Abstract:
BACKGROUND:Delay in cancer diagnosis may have serious prognostic consequences, and some patients experience delays lasting several months. However, we have no knowledge whether such delays are associated with general practitioner (GP) characteristics. The aim of the present study was to analyse whether GP and practice characteristics are associated with the length of delay in cancer diagnosis. METHODS:The study was designed as a population-based cohort study. The setting was the County of Aarhus, Denmark (640,000 inhabitants). Participants include 334 GPs and their 1,525 consecutive, newly diagnosed cancer patients. During one year (September 2004 to August 2005), patients with incident cancer were enrolled from administrative registries. GPs completed questionnaires on the patients' diagnostic pathways and on GP and practice characteristics. Delay was categorised as patient-related (more than 60 days), doctor-related (more than 30 days) and system-related (more than 90 days). The associations between delay and characteristics were assessed in a logistic regression model using odds ratios (ORs). RESULTS:No GP characteristics (seniority, practice organization, list size, participation in continuing medical education, job satisfaction and level of burnout) were associated with doctor delay. Patients of female GPs more often had a short patient delay than patients of male GPs (OR 0.44, 95% confidence interval (95% CI) 0.28 to 0.71). Patients whose GPs provided many services (OR 0.66, 95% CI 0.44 to 0.95) and patients attending GPs with little former knowledge of their patients (OR 0.68, 95% CI 0.47 to 0.99) more often experienced a short system delay than patients attending GPs with less activity and more knowledge of their patients. Patients listed with a female GP more often experienced a long system delay than patients of male GPs (OR 1.50, 95% CI 1.02 to 2.21). Finally, patients with low GP-reported compliance more often experienced a long system delay (OR 1.73, 95% CI 1.07 to 2.80) than patients with higher compliance. CONCLUSIONS:GP characteristics were not statistically significantly associated with doctor delay. However, some GP characteristics were associated with patient and system delay, which indicates that these factors may be important for understanding patient delay (e.g. perceived GP accessibility and the GP-patient relationship) and system delay (e.g. the GP's experience and opportunities for referring and coordinating diagnostic work-up).
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Hansen RP,Vedsted P,Sokolowski I,Søndergaard J,Olesen Fdoi
10.1186/1471-2296-12-100subject
Has Abstractpub_date
2011-09-26 00:00:00pages
100issn
1471-2296pii
1471-2296-12-100journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Prognosis has been described as an important but neglected branch of clinical science. While patients' views have been sought in the context of life-threatening illness, similar research is lacking for patients presenting with common, non-life-threatening musculoskeletal complaints. The aim of this study was...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-50
更新日期:2009-07-07 00:00:00
abstract:BACKGROUND:While increasing attention is being paid to enabling terminal patients to remain at home until death, limited information is available on the circumstances in which people at home actually die. Therefore this study aims to describe patient characteristics, functional and cognitive status and physical and psy...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-4
更新日期:2012-01-19 00:00:00
abstract:BACKGROUND:Multimorbidity is a major issue for primary care. We aimed to explore primary care professionals' accounts of managing multimorbidity and its impact on clinical decision making and regional health care delivery. METHODS:Qualitative interviews with 12 General Practitioners and 4 Primary Care Nurses in New Ze...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0622-4
更新日期:2017-04-05 00:00:00
abstract:BACKGROUND:Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians con...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0743-4
更新日期:2018-05-14 00:00:00
abstract:BACKGROUND:Long-term needs of stroke survivors are often not adequately addressed and many patients are dissatisfied with care post-discharge from hospital. Primary care could play an important role in identifying need in people with stroke. AIM:We aimed to explore, refine and test the feasibility and acceptability of...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0894-3
更新日期:2019-01-04 00:00:00
abstract:BACKGROUND:Sleep problems are common, affecting over a third of adults in the United Kingdom and leading to reduced productivity and impaired health-related quality of life. Many of those whose lives are affected seek medical help from primary care. Drug treatment is ineffective long term. Psychological methods for man...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-10-9
更新日期:2009-01-26 00:00:00
abstract:BACKGROUND:Unattached patients do not have a regular primary care provider. Initiatives are being developed to increase attachment rates across Canada. Most existing attention paid to patient unattachment has focused on quantifying the problem and health system costs. Our purpose is to qualitatively identify the implic...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-69
更新日期:2012-07-16 00:00:00
abstract:BACKGROUND:Evidence-based medicine (EBM) is gradually being recognized worldwide as an important clinical skill and plays an important role in health care. Although the concept has successfully spread in the health care field, EBM still has not been widely incorporated into clinical decisions in primary care due to pot...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-1062-0
更新日期:2019-12-06 00:00:00
abstract:BACKGROUND:Over 90% of antibiotics for human use in Europe are prescribed in primary care. We assessed the congruence between primary care treatment guidelines for skin infections and commensal Staphylococcus aureus (S. aureus) antimicrobial resistance levels in community-dwelling persons. METHODS:The prevalence of an...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-014-0175-8
更新日期:2014-10-25 00:00:00
abstract:BACKGROUND:Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety me...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0793-7
更新日期:2018-06-30 00:00:00
abstract:BACKGROUND:Symptoms of cancer may be interpreted differently by different patients before the diagnosis. This study investigated symptom attributions in Danish patients with colorectal cancer and the potential associations with symptom type, socio-demographic characteristics and patient interval. METHODS:Data were col...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0315-9
更新日期:2015-09-03 00:00:00
abstract:BACKGROUND:The Mini-Mental State Examination (MMSE) has contributed to detecting cognitive impairment, yet few studies have evaluated its accuracy when used by general practitioners (GP) in an actual public-health setting. OBJECTIVES:We evaluated the accuracy of MMSE scores obtained by GPs by comparing them to scores ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-9-29
更新日期:2008-05-13 00:00:00
