Family practice
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Observational Study
Variation in general practice referral rate to acute medicine services and association with hospital admission. A retrospective observational study.
Variation in general practice (GP) referral rates to outpatient services is well described however variance in rates of referral to acute medical units is lacking. ⋯ High variation in GP practice referral rate for acute medical assessment is incompletely explained by practice population socioeconomic factors and negatively associates with need for urgent inpatient care. Identifying modifiable factors influencing referral rate may provide opportunities to facilitate community-based care and reduce congestion on acute unscheduled care pathways.
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Spinal muscular atrophy (SMA) is a rare genetic disease with a broad spectrum of severity. Although an early diagnosis of SMA is crucial to allow proper management of patients, the diagnostic delay is still an issue. Therefore, this study aimed to investigate the clinical correlates of SMA among primary care patients. ⋯ Our findings suggest that primary care databases may be used to enhance the early identification of SMA. Additional efforts are needed to exploit the electronic health records of general practitioners to allow early recognition of SMA.
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Abdominal obesities are better markers for predicting cardiovascular abnormalities than risk stratification based only on body mass index (BMI). We aimed to estimate the prevalence of abdominal adiposities using predictive equations for Asian Indian adults and to determine the prevalence of metabolically healthy subjects among those overweight/obese and with normal BMI. ⋯ We highlight the substantially high prevalence of IAAT, TAF, and SCAT in the district of Puducherry. Almost all the study population was metabolically unhealthy irrespective of their BMI levels.
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Multimorbidity is prevalent in general practice and general practitioners internationally report challenges in its management. Understanding the perspectives of general practitioners at the frontline of care is important for system sustainability and accessibility as populations age. ⋯ Australian general practitioners share many multimorbidity concerns with international colleagues. While multimorbidity-specific evidence may be unrealistic to expect in the immediate term, system investment and adaptation is needed to support general practice sustainability and clinician ability to provide adequate multimorbidity care, suitably remunerated, into the future.
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Continuity of care (CoC) is an important component of health care delivery that can have cost implications and improve patient outcomes. We analysed data obtained from the Department of Veterans Affairs to examine the relationship between CoC and use of image-oriented diagnostic tests in patients with comorbid chronic conditions. ⋯ Overall, greater CoC was associated with fewer use of tests, representing a greater presumed efficiency of care. This has implications for designing health care delivery.