An Audit of the Impact of Introducing Microacupuncture into Primary Care

2001 ◽  
Vol 19 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Juliette Ross
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cost Saving ◽  
Computer System ◽  
Patient Records ◽  
Considerable Cost ◽  
Considerable Cost Saving ◽  
The Impact

In 1997, one of the partners in a general practice in NW London comprising 6700 patients began using microacupuncture - a very brief form of treatment described by Felix Mann. The computer system used for patient records was modified to allow easy recording of details of acupuncture treatments; the latter being performed opportunistically in standard 10-minute consultations. Over the course of three years, during which time a second partner began using acupuncture, referrals to acute physiotherapy (conditions present for < 3 months) fell by 86%, and referrals to outpatient rheumatology fell by 51%. This is likely to represent a considerable cost saving to the NHS.

The Impact of COVID-19 on Primary Care General Practice Consultations in a Teaching Hospital in Shanghai, China

2020 ◽  
Author(s):  
Zhongqing Xu ◽  
Jingchun Fan ◽  
Jingjing Ding ◽  
Xianzhen Feng ◽  
Shunyu Tao ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Teaching Hospital ◽  
The Impact

The impact of electronic patient records on workflow in general practice

2007 ◽  
Vol 13 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Matthew R. Cauldwell ◽  
Caroline E. Beattie ◽  
Benita M. Cox ◽  
William J. Denby ◽  
Jessica A. Ede-Golightly ◽  
...  
Keyword(s):  
General Practice ◽  
Patient Records ◽  
Electronic Patient Records ◽  
The Impact

scholarly journals The Cochrane 2018 Review on Brief Interventions in Primary Care for Hazardous and Harmful Alcohol Consumption: A Distillation for Clinicians and Policy Makers

2019 ◽  
Vol 54 (4) ◽  
pp. 417-427 ◽  
Author(s):  
F R Beyer ◽  
F Campbell ◽  
N Bertholet ◽  
J B Daeppen ◽  
J B Saunders ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Alcohol Consumption ◽  
Brief Intervention ◽  
Emergency Care ◽  
Total Duration ◽  
Brief Interventions ◽  
Men And Women ◽  
Harmful Alcohol ◽  
The Impact

Abstract Aims An updated Cochrane systematic review assessed effectiveness of screening and brief intervention to reduce hazardous or harmful alcohol consumption in general practice or emergency care settings. This paper summarises the implications of the review for clinicians. Methods Cochrane methods were followed. Reporting accords with PRISMA guidance. We searched multiple resources to September 2017, seeking randomised controlled trials of brief interventions to reduce hazardous or harmful alcohol consumption in people attending general practice, emergency care or other primary care settings for reasons other than alcohol treatment. Brief intervention was defined as a conversation comprising five or fewer sessions of brief advice or brief lifestyle counselling and a total duration of less than 60 min. Our primary outcome was alcohol consumption, measured as or convertible to grams per week. We conducted meta-analyses to assess change in consumption, and subgroup analyses to explore the impact of participant and intervention characteristics. Results We included 69 studies, of which 42 were added for this update. Most studies (88%) compared brief intervention to control. The primary meta-analysis included 34 studies and provided moderate-quality evidence that brief intervention reduced consumption compared to control after one year (mean difference −20 g/wk, 95% confidence interval −28 to −12). Subgroup analysis showed a similar effect for men and women. Conclusions Brief interventions can reduce harmful and hazardous alcohol consumption in men and women. Short, advice-based interventions may be as effective as extended, counselling-based interventions for patients with harmful levels of alcohol use who are presenting for the first time in a primary care setting.

Child Health General Practice Hubs: a service evaluation

2015 ◽  
Vol 101 (4) ◽  
pp. 333-337 ◽  
Author(s):  
Sarah Montgomery-Taylor ◽  
Mando Watson ◽  
Robert Klaber
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Child Health ◽  
Service Evaluation ◽  
High Patient Satisfaction ◽  
Patient Reported ◽  
The Impact ◽  
Lower Capacity ◽  
Inside Out

ObjectiveTo evaluate the impact of an integrated child health system.DesignMixed methods service evaluation.Setting and patientsChildren, young people and their families registered in Child Health General Practitioner (GP) Hubs where groups of GP practices come together to form ‘hubs’.InterventionsHospital paediatricians and GPs participating in joint clinics and multidisciplinary team (MDT) meetings in GP practices, a component of an ‘Inside-Out’ change known as ‘Connecting Care For Children (CC4C)’.Main outcome measuresCases seen in clinic or discussed at MDT meetings and their follow-up needs. Hospital Episode data: outpatient and inpatient activity and A&E attendance. Patient-reported experience measures and professionals’ feedback.ResultsIn one hub, 39% of new patient hospital appointments were avoided altogether and a further 42% of appointments were shifted from hospital to GP practice. In addition, there was a 19% decrease in sub-specialty referrals, a 17% reduction in admissions and a 22% decrease in A&E attenders. Smaller hubs running at lower capacity in early stages of implementation had less impact on hospital activity. Patients preferred appointments at the GP practice, gained increased confidence in taking their child to the GP and all respondents said they would recommend the service to family and friends. Professionals valued the improvement in knowledge and learning and, most significantly, the development of trust and collaboration.ConclusionsChild Health GP Hubs increase the connections between secondary and primary care, reduce secondary care usage and receive high patient satisfaction ratings while providing learning for professionals.

