scholarly journals Change in glycemic control for patients enrolled in a membership-based primary care program: longitudinal observational study (Preprint)

JMIR Diabetes ◽  
10.2196/27453 ◽  
2021 ◽  
Author(s):  
Lenard Ira Lesser ◽  
Raj Behal
Keyword(s):  
Primary Care ◽  
Glycemic Control ◽  
Observational Study ◽  
Care Program ◽  
Longitudinal Observational Study ◽  
Primary Care Program

scholarly journals Impact of organizational context on patient outcomes in a proactive primary care program:a longitudinal observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linda C. Smit ◽  
Niek J. De Wit ◽  
Meggie L. Nieuwenhuizen ◽  
Marieke J. Schuurmans ◽  
Nienke Bleijenberg
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Outcomes ◽  
Organizational Context ◽  
Care Program ◽  
District Nurse ◽  
Out Of Hours ◽  
Longitudinal Observational Study ◽  
Primary Care Program ◽  
General Practices

Abstract Background The effectiveness of health care interventions is co-determined by contextual factors. Unknown is the extent of this impact on patient outcomes. Therefore, the aim of this study is to explore which characteristics of general practices are associated with patient outcomes in a proactive primary care program, the U-PROFIT 2.0. Methods A longitudinal observational study was conducted from January 2016 till October 2017. Two questionnaires were send out, one to collect characteristics of general practices such as practice neighbourhood socio-economic status, general practice versus healthcare centre (involving multiple primary care professionals), and professional- frail older patient ratio per practice of general practitioners and practice nurses. Regarding delivering the program, the practice or district nurse who delivered the program, number of years since the start of the implementation, and choice of age threshold for frailty screening were collected. Patient outcomes collected by the second questionnaire and send to frail patients were daily functioning, hospital admissions, emergency department visits, and general practice out-of-hours consultations. Linear and generalized linear mixed models were used. Results A total of 827 frail older people were included at baseline. Delivery of the program by a district nurse compared to a practice nurse was significantly associated with a decrease in daily functioning on patient-level (β = 2.19; P = < 0.001). Duration since implementation of 3 years compared to 9 years was significantly associated with less out-of-hours consultations to a general practice (OR 0.11; P = 0.001). Applying frailty screening from the age of 75 compared to those targeted from the age of 60 showed a significant increase in emergency visits (OR 5.26; P = 0.03). Conclusion Three associations regarding the organizational context 1) the nurse who delivered the program, 2) the number of years the program was implemented and 3) the age threshold for defining a frail patient are significant and clinically relevant for frail patients that receive a proactive primary care program. In general, contextual factors need more attention when implementing complex primary care programs which can result in better balanced choices to enhance effective proactive care for older people living in the community.

scholarly journals The effect of COVID-19 pandemic and lockdown on consultation numbers, consultation reasons and performed services in primary care: results of a longitudinal observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ingmar Schäfer ◽  
Heike Hansen ◽  
Agata Menzel ◽  
Marion Eisele ◽  
Daniel Tajdar ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Rural Areas ◽  
Longitudinal Observational Study ◽  
Multivariable Analyses ◽  
Gastrointestinal Complaints ◽  
Urban And Rural Areas ◽  
Quota Sampling ◽  
Primary Care Practices

Abstract Objectives The aims of our study were to describe the effect of the COVID-19 pandemic and lockdown on primary care in Germany regarding the number of consultations, the prevalence of specific reasons for consultation presented by the patients, and the frequency of specific services performed by the GP. Methods We conducted a longitudinal observational study based on standardised GP interviews in a quota sampling design comparing the time before the COVID-19 pandemic (12 June 2015 to 27 April 2017) with the time during lockdown (21 April to 14 July 2020). The sample included GPs in urban and rural areas 120 km around Hamburg, Germany, and was stratified by region type and administrative districts. Differences in the consultation numbers were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the administrative districts and GP practices. Results One hundred ten GPs participated in the follow-up, corresponding to 52.1% of the baseline. Primary care practices in 32 of the 37 selected administrative districts (86.5%) could be represented in both assessments. At baseline, GPs reported 199.6 ± 96.9 consultations per week, which was significantly reduced during COVID-19 lockdown by 49.0% to 101.8 ± 67.6 consultations per week (p < 0.001). During lockdown, the frequency of five reasons for consultation (-43.0% to -31.5%) and eleven services (-56.6% to -33.5%) had significantly decreased. The multilevel, multivariable analyses showed an average reduction of 94.6 consultations per week (p < 0.001). Conclusions We observed a dramatic reduction of the number of consultations in primary care. This effect was independent of age, sex and specialty of the GP and independent of the practice location in urban or rural areas. Consultations for complaints like low back pain, gastrointestinal complaints, vertigo or fatigue and services like house calls/calls at nursing homes, wound treatments, pain therapy or screening examinations for the early detection of chronic diseases were particularly affected.

scholarly journals Treatment Fidelity of an Evidence-Based Nurse-Led Intervention in a Proactive Primary Care Program for Older People

2016 ◽  
Vol 13 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Nienke Bleijenberg ◽  
Valerie H. ten Dam ◽  
Irene Drubbel ◽  
Mattijs E. Numans ◽  
Niek J. de Wit ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Care Program ◽  
Treatment Fidelity ◽  
Evidence Based ◽  
Primary Care Program

The Public Housing and Primary Care Program

2007 ◽  
Vol 18 (4) ◽  
pp. 735-743 ◽  
Author(s):  
Kathie Culhane-Pera ◽  
Dillard Ellmore ◽  
Lois A Wessel
Keyword(s):  
Primary Care ◽  
Public Housing ◽  
Care Program ◽  
The Public ◽  
Primary Care Program

Rural Primary Care Program Survival: An Analysis of Financial Variables

1994 ◽  
Vol 10 (3) ◽  
pp. 173-182 ◽  
Author(s):  
Leiyu Shi ◽  
Michael E. Samuels ◽  
Thomas R. Konrad ◽  
Carol Q. Porter ◽  
Carleen H. Stoskopf ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Program ◽  
Rural Primary Care ◽  
Financial Variables ◽  
Primary Care Program ◽  
Program Survival
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