scholarly journals The prevalence of obesity documentation in Primary Care Electronic Medical Records

2017 ◽  
Vol 26 (01) ◽  
pp. 67-79 ◽  
Author(s):  
Ahmed Mattar ◽  
David Carlston ◽  
Glen Sariol ◽  
Tongle Yu ◽  
Ahmad Almustafa ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
International Classification Of Diseases ◽  
Morbidly Obese ◽  
Problem List ◽  
Cumulative Number ◽  
Exercise Counseling ◽  
Classification Of Diseases ◽  
Prevalence Of Obesity ◽  
And Gender

Summary Background: Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient’s problem list for patients with eligible body mass indexes (BMI) as contained in the patients’ electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels. Method: This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015. International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify obesity documentation in the EMR problem list. Univariate and multivariate logistic regression analyses were used. Results: Out of 10,540, a total of 3,868 patients were included in the study. 2,003 (52%) patients met the criteria for obesity (BMI30.0); however, only 112 (5.6%) patient records included obesity in the problem list. Moreover, in a multivariate analysis, in addition to age and gender, morbid obesity and cumulative number of comorbidities were significantly associated with obesity documentation, OR=1.6 and OR=1.3, respectively, with 95% CI [1.4, 1.9] and [1.0, 1.7], respectively. For those with obesity documentation, exercise counseling was provided more often than diet counselling. Conclusion: Based on EHR documentation, obesity is under coded and generally not identified as a significant problem in primary care. Physicians are more likely to document obesity in the patient record for those with higher BMI scores who are morbidly obese. Moreover, physicians more frequently provide exercise than diet counseling for the documented obese.

scholarly journals Online Ratings of Primary Care Physicians: Comparison of Gender, Training, and Specialty

2021 ◽  
Vol 8 ◽  
pp. 237437352110077
Author(s):  
Daliah Wachs ◽  
Victoria Lorah ◽  
Allison Boynton ◽  
Amanda Hertzler ◽  
Brandon Nichols ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Waiting Times ◽  
Wait Time ◽  
Primary Care Providers ◽  
Wait Times ◽  
Care Providers ◽  
Female Physicians ◽  
Online Ratings ◽  
And Gender

The purpose of this study was to explore patient perceptions of primary care providers and their offices relative to their physician’s philosophy (medical degree [MD] vs doctorate in osteopathic medicine [DO]), specialty (internal medicine vs family medicine), US region, and gender (male vs female). Using the Healthgrades website, the average satisfaction rating for the physician, office parameters, and wait time were collected and analyzed for 1267 physicians. We found female doctors tended to have lower ratings in the Midwest, and staff friendliness of female physicians were rated lower in the northwest. In the northeast, male and female MDs were rated more highly than DOs. Wait times varied regionally, with northeast and northwest regions having the shortest wait times. Overall satisfaction was generally high for most physicians. Regional differences in perception of a physician based on gender or degree may have roots in local culture, including proximity to a DO school, comfort with female physicians, and expectations for waiting times.

scholarly journals Age and gender based prevalence of obesity in residents of Punjab, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1038 ◽  
Author(s):  
Satinderjit Singh ◽  
Ravjit Kaur Sabharwal ◽  
Jagminder Kaur Bajaj ◽  
Indira R. Samal ◽  
Megha Sood
Keyword(s):  
Morbid Obesity ◽  
Action Plan ◽  
Age Groups ◽  
Neurological Complications ◽  
Overweight And Obesity ◽  
Morbidly Obese ◽  
Prevalence Of Obesity ◽  
Study Population ◽  
Gender Based ◽  
And Gender

