scholarly journals Trends in Family Physician Usage among Canadians from 2001 to 2016: An Age-Period-Cohort Analysis

2021 ◽  
Author(s):  
Jessie Yeung
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Family Physician ◽  
Cohort Analysis ◽  
Critical Role ◽  
Family Doctor ◽  
Temporal Trends ◽  
Cohort Effect ◽  
Care Providers ◽  
Physician Visits

As primary health care providers, family physicians play a critical role in Canada’s health care system by providing first-level contact for patients and acting as advocates for preventative medicine. Due to their essential role in population health, public health practitioners are concerned about temporal trends surrounding family physician visits. This study uses eight cycles of the Canadian Community Health Survey, a nationally representative survey, to conducing an age-period-cohort analysis with the bounding method, while controlling for sex and race. Most notably, we discover a declining cohort trend indicating that later cohorts are less likely to visit a family doctor over a 12-month period. These results suggest that health promotion policies surrounding family physician use should not only be targeted towards middle and older-aged adults who experience declining health, as the cohort effect implies that a portion of health care avoidance behaviour is molded in youth and young adulthood.

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 New Syphilis Cases in Older Adults, 2004–2019: An Analysis of Surveillance Data From South China

2021 ◽  
Vol 8 ◽  
Author(s):  
Cheng Wang ◽  
Peizhen Zhao ◽  
Mingzhou Xiong ◽  
Joseph D. Tucker ◽  
Jason J. Ong ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Temporal Trends ◽  
Health Concern ◽  
Targeted Prevention ◽  
Care Providers ◽  
Annual Percent Change ◽  
Syphilis Infection ◽  
Over Time

Background: Sexual health among older adults is a major public health concern globally. The syphilis burden is increasing in older adults in China. This study aimed to describe factors associated with syphilis infection and diagnosis among older adults in China during a 16 year period.Methods: Using 16 years of data (2004–2019) from the syphilis case report system of Guangdong, China, we compared data from older adults (aged ≥50 years) with those from younger people (aged 15–49 years). We compared the two age group with the Chi-square test for difference, and Joinpoint regression models to assess the temporal trends.Results: During the study period, 242,115 new syphilis diagnoses were reported in older adults. The mean notification rate of new diagnoses was 64.1 per 100,000 population across the entire 16-year period, which significantly increased over time (average annual percent change [AAPC] 16.2%, 95% CI 13.7–18.7). Syphilis diagnoses increased significantly over time among less developed cities and older women. In 2019, compared with younger adults, newly diagnosed older adults were more likely to be male, native to reporting city, had unknown transmission routes, and were diagnosed late.Conclusion: Our findings call for an urgent need to deliver more targeted prevention interventions for older adults, such as strengthen awareness among health care providers, and integration of syphilis services and primary health care for older adults.

scholarly journals Achievements and Challenges in Implementing Urban Family Physician Program in Iran: Viewpoint of Managers and Executives

2019 ◽  
Author(s):  
Mohammad Javad Kabir ◽  
Hasan Ashrafian Amiri ◽  
Zahra Hassanzadeh-Rostami ◽  
Reza Momtahen ◽  
Rasoul Zafarmand ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Family Physician ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Sustainable Resources ◽  
Urban Family ◽  
The Individual ◽  
Challenges And Strategies

Background: Urban family physician program is one of the relatively large reforms in Iran's health care system implemented in Fars and Mazandaran provinces since 2012. Nearly five years after implementation of the program, this study aimed to identify the achievements and challenges of this program from the viewpoints of managers and administrators. Methods: This cross-sectional study was conducted in winter of 2016. The research population included administrators and experts monitoring the urban family physician program and representatives of the family physicians and health care providers selected using the census method. The data collection tool was a two-part researcher-made questionnaire containing 15 questions with confirmed validity. To collect data, 29 panels of experts were held and the collected information was analyzed by SPSS 23 using independent t-tests and ANOVA. Results: Among the total of 647 participants in 2 provinces, 1540 achievement cases, 2387 challenge cases, and 1641 strategies were found. The average numbers of achievements, challenges, and strategies stated by each person were 2.38 ± 2.0, 3.70 ± 2.7, and 2.54 ± 2.0, respectively. The most frequent achievements, challenges, and strategies were increased disease detection and care (430), untimely payment to physicians (198), and providing sustainable resources for timely payments (119).  The means of achievements, challenges, and strategies had significant relationship with some of the individual and social variables (p < 0.05). Conclusion: This study showed that increasing the rate of detection was the most important achievement and lack of timely payment was the biggest challenge of the program, which should be considered by policy makers.

