Abstract:
OBJECTIVE:To explore whether the patient-list system, recently introduced in general practice, has influenced general practitioners' (GPs') self-perception as gatekeepers. DESIGN:Structured focus group interviews with GPs and a short self-administered questionnaire. SETTING:Primary care within the public health care system in Norway. Group interviews were conducted 6 months to 1 year after the patient-list system was introduced in June, 2001. SUBJECTS:81 GPs attending tutorial groups or specialists' continuous education groups. OUTCOME MEASURES:GPs' experience with the reform as stated in 11 group discussions, recorded, transcribed and systematically analysed through coding and extracting of the informants' statements. The questionnaire provided background information about each participant. RESULTS:The doctors generally perceived themselves as less concerned with the gatekeeper role under the new system. They felt it more important to provide better services and keep patients satisfied. The practitioners explained this shift using three contextual factors: increased and more visible competition, higher expectations from the patients and more responsibility assigned to the GP. CONCLUSION:GPs in Norway have experienced a shift in power in the physician-patient relationship favouring the patient. The GP's consciousness of the gatekeeper role has diminished. We question whether the new system lessens the incentive to consider resource use in decision-making.
journal_name
Scand J Prim Health Carejournal_title
Scandinavian journal of primary health careauthors
Carlsen B,Norheim OFdoi
10.1080/02813430310004155subject
Has Abstractpub_date
2003-12-01 00:00:00pages
209-13issue
4eissn
0281-3432issn
1502-7724journal_volume
21pub_type
杂志文章abstract:OBJECTIVE:To describe adherence to international guidelines for chronic heart failure (CHF) management concerning diagnostics, pharmacological treatment and self-care behaviour in primary health care. DESIGN:A cross-sectional descriptive study of patients with CHF, using data obtained from medical records and a postal...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813432.2017.1397253
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:This paper investigated patients' experiences of disease and self-care as well as perceptions of the general practitioner's role in supporting patients with impaired self-care ability. DESIGN:Qualitative interviews with 13 patients with type 2 diabetes, concurrent chronic diseases, and impaired self-care abi...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813432.2018.1487436
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To compare frequent attenders in different age and sex groups with a control group according to characteristics and use of primary health care. DESIGN:Descriptive study of medical records. SETTING:Primary health care centre. SUBJECTS:341 frequent attenders, divided by age and sex, were compared with 1025 c...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430310001149
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:To study factors of importance for infants' use of health and medical care. DESIGN:We studied the medical records of the mother during pregnancy (at the health centre, at the antenatal clinics, and at the department of obstetrics and gynaecology) and of her infant during the first 18 months of life (at the h...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439609024173
更新日期:1996-09-01 00:00:00
abstract::A substantial proportion of GPs' patients are women who suffer from "unexplained" pain conditions, often from the musculoskeletal system. Few medical findings are revealed, although the symptoms lead to extensive suffering and disability. Two experienced Swedish GPs, Katarina Hamberg and Eva E Johansson, took their ow...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134398750002945
更新日期:1998-12-01 00:00:00
abstract::Patients and general practitioners in northern Norway were asked their opinion on the doctors' use of a white coat in the consultation. 51.9% of the patients wanted their doctor not to wear a white coat, whereas 11.7% of the doctors never wore one. 5.7% of the doctors' staff members never wore a white coat. The patien...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439008994937
更新日期:1990-07-01 00:00:00
abstract::Objective: Explore the perceptions of patients and health care professionals about patients' ideas, concerns, expectations (ICE), and satisfaction in consultations with general practitioners (GPs), district nurses (DNs) and physiotherapists (PTs).Design: Cross-sectional questionnaire study of participants in planned c...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章,多中心研究
doi:10.1080/02813432.2019.1684430
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:How do physician visits vary when GPs are given the opportunity to send their patients to private specialists for consultation rather than simply to hospital outpatient clinics. DESIGN:An experimental study. SETTING AND SUBJECTS:In the City of Turku, 3 populations were served over 34 months by different ser...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430310001671
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:To explore experiences and consequences of the process of being diagnosed with fibromyalgia. DESIGN:Qualitative focus-group study. SETTING:Two local self-help groups. SUBJECTS:Eleven women diagnosed with fibromyalgia. MAIN OUTCOME MEASURES:Descriptions of experiences and consequences of the process of bei...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430701706568
更新日期:2007-12-01 00:00:00
abstract:UNLABELLED:OBJECTIVE--To compare general practitioners' routines regarding iron supplementation in pregnancy with national recommendations. DESIGN:Mailed questionnaire to general practitioners. SETTING:A county in western Norway. SUBJECTS:184 general practitioners. MAIN OUTCOME MEASURES:Descriptive registration of ...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439308994841
更新日期:1993-12-01 00:00:00
abstract:OBJECTIVE:To explore how well physicians and patients predict sick-listing duration and the correspondence between their respective predictions. To study possible gender differences concerning prediction accuracy. DESIGN:Prospective observational study. SETTING:Two medium-sized primary care centres (PCC) in western S...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2014.915132
更新日期:2014-06-01 00:00:00
abstract::Self-assessed well-being has been shown to be related to earlier medical events and to be a predictor of mortality. 50-year-old men and women (n = 314) in Kungsör were invited to an examination for traditional risk factors for cardiovascular diseases and different aspects of self-assessed well-being. The differences b...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439008994950
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To describe medical and odontological aspects of patients who believed their illness was caused by mercury in dental fillings. DESIGN:Comparison of self-reported and assessed medical and odontological variables. SETTING:The School of Dentistry, Karolinska Institute. SUBJECTS:Sixty-seven patients, referred ...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134398750003043