Background: Obesity is recognized as a chronic disease, associated with a variety of metabolic, cardiovascular and neurological complications. Prevalence of obesity is increasing worldwide, more so in the developing countries. It is affecting both sexes and all age groups. Body mass index BMI along with presence and severity of obesity associated complications are used to identify, successively increasing stages of obesity. The present study aims to study prevalence of overweight, obesity (stage 0,1,2) and morbid obesity in adult residents of Punjab state in an effort to determine burden of this lifestyle disorder in different age groups and sexes, so that a comprehensive action plan can be designed to target appropriate group with specific preventive measures .Methods: 1000 subjects were surveyed and labelled as non-obese, overweight, obese or morbid obese based on their BMI, presence and severity of obesity related complications. Point prevalence amongst different age groups of both sexes were determined and compared.Results: In study population 41.5% subjects were non-obese, 15.9% were overweight, 29.4% were obese and 13.2% were morbidly obese. The prevalence of all the 3 conditions (overweight, obesity and morbid obesity) increased with increasing age in both sexes. The prevalence was more among females of all age groups than males for ‘overweight’ and ‘obesity’. But gender based difference narrowed down with increasing severity of disease, such that female to male ratio reversed (<1) for morbid obesity. Moreover, peak prevalence of overweight and obesity were attained little later in females as compared to males. However, for morbid obesity peak prevalence is seen in same age group (40-49 years) in both sexes.Conclusions: Overweight and obesity are more prevalent among females of all age groups than males with peak prevalence achieved little later in females as compared to males. However, gender based differences in prevalence decreased as severity increased and morbid obesity was more prevalent among males than females.

scholarly journals Trends in the Treatment of Dupuytren Disease in the United States Between 2007 and 2014

Hand ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Marc D. Lipman ◽  
Samuel Evan Carstensen ◽  
Dylan Nicole Deal
Keyword(s):  
United States ◽  
Treatment Options ◽  
International Classification Of Diseases ◽  
The United States ◽  
Classification Of Diseases ◽  
And Gender ◽  
Needle Aponeurotomy ◽  
Gender Change ◽  
Dupuytren Disease

Background: Dupuytren disease is a common fibroproliferative disorder. Multiple procedural treatment options are available, with Collagenase Clostridium Histolyticum (CCH) injection being introduced in 2010. The purpose of this study was to investigate trends in the treatment of Dupuytren disease in the United States between 2007 and 2014. Methods: The PearlDiver Humana database was queried using International Classification of Diseases, Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) codes for patients with Dupuytren disease that received percutaneous needle aponeurotomy (PNA), fasciotomy, fasciectomy, and CCH injection. Patients were filtered by age, number of comorbidities, and gender. Change in composition of treatments over time was analyzed for each demographic group between 2007 and 2014. Results: Patients presenting to clinic for Dupuytren disease increased from 1118 to 3280, with unchanging treatment percentage of 41. Percent fasciotomies and fasciectomies decreased from 5% to 3% and 33% to 21%, while CCH injection increased to 11% by 2012 to 2014. Percent fasciotomies decreased ( P < .05) in younger healthier (age <65, 0-1 comorbidities) and older less healthy (age 65-74, 4+ comorbidities) populations. Percent fasciectomies decreased significantly in nearly all age and comorbidity groups, but by greater amounts in patients with 2+ comorbidities with increasing age. Percent CCH injections increased in all groups, at rates similar to the losses seen in open procedures. Conclusions: CCH injections have risen to substantial levels, with corresponding decreases in the percentage of patients receiving fasciotomies and fasciectomies. Patient age, comorbidities, and gender appear to have influence on the treatment chosen, likely due to their effects on surgical risk and the importance of timely return to activity.

Likelihood of Normal ABI Increases With Physiologic Testing Referrals From Rural Primary Care Physicians

2019 ◽  
Vol 43 (3) ◽  
pp. 123-127
Author(s):  
Robert P. Scissons ◽  
Abraham Ettaher ◽  
Sophia Afridi
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Bypass Graft ◽  
Ankle Brachial Index ◽  
Care Physician ◽  
Health Care Facilities ◽  
Rural Primary Care ◽  
And Gender

Disparities in diagnostic capabilities have been noted between rural and urban health care facilities. We believe the clinical evaluation of peripheral arterial disease (PAD) by rural physicians may be similarly affected. Patients referred for arterial physiologic testing in an urban and rural regional health care network for a consecutive 7-month period were reviewed. Patients were classified into 3 groups based on referring physician specialty: (1) vascular surgeon or vascular medicine specialist (Vasc), (2) urban primary care physician (Urban), and (3) rural primary care physician (Rural). Normal patients were defined by a posterior tibial (PT) or dorsalis pedis (DP) ankle-brachial index (ABI) of ⩾0.90, bilaterally. Abnormal patients had both PT and DP ABI <0.90 in one or both extremities. Group comparisons were made for normal and abnormal patients, age (⩾65 years old), and gender. Patients with history of amputations, angioplasty, bypass graft, stent, calcification (PT or DP ABI ⩾1.30), and previous physiologic testing outside the designated period of analysis were considered a separate subclassification and analyzed separately. Emergency room referrals, inpatients, and patients with incomplete examination data were excluded from the analysis. A total of 430 patient exams were evaluated. Group-Rural had significantly greater numbers of normal ABI patients compared with Group-Urban ( P = .0028) and Group-Vasc ( P = .0000). No significant differences were noted between all groups for age and gender. Substantial disparities were noted in normal and abnormal ABI patients between rural health care physicians and their urban primary care and vascular specialist counterparts. Significantly greater numbers of normal ABI referrals by rural primary care physicians may warrant enhanced PAD diagnosis education or telemedicine alternatives.

