Scandinavian journal of primary health care
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Scand J Prim Health Care · Dec 2019
The ecology of medical care: access points to the health care system in Austria and other developed countries.
Objective: This study aimed to analyze the Austrian health care system using the ecology of care model. Our secondary aim was to compare data from Austria with those available from other countries. Design: 3508 interviews employing a 30-item questionnaire related to the utilization of the health care system including demographic factors were conducted. ⋯ Key pointsIn Austria and similarly organized countries, there appears to be high utilization of health care in general, as well as with particular utilization of specialists and hospitalizations. The high utilization of all levels of care in Austria may be the result of competition, lack of a clear demarcation line between the primary and secondary level of care, and the presence of universal health coverage. Pathways between primary and secondary care should be strengthened as previous studies have shown that comparable countries lack the health benefits of strong primary care and its function for health care coordination.
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Scand J Prim Health Care · Dec 2019
Multicenter StudyLegitimacy of work tasks, psychosocial work environment, and time utilization among primary care staff in Sweden.
Objective: Primary care staff faces a complex work environment including a heavy administrative work load and perceive some work tasks as illegitimate. This study aimed to elucidate associations between the perceived legitimacy of work tasks, the psychosocial work environment, and the utilization of work time among Swedish primary care staff. Design and setting: The study was designed as a multicenter study involving all staff categories, i.e. registered nurses, primary care physicians, care administrators, nurse assistants and allied professionals, at eleven primary care centers in Sweden. ⋯ Also, the perception of having to perform a large amount of illegitimate work tasks affected the psychosocial work environment negatively, which might influence staffs perception of their professional roles. These results illuminate the importance of decision makers to thoroughly consider the distribution and allocation of non-patient related work tasks among staff in primary care. Key pointsWe observed an interaction between perception of having a large proportion of illegitimate work tasks and impaired psychosocial work environment. • More than a quarter of the primary care physicians perceived a high proportion of unnecessary work tasks.• Across all staff groups, performing unreasonable work tasks was associated with an experience of having role conflicts.• Across all staff groups, a perception of performing unreasonable work tasks was associated with the proportion of non-patient related administrative work tasks.
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Scand J Prim Health Care · Dec 2019
Erroneous computer-based interpretations of atrial fibrillation and atrial flutter in a Swedish primary health care setting.
Objective: To describe the incidence of incorrect computerized ECG interpretations of atrial fibrillation or atrial flutter in a Swedish primary care population, the rate of correction of computer misinterpretations, and the consequences of misdiagnosis. Design: Retrospective expert re-analysis of ECGs with a computer-suggested diagnosis of atrial fibrillation or atrial flutter. Setting: Primary health care in Region Kronoberg, Sweden. ⋯ In a Swedish primary care setting, computer-based ECG interpretations of atrial fibrillation or atrial flutter were incorrect in 89 of 988 (9.0%) consecutive cases. Incorrect computer diagnoses of atrial fibrillation or atrial flutter were not corrected by the primary-care physician in 47% of cases. In 12 of the cases with an incorrect computer rhythm diagnosis, misdiagnosed atrial fibrillation or flutter led to inappropriate treatment with anticoagulant therapy.
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Scand J Prim Health Care · Dec 2019
Observational StudyFractures diagnosed in primary care - a five-year retrospective observational study from a Norwegian rural municipality with a ski resort.
Objective: The aim of this study was to characterize fractures recorded at a Norwegian primary care centre near a ski resort. Design: A retrospective five-year observational study in the period 2010-2014. Setting: A primary care centre equipped with an x-ray machine and located near a ski resort in a small rural municipality of 931 inhabitants in Norway. ⋯ More than 60% had fractures in the wrist, collarbone, shin or ankle. More than half of the patients with a fracture were males and below 20 years old. Most fractures were ski-related.
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Scand J Prim Health Care · Dec 2019
Randomized Controlled Trial Multicenter StudyInforming patients on planned consultation time - a randomised controlled intervention study of consultation time in primary care.
Objective: To investigate whether patients' pre-consultation knowledge of the time frames for the consultation influences the actual consultation time and/or patient and physician related outcomes; satisfaction and enablement. Design: Randomised controlled blinded intervention study. Setting: Four strategically chosen Primary Health Care Centres (PHCC:s) in Kronoberg county in Sweden participated. ⋯ Key pointsPatients prepare before their consultation but to influence its contents and length is difficult. Informing patients on estimated consultation time can influence actual consultation time. Informing patients on planned consultation time has no adverse effects in this study.