scholarly journals Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors

2009 ◽  
Vol 7 (4) ◽  
pp. 309-318 ◽  
Author(s):  
G. M. Russell ◽  
S. Dahrouge ◽  
W. Hogg ◽  
R. Geneau ◽  
L. Muldoon ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Organizational Factors ◽  
The Impact

scholarly journals Long-term effectiveness of elderly health care voucher scheme strategies: a system dynamics simulation analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Ho Kwan Yam ◽  
Patsy Yuen Kwan Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public ◽  
The Impact

Abstract Background The elderly healthcare voucher (EHCV) scheme is expected to lead to an increase in the number of elderly people selecting private primary healthcare services and reduce reliance on the public sector in Hong Kong. However, studies thus far have reported that this scheme has not received satisfactory responses. In this study, we examined changes in the ratio of visits between public and private doctors in primary care (to measure reliance on the public sector) for different strategic scenarios in the EHCV scheme. Methods Based on comments from an expert panel, a system dynamics model was formulated to simulate the impact of various enhanced strategies in the scheme: increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for the model calibration were collected from various sources. Results The simulation results show that the current EHCV scheme is unable to reduce the utilization of public healthcare services, as well as the ratio of visits between public and private primary care among the local aging population. When comparing three different tested scenarios, even if the increase in the annual voucher amount could be maintained at the current pace or the age eligibility can be lowered to include those aged 60 years, the impact on shifts from public-to-private utilization were insignificant. The public-to-private ratio could only be marginally reduced from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in a significant drop of 0.50 in the public-to-private ratio during the early implementation phase. However, the effect could not be maintained for an extended period. Conclusions Our findings will assist officials in improving the design of the EHCV scheme, within the wider context of promoting primary care among the elderly. We suggest that an additional chronic disease-oriented voucher can serve as an alternative strategy. The scheme must be redesigned to address more specific objectives or provide a separate voucher that promotes under-utilized healthcare services (e.g., preventive care), instead of services designed for unspecified reasons, which may lead to concerns regarding exploitation.

scholarly journals Hospital Readmissions of Patients with Heart Failure: The Impact of Hospital and Primary Care Organizational Factors in Northern Italy

PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0127796 ◽  
Author(s):  
Vera Maria Avaldi ◽  
Jacopo Lenzi ◽  
Ilaria Castaldini ◽  
Stefano Urbinati ◽  
Giuseppe Di Pasquale ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Hospital Readmissions ◽  
Organizational Factors ◽  
Northern Italy ◽  
Patients With Heart Failure ◽  
The Impact

scholarly journals Nurses’ knowledge of chronic disease management

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Saloshni Naidoo ◽  
Ozayr H. Mahomed ◽  
Shaidah Asmall ◽  
Myra Taylor
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Diseases ◽  
Chronic Disease Management ◽  
Diabetes Management ◽  
T Test ◽  
And Control ◽  
The Impact ◽  
Nurses Knowledge

Background: Chronic diseases of lifestyle are detrimentally affecting South Africans. National Health Insurance, which is intended to improve care, requires capacity building for nurses at primary care clinics to ensure appropriate service provision.Objective: This study’s objective was to evaluate the impact of the ‘Primary Care 101’ chronic disease management guideline and training on nurses’ knowledge of chronic diseases management.Method: A population-based, unblinded, stratifid cluster randomised controlled trialwith intervention (n = 20) and control clinics (n = 10) in three South African districts was conducted over six months in 2012. Nurses in the clinics participated in surveying knowledge on management of tuberculosis, human immunodefiiency virus infection, mental health, epilepsy, diabetes, hypertension and asthma and chronic obstructive pulmonary disease (COPD). All nurses were surveyed at baseline and six months later. Intervention clinic nurses were also surveyed immediately after training and three months post-training. Data were analysed using SPSS version 19 (SPSS Inc., Chicago, IL).Total mean knowledge percentage scores were calculated for each chronic disease. Mean knowledge percentage score changes between baseline and six months amongst all nurses and between intervention and control clinic nurses were compared using the paired samples t-test and independent samples t-test respectively.Results: There were signifiant improvements in nurses’ knowledge of hypertension and diabetes management over six months. Knowledge about asthma and COPD management decreased in all districts and nurse categories.Conclusion: The improvements in nurses’ knowledge can ensure improved patientmanagement, but attention to asthma and COPD management is required.Agtergrond: Chroniese lewenstylsiektes beïnvloed Suid-Afrikaners nadelig. Die nasionale gesondheidsversekering, wat ten doel het om sorg te verbeter, vereis kapasiteitsbou vir verpleegsters by primêre-sorg-klinieke om sodoende toepaslike dienslewering te verseker.Doelwitte: Hierdie studie se doel was te evalueer wat die impak van die ‘Primary Care 101’ chroniese siekte bestuursriglyn, asook opleiding is op verpleegsters se kennis van hoe om chroniese siektes te bestuur.Metode: ’n Bevolkingsgebaseerde, onverblinde, ewekansige gekontroleerde trossteekproef met ingrypings- (n = 20) en kontrole-klinieke (n = 10) is oor ’n tydperk van ses maande in 2012 in drie Suid-Afrikaanse distrikte uitgevoer. Verpleegsters in hierdie klinieke het deelgeneem aan ’n opname oor hul kennis oor die bestuur van tuberkulose, menslike immuniteitsgebreksvirus-infeksie, geestesgesondheid, epilepsie, diabetes, hoë bloeddruk, asook asma en chroniese obstruktiewe longsiekte (COPD). Alle verpleegsters is by die basislyn ondervra en ses maande later. Intervensie kliniekverpleegsters is ook ondervra onmiddellik na die opleiding en drie maande post-opleiding. Data is ontleed met behulp van SPSS, weergawe 19 (SPSS Inc, Chicago, IL). Totale gemiddelde kennis persentasietellings isvir elke chroniese siekte bereken. Veranderinge in die gemiddelde kennis persentasietellings tussen die basislyn en ses maande later is onder alle verpleegsters, asook tussen ingrypingsen kontrole-kliniekverpleegsters vergelyk met behulp van die gepaarde steekproef t-toets en die onafhanklike steekproef t-toets onderskeidelik.Resultate: Daar was ’n aansienlike verbetering in verpleegsters se kennis oor die bestuur van hoë bloeddruk en diabetes na ses maande. Kennis oor die bestuur van asma en COPD het in alle distrikte en verpleegster-kategorieë afgeneem.Gevoltrekking: Die verbetering in die verpleegsters se kennis kan verbeterde pasiëntbestuur verseker, maar die bestuur van asma en COPD vereis verdere aandag.