Ocular emergencies presenting to an emergency department in Central Spain from 2013 to 2018

2019 ◽  
pp. 112067211989642
Author(s):  
Alicia Galindo-Ferreiro ◽  
Hortensia Sanchez-Tocino ◽  
Yago Varela-Conde ◽  
Cecilia Diez-Montero ◽  
Minal Belani-Raju ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Primary Care Physicians ◽  
International Classification Of Diseases ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Care Providers ◽  
Primary Health Care Providers ◽  
Ocular Surface Diseases ◽  
Classification Of Diseases

Purpose: To determine the frequency of ocular conditions among patients presenting to an emergency department at a tertiary hospital in Spain. Methods: A retrospective, longitudinal analysis of all patients who presented to the ocular emergency department of Rio Hortega University Hospital, Valladolid, Spain, from 2013 to 2018 was performed. Data on demographics, ophthalmic examination, and diagnosis were collected. Diseases were classified according the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Results: We had 20,822 patients, of which 10,878 (52.2%) were women. The main age categories were 45–65 years (7391 patients; 35.5%) and 15–45 years (5979 patients; 28.2%). Most of the patients (17,793; 85.5%) were discharged on the same day. Conjunctival pathology was the most common cause of presentation (4110; 19.7%), followed by corneal disorders (4025; 19.3%). Acute conjunctivitis was diagnosed in 2920 (14%) and ocular trauma in 2125 (10.2%) patients. Non-emergency ophthalmic conditions were diagnosed in 1581 (7.6%) patients. Retinal detachments and peripheral holes occurred more commonly in patients aged 45–65 years ( p <0.001). Corneal or conjunctival disorders and lid inflammation ( p <0.001) were more frequent in women, whereas men had higher incidences of trauma ( p <0.001). Conclusion: Most of our patients presented ocular surface diseases. Men were more vulnerable to trauma, mainly superficial foreign body. The majority of the patients presented with uncomplicated ocular conditions that would be managed more cost-effectively by primary health care providers. We advocate greater education of primary care physicians and patients in managing simple ocular emergencies to reduce the cases presenting to an emergency department of a tertiary hospital.

scholarly journals Mortality from idiopathic pulmonary fibrosis: a temporal trend analysis in Brazil, 1979-2014

2017 ◽  
Vol 43 (6) ◽  
pp. 445-450 ◽  
Author(s):  
Eduardo Algranti ◽  
Cézar Akiyoshi Saito ◽  
Diego Rodrigues Mendonça e Silva ◽  
Ana Paula Scalia Carneiro ◽  
Marco Antonio Bussacos
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Temporal Trend ◽  
Population Aging ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Age Group ◽  
Classification Of Diseases ◽  
And Gender

ABSTRACT Objective: To analyze mortality from idiopathic pulmonary fibrosis (IPF) in Brazil over the period 1979-2014. Methods: Microdata were extracted from the Brazilian National Ministry of Health Mortality Database. Only deaths for which the underlying cause was coded as International Classification of Diseases version 9 (ICD-9) 515 or 516.3 (until 1995) or as ICD version 10 (ICD-10) J84.1 (from 1996 onward) were included in our analysis. Standardized mortality rates were calculated for the 2010 Brazilian population. The annual trend in mortality rates was analyzed by joinpoint regression. We calculated risk ratios (RRs) by age group, time period of death, and gender, using a person-years denominator. Results: A total of 32,092 deaths were recorded in the study period. Standardized mortality rates trended upward, rising from 0.24/100,000 population in 1979 to 1.10/100,000 population in 2014. The annual upward trend in mortality rates had two inflection points, in 1992 and 2008, separating three distinct time segments with an annual growth of 2.2%, 6.8%, and 2.4%, respectively. The comparison of RRs for the age groups, using the 50- to 54-year age group as a reference, and for the study period, using 1979-1984 as a reference, were 16.14 (14.44-16.36) and 6.71 (6.34-7.12), respectively. Men compared with women had higher standardized mortality rates (per 100,000 person-years) in all age groups. Conclusion: Brazilian IPF mortality rates are lower than those of other countries, suggesting underdiagnosis or underreporting. The temporal trend is similar to those reported in the literature and is not explained solely by population aging.

