The British journal of general practice : the journal of the Royal College of General Practitioners
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UK Asian and black patients experience longer cancer diagnostic intervals - period between initial symptomatic presentation in primary care and cancer diagnosis. ⋯ We found evidence of ethnic differences in diagnostic intervals, with prolonged secondary care intervals for four common cancers and prolonged primary care intervals for two. Although these differences are relatively modest, they are unjustified and may indicate shortcomings in healthcare delivery that disproportionately affect ethnic minorities.
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Background General practice has a key role in reducing inequity in access to sexual and reproductive health (SRH). Unplanned pregnancy, abortion and STIs are increasing and disproportionately affects deprived communities and ethnic minority groups. The candidacy framework offers a practical, theoretical framework for understanding the complex interactional processes of access to SRH in general practice. ⋯ There are multiple barriers, which include the behaviours of healthcare professionals who have a crucial role in recognising an individual's SRH need. Conclusions General practice offers a cradle-to-grave healthcare service, which should have SRH as a priority area of provision. Further understanding is needed of the impact of historic harms by medicine and healthcare on racialised individuals and gender minorities.
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Presenting to primary care with fatigue is associated with a wide range of conditions, including cancer, although their relative likelihood is unknown. ⋯ This study ranked the likelihood of possible diagnoses in patients who presented with fatigue, to inform diagnostic guidelines and doctors' decisions. Age-specific findings support recommendations to prioritise cancer investigation in older men (aged ≥70 years) with fatigue, but not in women at any age, based solely on the presence of fatigue.
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Better continuity in primary and secondary care is linked to improved health outcomes, but it is unclear whether the sociodemographic determinants of continuity are the same in both settings and whether continuity measures in each setting are associated. ⋯ We found a lack of strong association between continuity of care in GP and outpatient settings. This suggests that fragmented hospital care is not mitigated by increased continuity in GP.
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effectiveness of single disease management programs (DMP) in general practice may be limited for patients with low socioeconomic status (SES), as DMPs insufficiently take into account the specific problems and needs of this population. A Person-Centred Integrated Care (PC-IC) approach focusing on patient's needs could address these problems. ⋯ the PC-IC approach seems helpful for chronic disease patients, provided that it is tailored to their skills and abilities. Several modifications for patients with low SES were suggested.