scholarly journals Spirituality as an Essential Element of Person-Centered Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 885-886
Author(s):  
Rachel Nathan ◽  
Deborah Zuercher ◽  
Steven Eveland ◽  
Anjana Chacko ◽  
Raya Kheirbek
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Health Care Providers ◽  
Spiritual Care ◽  
Ethical Issues ◽  
Critical Role ◽  
Essential Element ◽  
Care Providers ◽  
Sensitivity Assessment ◽  
Centered Care

Abstract Data demonstrate that the majority of patients with serious or chronic illness would like their clinicians to address their spirituality but that the majority of clinicians do not provide such care. Reasons cited include lack of training. Palliative Medicine, built on the biopsychosocial-spiritual model of care, has long recognized the critical role of spirituality in the care of patients with complex, serious, and chronic illness. There is mounting evidence that spiritual care is a fundamental component of all high-quality compassionate health care, and it is most effective when it is recognized and reflected in the attitudes and actions of both patients and health care providers. We conducted focus groups as a first step in the process to arrive at a consensus definition of “spiritual care.” A second step involved collecting and comparing frameworks and models that recognize that providers cannot be made compassionate simply through the imposition of rules; methods were needed to achieve behavior change. The study group developed and piloted curriculum to train health care providers. The created curricula covered the definitions of a spiritual care, self-awareness, cultural sensitivity, assessment, and skills. As part of ongoing curriculum development processes, training included evaluation tools to accompany skill development . Our work demonstrated the need for compassionate presence during encounters, for applying the spirituality in professional life; and for identifying ethical issues in inter-professional spiritual care. We concluded that it is feasible to train clinicians to address spirituality and provide holistic and patient-centered care in an effort to minimize suffering.

Ensuring Health Care Providers Have Comprehensive Communication Tools for Future Microbicide Introduction in Kenya: A Formative Research Study

2017 ◽  
Vol 3 (4) ◽  
pp. 246-254
Author(s):  
Allison P. Pack ◽  
Alesha Majors ◽  
Alice Olawo ◽  
Elizabeth E. Tolley ◽  
Caroline Mackenzie ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Critical Role ◽  
Sexual Relationships ◽  
Care Providers ◽  
Hiv Counseling ◽  
Vaginal Microbicide ◽  
Flip Chart ◽  
Research Assistants ◽  
Counseling Practices

As the field of HIV prevention advances and new antiretroviral (ARV)-based prevention products are developed, health care providers will play a critical role in promoting or limiting new product use. To provide evidence-based communication supporting potential product roll-out, we developed and assessed a suite of vaginal microbicide communication materials tailored to various Kenyan audiences. However, our materials could potentially be adapted for use with other ARV-based prevention products and settings. For health care providers, we developed three sets of materials: informational brochures, wall charts, and a counseling flip chart. Trained research assistants conducted 24 in-depth interviews with providers from a range of health facilities in Nairobi and Nakuru, Kenya. Interviews assessed providers’ current HIV counseling practices for women in different types of sexual relationships, attitudes toward vaginal microbicide gel, and thoughts on the content and usefulness of the microbicide communication materials; priority was given to the counseling flip chart. Interviews also included hypothetical counseling scenarios to assess providers’ potential to appropriately use materials and adapt their counseling techniques. Microbicide communication materials were well received and effective in educating providers about microbicides and in helping them provide appropriate counseling for hypothetical scenarios involving women in different sexual contexts.

