Primary Health Care Utilisation Among Survivors of Childhood Acute Lymphoblastic Leukaemia

Abstract. Greater investments and improvements in primary health care (PHC) can provide benefits in reducing the high costs of hospital admissions. Potentially preventable hospitalisations (PPH) are a health system performance indicator used to evaluate access to and effectiveness of community-based health services. The Western Australia Department of Health obtained detailed primary health care data, for the first time at the postcode level scale, and analysed its associations with PPH information for selected conditions. PHC data obtained from the Commonwealth Department of Health for the financial year 2013/14 was Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) records at postcode level. In this paper we explore the sensitivity of various benchmarks of spatial zonings for comparison of diabetes-related primary health care utilisation and potentially preventable hospitalisations and then examine the relationship between them among the various spatial zonings. From the geospatial visualisation and analysis undertaken, conclusions are drawn about the patterns and relationships between diabetes-related primary health care utilisation and potentially preventable hospitalisations. The scale of spatial zonings used for comparison is important as too large or too small areas may mask out the relative geospatial variation of diabetes-related PHC utilisation and PPH evident among postcode areas.

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Analysis of primary health care utilisation in south-western Finland—a tool for management

Health Policy ◽

10.1016/s0168-8510(03)00116-7 ◽

2003 ◽

Vol 66 (3) ◽

pp. 229-238 ◽

Cited By ~ 6

Author(s):

P.T. Ovaskainen ◽

P.T. Rautava ◽

A. Ojanlatva ◽

J.K. Päkkilä ◽

R.M. Päivärinta

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care Utilisation ◽

Primary Health ◽

Care Utilisation

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Primary health care utilisation and its costs among middle-aged smokers

The European Journal of Health Economics ◽

10.1007/s10198-016-0793-2 ◽

2016 ◽

Vol 18 (3) ◽

pp. 351-360 ◽

Cited By ~ 2

Author(s):

Jaana Keto ◽

Hanna Ventola ◽

Jari Jokelainen ◽

Markku Timonen ◽

Kari Linden ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care Utilisation ◽

Middle Aged ◽

Primary Health ◽

Care Utilisation

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Health care utilisation preceding relapse or second malignant neoplasm after childhood acute lymphoblastic leukaemia: a population-based matched cohort study

BMJ Open ◽

10.1136/bmjopen-2021-050285 ◽

2021 ◽

Vol 11 (8) ◽

pp. e050285

Author(s):

Karen Schow Jensen ◽

Birgitte Klug Albertsen ◽

Henrik Schrøder ◽

Alina Zalounina Falborg ◽

Kjeld Schmiegelow ◽

...

Keyword(s):

Health Care ◽

General Practice ◽

Malignant Neoplasm ◽

Population Based ◽

Health Care Utilisation ◽

Second Malignant Neoplasm ◽

Childhood All ◽

Bimodal Structure ◽

Childhood Acute Lymphoblastic Leukaemia ◽

Care Utilisation

ObjectivesTo investigate health care utilisation including both primary and secondary health care 6 months before the diagnosis of a relapse or a second malignant neoplasm (SMN) in survivors of childhood acute lymphoblastic leukaemia (ALL).Design and settingA Danish population-based matched cohort study linking multiple nationwide registries.ParticipantsParticipants were recruited from a total of 622 childhood ALL 2.5-year event-free survivors diagnosed between 1994 and 2015. Cases were survivors developing a relapse or an SMN and references were survivors still in first remission. Each case was matched with five references on age, sex, treatment protocol and risk group.Primary outcome measuresConsultations in general practice and hospital the last 6 months before relapse or SMN. Cases and references were compared with monthly incidence rate ratios (IRRs) from negative binomial regression models.ResultsOf the 622 childhood ALL survivors, 60 (9.6%) developed a relapse (49) or an SMN (11) and 295 matched references were identified. Health care utilisation in general practice increased among cases the last month before the event compared with references with an IRR of 2.71 (95% CI 1.71 to 4.28). Data showed a bimodal structure with a significantly increased number of visits 4, 5 and 6 months before the event. Hospital health care utilisation increased 2 months before the event in cases with an IRR of 5.01 (3.78 to 6.63) the last month before the event and an IRR of 1.94 (1.32 to 2.85) the second-last month comparing cases and references.ConclusionsSurvivors of childhood ALL developing a relapse or an SMN have a short period of increased health care utilisation before diagnosis. At hospital, this might be explained by pre-diagnostic examinations. In general practice, data suggest a bimodal structure with children later developing a relapse having more contacts also half a year before the relapse, suggesting that there could be early warnings.

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Skin diseases in children in rural Kenya: long-term results of a dermatology project within the primary health care system

British Journal of Dermatology ◽

10.1046/j.1365-2133.2001.03962.x ◽

2001 ◽

Vol 144 (1) ◽

pp. 118 ◽

Cited By ~ 6

Author(s):

W. Schmeller

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care System ◽

Skin Diseases ◽

Long Term Results ◽

Primary Health Care System ◽

Primary Health ◽

Rural Kenya ◽

Care System

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Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽

10.1027/0227-5910/a000589 ◽

2019 ◽

Vol 40 (6) ◽

pp. 422-428 ◽

Cited By ~ 1

Author(s):

Chris Rouen ◽

Alan R. Clough ◽

Caryn West

Keyword(s):

Health Care ◽

Primary Health Care ◽

Care Center ◽

Indigenous Communities ◽

Indigenous Australians ◽

Deliberate Self Harm ◽

Health Care Center ◽

Far North ◽

Primary Health ◽

Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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