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:To find a method for quality assessment in primary health care and to apply this method on a defined disease. DESIGN:General practitioners and hospital doctors worked out a programme for evaluating the quality of outpatient care of patients with insulin treated diabetes as one of five tracers. An expert comm...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章,多中心研究
doi:10.3109/02813439709018494
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:Consultation time has a serious impact on physicians' work and patient satisfaction. No systematic study of consultation time in general practice in Slovenia has yet been carried out. The aim of the present study was to measure consultation time, to identify the factors influencing it, and to study the influe...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430701760789
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To investigate the public knowledge of cardiovascular risk factors including hyperlipidaemia, and attitudes to changes in lifestyle and to the role of the primary health care in preventive work. DESIGN:Postal questionnaire. SETTING:A physically defined area in south-western Stockholm. SUBJECTS:1000 randoml...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439508996739
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:Evaluate the feasibility of the COPD Web and its study design and study procedures and to increase the understanding of the potential effect of the tool in order to provide guidance for a future large scale trial. DESIGN:Parallel-group controlled pragmatic pilot trial. SUBJECTS:There was a total of 83 patie...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章,随机对照试验
doi:10.1080/02813432.2019.1569415
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To investigate the prevalence of headache and its association with lifestyle among schoolchildren and to test an intervention programme. DESIGN:A cross-sectional survey of all pupils in the school who were asked to complete a questionnaire about headache and lifestyle factors. SETTING:School health care at ...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134301750235349
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVE:To analyse the relation of ethnicity, social deprivation (Underprivileged area, UPA-score), social class V, unemployment and overcrowding on age- and sex-standardized mortality ratio (SMR). DESIGN:This ecological study used the SMR for people under the age of 65 years as dependent variable. Mortality data fo...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439608997075
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVES:To investigate the relationship between the length of a medical consultation in a general practice setting and the biopsychosocial information obtained by the physician, and to explore the characteristics of young physicians obtaining comprehensive, especially psychosocial information. DESIGN:A prospective,...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2012.751698
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:Cluster headache (CH) may cause excruciating pain and not all patients get satisfactory help. Patient dissatisfaction with general practitioners (GPs) and neurologists, and use of complementary and alternative treatment (CAM) may reflect this. The authors studied patient satisfaction with doctors' treatment a...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2014.944410
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To study the distribution of prenatal and postnatal risk factors for sudden infant death syndrome (SIDS). DESIGN:A questionnaire-based survey for SIDS risk factors; family interviews were performed among the parents of SIDS victims and symptom-free infants. SETTING:The survey was conducted in paediatric pri...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134301316982414
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:To investigate associations between patients' family, leisure time, and work-related factors and physicians' measure as to whether or not to sickness certify the patient in connection with the consultation. DESIGN:Questionnaire survey to physicians in general practice and their patients. Setting. General pra...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813431003765265
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To explore the association between abdominal obesity and insulin resistance in patients with type 2 diabetes. DESIGN:A cross-sectional observational study. SETTING:Primary care in Skara, Sweden. SUBJECTS:A total of 198 men and 186 women with type 2 diabetes who consecutively completed an annual check-up in...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430601035290
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:To study predicting value of pain symptoms in detecting depression among adolescents. DESIGN:A population-based classroom survey of 14-16-year-old adolescents. SETTING:Secondary schools in two regions of Finland (Vaasa and Pirkanmaa). SUBJECTS:Every secondary school in these two regions was asked to partic...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:To evaluate barriers to adherence to hypertension guidelines among publicly employed general practitioners (GPs). DESIGN:Questionnaire-based survey distributed to GPs in 24 randomly selected primary care centres in the Region of Skåne in southern Sweden. SUBJECTS:A total of 109 GPs received a self-administe...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430802202111
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:It is logical that tailoring implementation strategies to address identified determinants of adherence to clinical practice guidelines should improve adherence. This study aimed to identify and prioritize determinants of adherence to six recommendations for elderly patients with depression. DESIGN AND SETTIN...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2014.984961
更新日期:2014-12-01 00:00:00
abstract::The general practitioners dealing with cancer has other parameters than statistics of incidence and prevalence. In 400 consecutive interviews with patients in general practice when asked if the consultation was brought about because of fear or thoughts of cancer, eight % answered "yes" and 11% "partly". When asked if ...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438409017697
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVE:To investigate the association between serum total cholesterol and all-cause mortality in elderly individuals aged > or = 75 years. Design. A prospective cohort study with a six-year follow-up. SETTING AND SUBJECTS:A random sample (n = 700) of all persons aged > or = 75 years living in Kuopio, Finland. After...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2010.487371
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To identify and describe variations in ways of experiencing asthma management among general practitioners (GPs) in Sweden. DESIGN:Descriptive and explorative study using a phenomenographic approach. Semi-structured tape-recorded face-to-face interviews, focusing on the GP's own experiences regarding asthma m...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134399750002458
更新日期:1999-12-01 00:00:00