing an outpatient healthcare model adapted to the situation. With a virtual model we established direct communication via online almost in "real time" between primary care and our Nephrology Service consultation, avoiding unnecessary travel of patients and relatives, risk exposures to interpersonal and reducing the cost and the public crowds in the hospital. Based on inter-consultation criteria adapted to the guidelines and consensus documents of different societies, we established a new intercommunication system between Primary Care Physicians and external nephrology consultations, to FILTER consultations that did not require unnecessary exposures and reducing the cost of healthcare and the waiting time among others. Between June 2020 and December 2021, we received 372 cases referred from Primary Care for a first virtual assessment in the high-resolution nephrology clinic, clinical recommendations were effectively issued regarding complementary tests, treatment … and the need to refer to our Nephrology outpatient clinic for study and follow-up or not. Results Of the 372 patients evaluated VIRTUALLY, 38 were referred by Acute Kidney Injury (AKI) of which 35 were discharged with follow-up by their Primary Care Physician, 37 patients were referred by eGFR <30 ml / min / 1.73m2 being discharged 29, 66 patients were referred by eGFR between 30-60 ml / min / 1.73m2, being discharged 51 , 15 had Albumin / creatinine ratio (ACR ) between 30-300 mg / gr discharging 100%, 22 cases were consulted for ultrasound renal abnormalities and 18 of them were discharged, 5 were referred for apparently non-urological hematuria, not requiring nephrological follow-up in any case, the reason for referral "other causes" had n = 102 of which the main reason was "loss of an appointment in consultation during the pandemic", nephrectomy, kidney transplants with decompensation, family history of hereditary kidney disease (PKD, Alport …) without follow up need in n=95 of cases In Spain the activity of presential care in outpatient Nephrology consultations was suspended in 47% of the services, carrying out activity through telephone calls in 98.9%, that is, in the majority of Spanish hospitals. In 16.5% of the centers, telemedicine was the only form of external clinical visits. In 57% of the centers, outpatient follow-up tests were stopped during the pandemic. Conclusion The actual COVID-19 pandemic has demonstrated that a transformation and adaptation plan based on the optimization of resources, the implementation of telemedicine and the reorganization of our healthcare activity is necessary. The activity of presential care in outpatient Nephrology consultations was suspended in 47% of the Spanish Nephrology services(1). Humanity has demonstrated once again that it is capable of overcoming adversity, readjusting to change. In our virtual consultation, we attended 372 cases of which 288 (66.6%) were discharged with recommendations to their Primary Care Physician. Avoiding costs, unnecessary exposure of patients, relatives and healthcare personnel, giving an almost "real time” response to the patient and avoiding unnecessary travels. A model of care in external consultations that has come to stay in the future.

scholarly journals Abdominal obesity in primary care

2017 ◽  
Vol 4 (4) ◽  
pp. 915 ◽  
Author(s):  
Sethu Prabhu Shankar ◽  
Golepu Kartikeya
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Abdominal Obesity ◽  
Primary Care Physicians ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Care Physician ◽  
Abdominal Circumference ◽  
Age Group ◽  
Cross Sectional

Background: Obesity is one of the important challenge in primary care. Abdominal obesity is associated with future cardiovascular disease when compared to non-obese individuals. The objective was to study the prevalence of abdominal obesity in patients attending primary care physician and to analyse abdominal obesity across different age groups and gender.Methods: The study was done as cross-sectional study at primary care centres in and around Pondicherry. Patients visiting primary care physician were included in the study. All adult patients of age more than 18 years, of both sexes visiting the primary care physician were included in study. Pregnant women, patients with abdomen diseases and patients those who are not willing to give written consent for participation in the study were excluded from the study. Demographic profile, anthropometric measurements were recorded. Abdominal circumference of all patients were recorded using a standard measuring tape. Abdominal obesity was diagnosed when the abdominal circumference was more than 90 centimetres in male and more than 80 centimetres in female.Results: A total number of 1030 patients were included in the study. There were 189 patients in age group 60-69. Females 535 outnumbered males 484. In the age group 50-59, 33 (40%) of males and 45 (44%) of females had increased abdominal circumference more than 90 centimetres in males and 80 centimetres in females. Across all age groups 121 (24%) males had abdominal circumference more than 90 centimetres in the study and 147 (28%) females had abdominal circumference more than 80 centimetres.Conclusions: Abdominal obesity is common at primary care level. The prevalence of abdominal obesity is more in females when compared with males. Hence all primary care physicians have to be stressed about the importance of abdominal obesity. 

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.

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