Scandinavian journal of primary health care
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Scand J Prim Health Care · Sep 2021
Observational StudyWeak association between socioeconomic Care Need Index and primary care visits per registered patient in three Swedish regions.
The objective was to examine the association between primary care consultations and a Care Need Index (CNI) used to compensate Swedish primary care practices for the extra workload associated with patients with low socioeconomic status. ⋯ For most levels of the CNI, there was no association with the number of consultations provided. This result may indicate insufficient compensation, weak incentives to spend the money, decisions to spend the money on other things than consultations, or stronger competition for patients among low-CNI practices. The result of this observational study should not be taken as evidence against the possibility that the CNI adjustment of capitation may have affected the socioeconomic equity in GP and nurse visits.Key PointsSwedish primary care practices receive extra compensation for socioeconomically deprived patients but it is unknown how this affects service provision.Practice-level data from three regions years 2017-2018 indicate weak or no relation between the socioeconomic burden and the number of physical consultations per patient.Results are similar when adjusting for patients' morbidity levels, suggesting that the weak gradient was not explained by longer consultations.The exception is that a small number of practices with very high burdens provide more consultations per patient.The results may reflect insufficient compensation, lack of incentives, or funds being spent on other things than consultations.
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Scand J Prim Health Care · Sep 2021
Good communication was valued as more important than accessibility according to 707 Nordic primary care patients: a report from the QUALICOPC study.
To explore Nordic patients' ranking of the importance of different aspects of general practice. ⋯ Organisational framework for general practice must allow for acceptable communication quality as well as availability.Key pointsIn order to identify relevant service areas for quality improvement in primary care, we aimed to increase knowledge of patient ranked importance of different dimensions of care.Nordic primary care patients valued good communication and involvement in decisions higher than accessibility to care.A singular focus on the access of care when developing services may not be in accordance with patient preferences.
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Scand J Prim Health Care · Sep 2021
Personal responsibility for health? A phenomenographic analysis of general practitioners' conceptions.
To analyse and describe general practitioners' perceptions of the notion of a 'personal responsibility for health'. ⋯ The notion of personal responsibility for health is relevant to GPs. However, it is open to a broad range of interpretations and modulated by the patient-physician interaction. This may make it unsuitable for usage in health care priority settings. More research is mandated to further investigate how physicians work with patient responsibility, and how this affects the patient-physician relationship and the physician's own well-being.Key PointsThe notion of personal responsibility for health has relevance for discussions about priority setting and person-centred care.This study, using a phenomenographic approach, investigated the views of Swedish GPs about the notion of personal responsibility for health.The participants found the notion relevant to their practice. They expressed a broad range of views of what a personal responsibility for health entails and how it arises. The GP was described as playing a key role in shaping and defining the patient's responsibilities for his/her health.The notion was emotionally charged to the participants, and when patients were seen as offloading all responsibility onto the GP this gave rise to frustration.
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Scand J Prim Health Care · Sep 2021
Multicenter Study Observational StudyWhite-coat hypertension detected during opportunistic blood pressure screening in a dental healthcare setting.
To study white-coat hypertension (WCHT, blood pressure ≥140/90 mmHg in a clinic and normal blood pressure <135/85 mmHg at home), with blood pressure screening of a healthy population during their dental healthcare visit and the associated risk factors. ⋯ The prevalence of WCHT in a healthy population was 17.7%. Regarding cardiovascular risk factors, WCHT seems to be in the middle of NT and HT. Individuals with WCHT can be identified and given lifestyle advice in connection with a dental check-up, but follow-up and assessment of their cardiovascular risk should take place in primary care.Key pointsScreening in dental practice can detect white-coat hypertension (WCHT) (17.7%) and suspected hypertension (HT) (12.4%).Individuals with WCHT have more cardiovascular risk factors than normotensive individuals.Individuals with WCHT could be given lifestyle advice in dental clinics according to current guidelines.
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Scand J Prim Health Care · Sep 2021
General practitioners' self-reported competence in the management of sexual health issues - a web-based questionnaire study from Finland.
Objective Although sexual problems are common, they are rarely brought up in appointments with general practitioners (GPs). We aimed to assess the barriers that hinder GPs from bringing up sexual health issues and to evaluate the need for education on sexual medicine. Design A web-based questionnaire was used. ⋯ In our study, the GPs reported a high competence in discussing patients' sexual health issues regardless of the patient's gender. However, several barriers to bringing up sexual health issues in appointments emerged. A majority of the GPs expressed a need for continuing education about sexual medicine.