Controlling sand placement during the building of artificial islands

1984 ◽  
Vol 21 (2) ◽  
pp. 371-375 ◽  
Author(s):  
D. H. Shields ◽  
L. Domaschuk ◽  
D. W. Corkal ◽  
J. R. McCutchon
Keyword(s):  
Cost Saving ◽  
Low Cost ◽  
Model Tests ◽  
Scale Model ◽  
Small Scale ◽  
Considerable Cost ◽  
Environmentally Safe ◽  
Considerable Cost Saving ◽  
Small Scale Model

A new way to construct artificial islands of sand is described. The method shows promise of considerable cost saving. The present high cost of island building is due to the difficulty of making underwater sand slopes steep. Simply dumping sand into the ocean results in slopes of from 12 to 15 horizontal to 1 vertical. These shallow slopes have enormous implications in terms of sand volume and cost. The sand can be tremied into place to form a steep-sided ring or bund. Handling large quantities of sand in this way is expensive. Small-scale model tests show that if the sand is mixed with certain chemicals the resulting 'cohesion' enables the sand to fall through seawater as a block, with little dispersion. Steep underwater slopes result. Low-cost, nontoxic (environmentally safe) chemicals were used in the experiment. Keywords: construction, artificial islands, sand, oceans, dredging.

scholarly journals Advanced Access scheduling in general practice and use of primary care: a Danish population-based matched cohort study

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101091
Author(s):  
Maria Bang ◽  
Henrik Schou Pedersen ◽  
Bodil Hammer Bech ◽  
Claus Høstrup Vestergaard ◽  
Jannik Falhof ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cohort Study ◽  
Population Based ◽  
Matched Cohort ◽  
Face To Face ◽  
Matched Cohort Study ◽  
Adjusted Incidence Rate ◽  
Advanced Access ◽  
The Impact

BackgroundAdvanced access scheduling (AAS) allows patients to receive care from their GP at the time chosen by the patient. AAS has shown to increase the accessibility to general practice, but little is known about how AAS implementation affects the use of in-hours and out-of-hours (OOH) services.AimTo describe the impact of AAS on the use of in-hours and OOH services in primary care.Design & settingA population-based matched cohort study using Danish register data.MethodA total of 161 901 patients listed in 33 general practices with AAS were matched with 287 837 reference patients listed in 66 reference practices without AAS. Outcomes of interest were use of daytime face-to-face consultations, and use of OOH face-to-face and phone consultations in a 2-year period preceding and following AAS implementation.ResultsNo significant differences were seen between AAS practices and reference practices. During the year following AAS implementation, the number of daytime face-to-face consultations was 3% (adjusted incidence rate ratio [aIRR] = 1.03; 95% confidence interval [CI] = 0.99 to 1.07) higher in the AAS practices compared with the number in the reference practices. Patients listed with an AAS practice had 2% (aIRR = 0.98; 95% CI = 0.92 to 1.04) fewer OOH phone consultations and 6% (aIRR = 0.94; 95% CI = 0.86 to 1.02) fewer OOH face-to-face consultations compared with patients listed with a reference practice.ConclusionThis study showed no significant differences following AAS implementation. However, a trend was seen towards slightly higher use of daytime primary care and lower use of OOH primary care.

scholarly journals Improving the Management of Atrial Fibrillation in General Practice: Protocol for a Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Simon de Lusignan ◽  
F D Richard Hobbs ◽  
Harshana Liyanage ◽  
Filipa Ferreira ◽  
Manasa Tripathy ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
General Practice ◽  
Real World ◽  
Early Recognition ◽  
Phase 1 ◽  
Second Phase ◽  
National Guidelines ◽  
Sentinel Network ◽  
The Impact

