Scandinavian journal of primary health care
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Scand J Prim Health Care · Mar 2024
Observational StudyInsulin initiation in patients with type 2 diabetes is often delayed, but access to a diabetes nurse may help-insights from Norwegian general practice.
Objective: We opted to study how support staff operational capacity and diabetes competences may impact the timeliness of basal insulin-initiation in general practice patients with type 2 diabetes (T2D). Design/Setting/Outcomes: This was an observational and retrospective study on Norwegian primary care patients with T2D included from the ROSA4-dataset. Exposures were (1) support staff size, (2) staff size relative to number of GPs, (3) clinic access to a diabetes nurse and (4) share of staff with diabetes course (1 and 2 both relate to staff operational capacity, whereas 3 and 4 are both indicatory of staff diabetes competences). ⋯ Adjusted risk of 'timely basal insulin-initiation' was more than twofold higher if access to a diabetes nurse (OR = 2.40, [95%CI, 1.68, 3.43]), but related only vaguely to staff size (OR = 1.01, [95%CI, 1.00, 1.03]). No other staff factors related significantly to neither the primary nor the secondary outcome. Conclusion: In Norwegian general practice, insulin initiation in people with T2D may be affected by therapeutic inertia but access to a diabetes nurse may help facilitating more timely insulin start-up.
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Scand J Prim Health Care · Mar 2024
The burden of persistent symptom diagnoses in primary care patients: a cross-sectional study.
The burden of symptoms is a subjective experience of distress. Little is known on the burden of feeling unwell in patients with persistent symptom diagnoses. The aim of this study was to assess the burden in primary care patients with persistent symptom diagnoses compared to other primary care patients. ⋯ Patients with persistent symptom diagnoses suffer from high levels of symptoms burden. The burden in patient with persistent symptoms should not be underestimated as awareness of this burden may enhance person-centered care.
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Scand J Prim Health Care · Mar 2024
Heart failure patients without echocardiography are more commonly diagnosed in hospital care and are associated with higher mortality compared to primary care.
This Swedish study aimed to assess the prevalence, associated clinical factors, and mortality rates of heart failure patients diagnosed without echocardiograms in both hospital and primary care settings. ⋯ In a Swedish region, heart failure diagnoses without echocardiograms were more common in hospitals, and these patients initially faced worse prognoses. After the first month, however, the prognosis of hospital-diagnosed patients mirrored that of those diagnosed in primary care. These findings emphasize the need for improved diagnostic and treatment approaches in both care settings to enhance outcomes.
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Scand J Prim Health Care · Mar 2024
Observational StudyIncidence of short-term community hospital stays and clinical profiles of patients: the Finnish Community Hospital Cohort Study.
A community hospital system covers the entire population of Finland. Yet there is little research on the system beyond routine statistics. More knowledge is needed on the incidence of hospital stays and patient profiles. We investigated the incidence of short-term community hospital stays and the features of care and patients. ⋯ Community hospitals have a substantial role in hospital care of older adults.
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Scand J Prim Health Care · Mar 2024
Health care services for older people in COVID-19 pandemic times - A Nordic comparison.
To explore the Nordic municipal health and care services' ability to promote principal goals within care for older people during the COVID-19 pandemic. ⋯ Measures that can improve opportunities for an active and social life during a pandemic should have high priority, particularily within home care.