Hepatitis C: Nutrition Care Canadian Guidelines for Health Care Providers

2003 ◽  
Vol 64 (3) ◽  
pp. 139-141 ◽  
Keyword(s):  
Health Care ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Health Care Providers ◽  
Scientific Evidence ◽  
Critical Role ◽  
Care Providers ◽  
Nutrition Care ◽  
On Line ◽  
Accepted Practice

Nutrition plays a critical role in the management of hepatitis C. Dietitians of Canada has developed comprehensive, evidencebased guidelines to familiarize health care providers with effective nutrition care for the growing number of Canadians infected with the hepatitis C virus. The complete guidelines and two supporting educational fact sheets are available for downloading from http://www.dietitians.ca/resources/HepatitisC_Guidelines.htm . The guidelines and fact sheets are available in both English and French. The guidelines contain the full text, practice essentials, references, and extensive appendices with practical tools to assist educators in promoting nutrition to persons infected with the hepatitis C virus. Reprinting or photocopying of the document is encouraged provided the source is acknowledged. In addition, an on-line education course is available for health care providers and is available on www.dieteticsatwork.ca . These guidelines are directed to all health care providers who are in a position to offer nutrition-related advice and guidance to persons infected with the hepatitis C virus, in all stages of the disease. A national advisory committee comprised of leading authorities in Canada steered the development of the guidelines. The guidelines are based on the best information available at the time of publication; where scientific evidence was not available, best-accepted practice is presented.

Intimate Partner Violence: Barriers to Action and Opportunities for Intervention Among Health Care Providers in São Paulo, Brazil

2019 ◽  
pp. 088626051988100 ◽  
Author(s):  
Dabney P. Evans ◽  
Danielle Z. Shojaie ◽  
Kashika M. Sahay ◽  
Nancy Williams DeSousa ◽  
Casey D. Hall ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Intimate Partner Violence ◽  
Health Care Providers ◽  
Partner Violence ◽  
Critical Role ◽  
Intimate Partner ◽  
Care Providers ◽  
Health Clinics ◽  
Public Health Clinics

Health care providers (HCPs) who directly interact with women play a critical role in intimate partner violence (IPV) prevention and response. The aim of this study was to identify the structural and interpersonal barriers to IPV response among HCPs working in public health clinics in Santo André, Brazil. Eligible participants included all HCPs providing direct care to individuals at three public health clinics. Participants self-administered an adapted Knowledge, Attitudes, and Practices survey on IPV. Data were analyzed using Epi Info 7 and SAS 9.4. 114 HCPs completed surveys. Less than half of HCPs (41%, n = 34) reported ever having asked a woman about abuse in the past year. HCPs who perceived fewer barriers were more likely to report asking about IPV. The top three reported barriers to asking women about IPV included the following: few opportunities for one-on-one interaction (77%, n = 65), a lack of privacy (71%, n = 60), and fear of offending women (71%, n = 60). Fewer providers who perceived the barriers of lack of privacy asked about IPV (50.8%, n = 33 compared with 84.2%, n = 16; p < .05); less providers who perceived few opportunities for private patient interactions asked about IPV (48.3%, n = 29 compared with 75.0%, n = 18; p < .05). Our results support the need for a systems approach of institution-wide reforms altering the health care environment and avoiding missed opportunities in IPV screening and referring women to appropriate resources or care. Two of the most frequently reported barriers to asking IPV were structural in nature, pointing to the need for policies that protect privacy and confidentiality. Within the Brazilian context, our research highlights the role of HCPs in the design and implementation of IPV interventions that both strengthen health systems and enable providers to address IPV.

scholarly journals Patients’ Shift from Public to Private Primary Health Care Providers in Lithuania: Analysis of the Main Reasons

2021 ◽  
Vol 58 ◽  
pp. 004695802110603
Author(s):  
Paulius Žvinakis ◽  
Roberta Kalibataitė ◽  
Vytenis Kalibatas
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Family Physician ◽  
Demographic Characteristics ◽  
Categorical Variables ◽  
Care Providers ◽  
Phone Calls ◽  
Primary Health ◽  
The Family