BACKGROUND Atrial fibrillation (AF) is one of the commonest arrhythmias observed in general practice. The thromboembolic complications of AF include transient ischemic attack, stroke, and pulmonary embolism. Early recognition of AF can lead to early intervention with managing the risks of these complications. OBJECTIVE The primary aim of this study is to investigate if patients are managed in general practice according to current national guidelines. In addition, the study will evaluate the impact of direct oral anticoagulant use with respect to AF complications in a real-world dataset. The secondary aims of the study are to develop a dashboard that will allow monitoring the management of AF in general practice and evaluate the usability of the dashboard. METHODS The study was conducted in 2 phases. The initial phase was a quantitative analysis of routinely collected primary care data from the Oxford Royal College of General Practitioners Research and Surveillance Center (RCGP RSC) sentinel network database. AF cases from 2009 to 2019 were identified. The study investigated the impact of the use of anticoagulants on complications of AF over this time period. We used this dataset to examine how AF was managed in primary care during the last decade. The second phase involved development of an online dashboard for monitoring management of AF in general practice. We conducted a usability evaluation for the dashboard to identify usability issues and performed enhancements to improve usability. RESULTS We received funding for both phases in January 2019 and received approval from the RCGP RSC research committee in March 2019. We completed data extraction for phase 1 in May 2019 and completed analysis in December 2019. We completed building the AF dashboard in May 2019. We started recruiting participants for phase 1 in May 2019 and concluded data collection in July 2019. We completed data analysis for phase 2 in October 2019. The results are expected to be published in the second half of 2020. As of October 2020, the publications reporting the results are under review. CONCLUSIONS Results of this study will provide an insight into the current trends in management of AF using real-world data from the Oxford RCGP RSC database. We anticipate that the outcomes of this study will be used to guide the development and implementation of an audit-based intervention tool to assist practitioners in identifying and managing AF in primary care. INTERNATIONAL REGISTERED REPORT RR1-10.2196/21259

scholarly journals Association of British Clinical Diabetologists (ABCD) position statement on the use of biosimilar insulin

2018 ◽  
Vol 18 (4) ◽  
pp. 171-174 ◽  
Author(s):  
Vijay Jayagopal ◽  
Russell Drummond ◽  
Dinesh Nagi
Keyword(s):  
Cost Saving ◽  
Position Statement ◽  
Healthcare Staff ◽  
Advantages And Disadvantages ◽  
Considerable Cost ◽  
Published Evidence ◽  
Considerable Cost Saving

Biosimilar insulins have the potential to offer the NHS a considerable cost saving. The acceptability and use of biosimilar insulin by clinicians and patients may, however, be limited by lack of experience, understanding and concerns about safety and tolerability. This article summarises information on the advantages and disadvantages of using biosimilar insulins and an overview of the published evidence in relation to efficacy, tolerability and safety of current and expected Biosimilar Insulins. The position of the ABCD on the use of Biosimilar Insulin is stated along with the key practical considerations for healthcare staff involved in insulin prescription and administration.

Varicose veins are a risk factor for deep venous thrombosis in general practice patients

VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 360-365 ◽  
Author(s):  
Müller-Bühl ◽  
Leutgeb ◽  
Engeser ◽  
N. Achankeng ◽  
Szecsenyi ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Risk Factor ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Potential Risk ◽  
Varicose Veins ◽  
Medical Attention ◽  
Increased Risk ◽  
The Impact

Background: The role of varicose veins (VV) as a risk factor for development of deep venous thrombosis (DVT) is still controversial. The aim of this study in primary care was to determine the impact of varicosity as a potential risk factor for developing DVT. Patients and methods: During the observation period between 01-Jan-2008 and 01-Jan-2011, all cases with VV (ICD code I83.9) and DVT (ICD codes I80.1 - I80.9) were identified out of the CONTENT primary care register (Heidelberg, Germany). The exposure of VV and DVT was based solely on ICD coding without regarding the accuracy of the diagnosis. The covariates age, gender, surgery, hospitalization, congestive heart failure, malignancy, pregnancy, hormonal therapy, and respiratory infection were extracted for each patient. Multivariate binary logistic regression was performed in order to assess potential risk factors for DVT. The SAS procedure “PROC GENMOD” (SAS version 9.2, 64-bit) was parameterised accordingly. A potential cluster effect (patients within practices) was regarded in the regression model. Results: There were 132 out of 2,357 (5.6 %) DVT episodes among patients with VV compared to 728 out of 80,588 (0.9 %) in the patient cohort without VV (p < 0.0001). An increased risk of DVT was associated with previous DVT (adjusted odds ratio (OR): 9.07, 95 % confidence interval (CI): 7.78 - 10.91), VV (OR 7.33 [CI 6.14 - 8.74]), hospitalization during the last 6 months (OR 1.69 [CI 1.29 - 2.22]), malignancy (OR 1.55 [CI 1.19 - 2.02]), and age (OR 1.02 [CI 1.01 - 1.03]). Conclusions: There are strong associations between VV and DVT in a general practice population with documented VV. Special medical attention is required for patients with VV, a history of previous venous thromboembolism, comorbid malignancy, and recent hospital discharge, particularly those with a combination of these factors.

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