scholarly journals The Role of COVID-19 in the Death of SARS-CoV-2–Positive Patients: A Study Based on Death Certificates

2020 ◽  
Vol 9 (11) ◽  
pp. 3459 ◽  
Author(s):  
Francesco Grippo ◽  
Simone Navarra ◽  
Chiara Orsi ◽  
Valerio Manno ◽  
Enrico Grande ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
Hypertensive Heart Disease ◽  
International Classification Of Diseases ◽  
Death Certificates ◽  
Respiratory Complications ◽  
Classification Of Diseases ◽  
Underlying Cause Of Death ◽  
And Gender ◽  
Low Prevalence

Background: Death certificates are considered the most reliable source of information to compare cause-specific mortality across countries. The aim of the present study was to examine death certificates of persons who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to (a) quantify the number of deaths directly caused by coronavirus 2019 (COVID-19); (b) estimate the most common complications leading to death; and (c) identify the most common comorbidities. Methods: Death certificates of persons who tested positive for SARS-CoV-2 provided to the National Surveillance system were coded according to the 10th edition of the International Classification of Diseases. Deaths due to COVID-19 were defined as those in which COVID-19 was the underlying cause of death. Complications were defined as those conditions reported as originating from COVID-19, and comorbidities were conditions independent of COVID-19. Results: A total of 5311 death certificates of persons dying in March through May 2020 were analysed (16.7% of total deaths). COVID-19 was the underlying cause of death in 88% of cases. Pneumonia and respiratory failure were the most common complications, being identified in 78% and 54% of certificates, respectively. Other complications, including shock, respiratory distress and pulmonary oedema, and heart complications demonstrated a low prevalence, but they were more commonly observed in the 30–59 years age group. Comorbidities were reported in 72% of certificates, with little variation by age and gender. The most common comorbidities were hypertensive heart disease, diabetes, ischaemic heart disease, and neoplasms. Neoplasms and obesity were the main comorbidities among younger people. Discussion: In most persons dying after testing positive for SARS-CoV-2, COVID-19 was the cause directly leading to death. In a large proportion of death certificates, no comorbidities were reported, suggesting that this condition can be fatal in healthy persons. Respiratory complications were common, but non-respiratory complications were also observed.

scholarly journals Rural–urban differences in suicide attempts and mortality among young people in northern Sweden, 1998–2017: A register-based study

2020 ◽  
Vol 48 (8) ◽  
pp. 794-800
Author(s):  
Miguel San Sebastián ◽  
Anette Edin-Liljegren ◽  
Frida Jonsson
Keyword(s):  
Suicide Attempts ◽  
International Classification Of Diseases ◽  
Northern Region ◽  
Northern Sweden ◽  
Men And Women ◽  
Diagnostic Codes ◽  
Classification Of Diseases ◽  
Rural Municipalities ◽  
And Gender ◽  
Suicide Prevention Programs

Aim: The aim of this study was to assess trends in suicide attempts and mortality between 1998 and 2017 by residential area and gender among northern Swedish youths. Methods: Events of suicide attempts and deaths for each municipality in the four counties of the northern Swedish region, stratified by gender, were retrieved for each year from 1998 to 2017. All cases identified within the registers with the diagnostic codes X60–X84 or Y10–Y34 (International Classification of Diseases, 10th revision) for individuals aged 15–24 years were included. Place of residence at municipal level was categorized into three groups: rural – municipalities with a population of <10,000 inhabitants; semi-rural – those between 10,000 and 50,000; and urban – those with >50,000 inhabitants. Results: The rates of attempted suicides in the northern region were higher in both men and women than in Sweden, while the rates of suicide deaths were slightly higher in young men but similar in young women compared to the national averages. Overall, the risk of suicide attempts was higher in semi-rural municipalities compared to urban ones, particularly among women. A significantly higher risk of mortality was also observed for men and women in semi-rural municipalities, but only in the period 2010–2013. Conclusions: The high rates of attempted and completed suicides among youth in northern Sweden and the higher risks in rural and semi-rural municipalities need close attention. The implementation of suicide prevention programs, especially in rural and semi-rural municipalities, should be intensified.