scholarly journals Enhanced Primary Care improves GP service regularity in older patients without impacting on service frequency

2012 ◽  
Vol 18 (4) ◽  
pp. 295 ◽  
Author(s):  
David A. J. Gibson ◽  
Rachael E. Moorin ◽  
David Preen ◽  
Jon Emery ◽  
C. D'Arcy J. Holman
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Multinomial Logistic Regression ◽  
Care Service ◽  
Primary Care Service ◽  
Service Utilisation ◽  
Relative Likelihood ◽  
Care Services ◽  
Primary Care Services ◽  
The Impact

The objective of this study was to assess the impact of Enhanced Primary Care service utilisation on subsequent GP service regularity and frequency. The study involved a retrospective population-based longitudinal cohort using linked administrative health records of hospital and primary care services for people over the age of 65 years. Multinomial logistic regression modelling was used to evaluate changes in the relative likelihood of increased primary care service regularity and frequency in exposed and unexposed individuals adjusting for age, sex and recent chronic disease hospitalisation history. Enhanced Primary Care services significantly and substantially increased the relative likelihood of increased regularity with no corresponding higher likelihood of increased frequency of GP contact. Increased regularity was more likely with increasing age except for the oldest age group (90+ years). Some chronic disease histories (e.g. diabetes) showed a higher likelihood of improved regularity while others were less likely to produce an increased regularity (e.g. hypertension). The study suggests a capacity for modification of physician and patient behaviour using incentivised services within the current fee-for-service system in Australia.

scholarly journals The impact of chronic disease management on primary care doctors in Switzerland: a qualitative study

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Olivia Braillard ◽  
Anbreen Slama-Chaudhry ◽  
Catherine Joly ◽  
Nicolas Perone ◽  
David Beran
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Qualitative Study ◽  
Chronic Disease Management ◽  
Primary Care Doctors ◽  
The Impact

Supporting quality care in general practice: The collaboratives approach

2008 ◽  
Vol 14 (2) ◽  
pp. 46 ◽  
Author(s):  
Catuscia Buiso ◽  
Bill Newton
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Quality Improvement ◽  
Chronic Disease ◽  
Quality Care ◽  
Quality Improvement Initiative ◽  
Building Practice ◽  
The Impact ◽  
International Phenomenon

An important role of divisions of general practice is to support general practice to build capacity for the delivery of quality care. The purpose of this paper is to discuss the National Primary Care Collaboratives Program and the impact this quality improvement initiative has had on building practice capacity to achieve improvements in the management of chronic disease. "The Collaboratives" are an international phenomenon, which, over the last three years, has been implemented in Australia and has achieved impressive results consistent with the success documented in other countries. This paper explores the key elements contributing to the success of the program and discusses the opportunities that have strengthened the ability of participating divisions to support general practice to deliver quality care.

scholarly journals The impact of regular GP visits on diabetic potentially preventable hospitalisations

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
David Youens ◽  
Rachael Moorin
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Chronic Disease ◽  
Care Program ◽  
Disease Status ◽  
Multilevel Modelling ◽  
Quality Of Healthcare ◽  
Gp Visits ◽  
The Impact ◽  
The Relationship

ABSTRACT ObjectivesPotentially preventable hospitalisations (PPHs) place a substantial burden on the Australian health system, with over 212,000 PPHs reported for diabetes alone in 2005/06. Timely and effective primary care may reduce the risk of acute episodes and subsequent hospitalisation among those with chronic diseases. The Medicare Enhanced Primary Care program, introduced to improve the regularity and quality of healthcare provided by GPs to Australians with chronic disease, has been shown to improve regularity of GP access. The aim of our study is to ascertain whether more regular GP access reduces diabetes PPHs. ApproachWhole of population longitudinal study using linked hospital, mortality, and general practice data. Regularity of GP access was determined through calculating the variance in the number of days between GP visits within a year. Regular GP contact was taken to indicate planned, proactive primary care, and irregular GP contact taken to indicate unplanned, reactive care. Multilevel modelling techniques were used to determine the relationship between regularity of GP access and diabetic PPHs in the population at risk of diabetes. Analyses were performed for the periods prior to and following the introduction of policies aimed at promoting primary care contact. ResultsThis paper will report results on the relationship between regular, proactive GP contact and diabetes PPHs in the population with and at risk of diabetes. Socio-demographic, geo-spatial and access factors were found to influence the regularity of GP access. Individual factors, in particular disease status, were found to substantially modify the relationship between regularity and PPH outcome. Findings differed between the periods prior to and following the introduction of government policies aimed at promoting proactive primary care in chronic disease. ConclusionFindings from this study will provide important evidence concerning strategies to reduce PPHs in relation to diabetes, which will be of interest to policy-makers wishing to reduce unnecessary hospitalisations. This work will extend to examine the impact of regularity on PPHs for a number of other chronic conditions considered priorities in Australia.

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