Aims Lithuania is one of the countries where public and private primary health care (PHC) providers compete for patients. Patients continuously shift from public to PHC providers, but an analysis of the main reasons was never performed. This study aimed to analyze the reasons why patients shift from public to private PHC providers and identify the associations between the reasons and demographic characteristics of the patients. Methods A cross-sectional study based on a phone questionnaire was conducted among patients who shifted from public to private primary health care (PHC) providers. A total of 810 phone calls were made, and 572 telephone surveys were completed. The response rate was 70.49%. The difference between the proportions was assessed using the Z-test. The association between categorical variables was assessed using the chi-square test. Results The study identified the following main reasons: long queues to obtain family physician appointments (23.6%), inconvenient location of public’s institution department (20.1%), patients relocating (19.2%), enrolment at a former family physician who transitioned from a public to private PHC institution (10.5%), and long waiting time at the family physician’s office for the appointment (9.4%). Some statistically significant correlations were found between the specific reasons for shifting from public to private PHC organizations and patients' demographic characteristics. Conclusions Personal reasons are the most common reasons for shifting from public to private PHC providers (43.36% of the respondents), following the reasons related exclusively to the family physician (25.17%) and related PHC institutions only (24.9%).

scholarly journals A qualitative study on the implementation of Family Health Team: the perspectives of providers and patients

2020 ◽  
Author(s):  
Ainul Nadziha Mohd Hanafiah ◽  
Mohammad Zabri Johari ◽  
Syafinas Azam
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Family Doctor ◽  
Family Health ◽  
Care Providers ◽  
Health Team ◽  
Primary Health ◽  
The Family ◽  
Family Health Team

Abstract Background: Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, particularly the family doctor concept. The Enhanced Primary Health Care (EnPHC) initiative was implemented to address the worrying upward trend of non-communicable disease[I1] prevalence, and incorporates the Family Health Team (FHT) concept. The aim of this paper is to describe the implementation of the FHT as part of the EnPHC intervention.Methods: In-depth interviews and focus group discussions were conducted with the intervention design team, healthcare providers and patients in two rounds during the implementation period. A total of 121 individuals in the two rounds, split into different groups, where some of the participants of the FGD were also interviewed individually[I2] . Data were analysed using a thematic analysis, with codes being organised into larger themes.Results: Themes that emerged from the data were around the process of FHT implementation and the advantages of the FHT, which included continuity of health care and improved quality of care. Patients and health care providers were receptive to the FHT concept, and took the effort to adapt the concept in the local settings. Conclusions: The FHT concept implemented at 20 public primary health clinics has benefits appreciated by health care providers and patients. Addressing the viable shortcomings would better prepare the current primary healthcare system to scale up the FHT concept nationwide and enhance its feasibility and sustainability.Trial registration: The study is registered with the National Medical Research Register, Ministry of Health Malaysia (NMRR-17-295-34771).

The Critical Role of Provider Practices in Undervaccination

PEDIATRICS ◽  
1996 ◽  
Vol 97 (5) ◽  
pp. 735-737
Author(s):  
Mark Grabowsky ◽  
Walter A. Orenstein ◽  
Edgar K. Marcuse
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Pertussis Vaccine ◽  
Critical Role ◽  
Immunization Coverage ◽  
Reminder Systems ◽  
Care Providers ◽  
Provider Practices ◽  
Full Benefit

There are five principal ways providers can raise immunization coverage levels among their patients. First, assure that all appropriate opportunities for vaccination are taken. Second, give patients all vaccines for which they are eligible. Third, use only valid contraindications. Fourth, assess immunization status and immunize at all visits, regardless of the reason the parent is seeking care. Fifth, implement aggressive reminder systems to notify parents when immunizations are due. The information presented here suggests that some changes in the way physicians deliver vaccinations are needed. Vaccination is one of the most beneficial services providers can give their patients. In addition to avoiding unnecessary suffering through prevention of disease, disability, and death, vaccination saves society from $6 for every $1 spent on oral poliovirus vaccine19 to $29.00 for every $1.00 spent on diphtheria-tetanus-pertussis vaccine.20 As health care providers, we have an opportunity to assure that our patients get the full benefit of this service. These results suggest that, once motivated, physicians and nurses should be able to determine the best way to get their patients vaccinated using a variety of techniques.

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