abstract:BACKGROUND:Poorly controlled diabetes leads to multiple complications including oral health problems. General practitioners (GPs) are at the forefront of management of chronic diseases in primary health care. Diabetes guidelines encourage a proactive role for GPs in oral health complications management in people with d...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1102-9
更新日期:2020-02-13 00:00:00
abstract:BACKGROUND:International disease management guidelines recommend the regular assessment of depression and anxiety in heart failure patients. Currently there is little data on the effect of screening for depression and anxiety on the quality of life and the prognosis of heart failure (HF). We will investigate the associ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-180
更新日期:2013-11-27 00:00:00
abstract:BACKGROUND:Depression is a major health concern, predominantly treated by general practitioners (GPs). Problem solving therapy (PST) is recognised as an effective treatment for depression that is not widely used by GPs. This research aims to explore barriers and enablers that may influence GPs use of this treatment. M...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-8-24
更新日期:2007-04-25 00:00:00
abstract:BACKGROUND:There is a high prevalence of potentially inappropriate prescriptions in primary care. This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. The aim of the present study is to summarise available evidence on the effe...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01166-1
更新日期:2020-06-08 00:00:00
abstract:BACKGROUND:Disabling fatigue is the main illness related reason for prolonged absence from school. Although there are accepted criteria for diagnosing chronic fatigue in adults, it remains uncertain as to how best to define disabling fatigue and Chronic Fatigue Syndrome (CFS) in children and adolescents. In this popula...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-33
更新日期:2005-08-09 00:00:00
abstract:BACKGROUND:'Ad hoc' help-seeking by trainees from their supervisors during trainee consultations is important for patient safety, and trainee professional development. We explored trainee objectives and activities in seeking supervisor assistance, and trainee perceptions of the outcomes of this help-seeking (including ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1084-7
更新日期:2020-02-07 00:00:00
abstract:BACKGROUND:Māori men in New Zealand have higher mortality from prostate cancer, despite having lower incidence rates. The objective of this study was to examine patterns of screening for prostate cancer in primary care and follow-up investigations after an elevated prostate-specific antigen (PSA) result in Māori and no...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-145
更新日期:2014-08-26 00:00:00
abstract:BACKGROUND:Although many studies have documented patient-, clinician-, and organizational barriers/facilitators of primary care among people with mental illnesses, few have examined whether these factors predict actual rates of preventive service use. We assessed whether clinician behaviors, beliefs, characteristics, a...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0693-2
更新日期:2018-01-12 00:00:00
abstract:BACKGROUND:It is common to find a high variability in the accuracy of heart failure (HF) diagnosis in electronic primary care medical records (EMR). Our aims were to ascertain (i) whether the prognosis of HF labelled patients whose ejection fraction (EF) was missing in their EMR differed from those that had it register...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0612-6
更新日期:2017-03-17 00:00:00
abstract:BACKGROUND:An open, constructive safety culture is key in healthcare since it is seen as a main condition for patient safety. Studies have examined culture improvement strategies in hospitals. In primary care, however, not much is known about effective strategies to improve the safety culture yet. The purpose of this s...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2296-14-127
更新日期:2013-08-29 00:00:00
abstract:BACKGROUND:Young people (12-24 years) visit general practice but may not have a 'regular' general practitioner (GP). Whether continuity of GP care influences experiences with, and barriers to, health care among young people is unknown. This paper explores the association between having a regular GP and experience of he...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01294-8
更新日期:2020-10-28 00:00:00
abstract:BACKGROUND:Reform of primary healthcare (PHC) organisations is underway in Canada. The capacity of various types of PHC organizations to respond to populations' needs remains to be assessed. The main objective of this study was to evaluate the association of PHC affiliation with unmet needs for care. METHODS:Populatio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-66
更新日期:2012-07-02 00:00:00
abstract:BACKGROUND:The protection and promotion of breastfeeding is considered a priority in Europe where only 22% of infants less than 6 months old are exclusively breastfed. In Spain this percentage reaches 24.8% but in our city it falls to 18.26%. Various studies emphasise that the improvement of these results should be bas...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-12-144
更新日期:2011-12-30 00:00:00
abstract:BACKGROUND:Increasing physical activity is a cornerstone in the treatment of type 2 diabetes and in general practice it is a challenge to achieve long-term adherence to this life style change. The aim of this study was to investigate in a non-randomised design whether the introduction of motivational interviewing combi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-83
更新日期:2010-11-03 00:00:00
abstract:BACKGROUND:Care for overweight children in general practice involves collaboration with parents. Acknowledging the parents' frames of references is a prerequisite for successful management. We therefore aimed to analyse parental beliefs about the presumed causes and consequences of overweight in children and expectatio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-152
更新日期:2013-10-11 00:00:00
abstract:BACKGROUND:There is wide variation in the quality of care provided by primary care practices to individuals with chronic illnesses. Individual doctor attitudes and interest have been demonstrated to influence patient outcomes in some instances. Given the trend towards larger practices and part-time working, continuity ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-9
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Unhealthy alcohol use involves a spectrum from hazardous use (exceeding guidelines but no harms) through to alcohol dependence. Evidence-based management of unhealthy alcohol use in primary health care has been recommended since 1979. However, sustained and systematic implementation has proven challenging. T...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1101-x
更新日期:2020-02-13 00:00:00
abstract:BACKGROUND:There are now effective drugs to prevent cardiovascular disease and guidelines recommend their use. Patients do not always choose to accept preventive medication at levels of risk reduction recommended in guidelines. The purpose of the study was to identify and explore the attitudes of patients and general p...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-59
更新日期:2011-06-26 00:00:00