Electronic Consults in Otolaryngology: A Pilot Study to Evaluate the Use, Content, and Outcomes in an Academic Health System

2019 ◽  
Vol 129 (2) ◽  
pp. 170-174 ◽  
Author(s):  
Sapideh Gilani ◽  
Krishna Bommakanti ◽  
Lawrence Friedman
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Primary Care Physicians ◽  
Multinomial Logistic Regression ◽  
Medical Center ◽  
Office Visits ◽  
Use Of Resources ◽  
And Gender ◽  
The University

Objectives: To categorize the primary reasons for electronic consults (eConsults) to otolaryngology from primary care physicians (PCPs). To determine how many patients avoided subsequent in-person otolaryngology office visits. Methods: This is a retrospective analysis of a pilot study that took place between 2016 and 2017 regarding eConsults to adult otolaryngology placed by primary care physicians at the University of California, San Diego (UCSD) Medical Center. The complaints were categorized as related to the following: ear, nose, throat or neck. Initial recommendations were classified as (1) providing education only (no intervention), (2) suggesting medical therapy provided by the PCP, or (3) suggesting surgical intervention. Univariate statistics and multinomial logistic regression were used to analyze the association of problem type with the need for follow-up in the otolaryngology offices. The data was analyzed for differences in patient age and gender. Results: The study population included 64 patients (average age 54.6 years, 60.9% male). Within this group, 41% of consults were for ear complaints, 15% for nose complaints, 28% had throat-related complaints, and 16% had neck-related complaints. In-person follow-up was not required for 82.8% of the consults. Overall, 76.9% of ear, 100% of nose, 88.9% of throat, and 70.0% of neck complaints did not require in-person visits. Conclusions: eConsults to otolaryngology were primarily for ear concerns. Of the eConsults, 82.4% did not require in-person follow-up. We therefore conclude that the use of eConsults prevented substantial office visits that would not otherwise be necessary. Efforts should be made to promote the widespread use of eConsults, which may to the more efficient use of resources.

scholarly journals Morbidity and GH deficiency: a nationwide study.

2008 ◽  
Vol 158 (4) ◽  
pp. 447-457 ◽  
Author(s):  
Kirstine Stochholm ◽  
Torben Laursen ◽  
Anders Green ◽  
Peter Laurberg ◽  
Marianne Andersen ◽  
...  
Keyword(s):  
Gh Deficiency ◽  
Neurological Diseases ◽  
International Classification Of Diseases ◽  
Childhood Onset ◽  
National Patient Registry ◽  
Hazard Ratios ◽  
Classification Of Diseases ◽  
National Patient ◽  
And Gender

ObjectiveTo estimate morbidity in Denmark in all patients with GH deficiency (GHD).DesignMorbidity was analyzed in 1794 GHD patients and 8014 controls matched on age and gender. All records in the GHD patients were studied and additional morbidity noted. Diagnoses and dates of admissions were identified in the National Patient Registry. Lag time until first admission was used as a measure of morbidity. Patients were divided into childhood onset (CO) and adult onset (AO), discriminated by an age cut-off of 18 years at onset of GHD.MethodSex- and cause-specific hazard ratios (HRs) in CO and AO GHD compared with controls.ResultsTotal morbidity was significantly increased in the GHD patients. HR for CO males: 3.1 (95% confidence interval (CI): 2.7–3.7), CO females: 3.2 (95% CI: 2.6–3.9), AO males: 2.9 (95% CI: 2.6–3.2), and AO females: 3.2 (95% CI: 2.8–3.6). In 18 out of 20 chapters from the International Classification of Diseases-10, a significantly increased morbidity was identified for at least one of the four subgroups of patients. Morbidity was significantly increased in all the four subgroups due to infectious, endocrine, pulmonary, urogenital, and neurological diseases; cancer; diseases of the eye, ear, and circulatory diseases; and traumas. Fractures were significantly increased in AO females, not in males.ConclusionsMorbidity was significantly increased in the GHD patients. The increased morbidity was due to a variety of disorders, some of which can readily be explained by GHD and other pituitary deficiencies, while others cannot be easily explained.

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