Abstract:
BACKGROUND:Primary health care systems are designed to provide comprehensive patient care. However, the ICD 9 coding system used for billing purposes in Canada neither characterizes nor captures the scope of clinical practice or complexity of physician-patient interactions. This study aims to describe the content of primary care clinical encounters and examine the limitations of using administrative data to capture the content of these visits. Although a number of U.S studies have described the content of primary care encounters, this is the first Canadian study to do so. METHODS:Study-specific data collection forms were completed by 16 primary care physicians in community health and family practice clinics in Winnipeg, Manitoba, Canada. The data collection forms were completed immediately following the patient encounter and included patient and visit characteristics, such as primary reason for visit, topics discussed, actions taken, degree of complexity as well as diagnosis and ICD-9 codes. RESULTS:Data was collected for 760 patient encounters. The diagnostic codes often did not reflect the dominant topic of the visit or the topic requiring the most amount of time. Physicians often address multiple problems and provide numerous services thus increasing the complexity of care. CONCLUSION:This is one of the first Canadian studies to critically analyze the content of primary care clinical encounters. The data allowed a greater understanding of primary care clinical encounters and attests to the deficiencies of singular ICD-9 coding which fails to capture the comprehensiveness and complexity of the primary care encounter. As primary care reform initiatives in the U.S and Canada attempt to transform the way family physicians deliver care, it becomes increasingly important that other tools for structuring primary care data are considered in order to help physicians, researchers and policy makers understand the breadth and complexity of primary care.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Katz A,Halas G,Dillon M,Sloshower Jdoi
10.1186/1471-2296-13-7subject
Has Abstractpub_date
2012-02-15 00:00:00pages
7issn
1471-2296pii
1471-2296-13-7journal_volume
13pub_type
杂志文章abstract:BACKGROUND:A territory-wide diabetes management program (Risk Assessment Management Program - RAMP) was recently established, providing comprehensive management for all diabetics, helping to delineate current level of control and complications prevalence among primary care diabetic patients in Hong Kong. METHOD:This c...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-8
更新日期:2014-01-10 00:00:00
abstract:BACKGROUND:In hypertensive patients, reducing plasma low-density lipoprotein cholesterol level (LDL-C) is one of the main interventions for preventing chronic cardiovascular diseases (CVD). However, LDL-C control remains generally insufficient, also in patients with hypertension. We analyzed Electronic Health Record (E...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01138-5
更新日期:2020-04-14 00:00:00
abstract:BACKGROUND:In medical malpractice litigations in recent years in Japan, it is notable that the growing number of medical litigation cases includes the issue of a doctor's explanation to the patient as a pivotal point. The objective of this study was to identify factors of physicians' communication skills with patients,...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-9-43
更新日期:2008-07-25 00:00:00
abstract:BACKGROUND:Obesity is an important public health problem. However, the effects of alcohol use on the risk for obesity have not been thoroughly explored. This study focuses on how frequency of alcohol use is related to the risk of obesity in a community medicine clinic population. METHODS:This study used a cross-sectio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-17
更新日期:2005-04-22 00:00:00
abstract:BACKGROUND:Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder, that affects approximately 10% of the general population and the majority are diagnosed in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, som...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0225-x
更新日期:2015-01-28 00:00:00
abstract::The editors have retracted this article [1] because it contains extensive overlap with an article published by the same authors in the Journal of Family & Community Medicine [2] and is therefore redundant. ...
journal_title:BMC family practice
pub_type: 杂志文章,撤回出版物
doi:10.1186/s12875-019-1043-3
更新日期:2019-11-05 00:00:00
abstract:BACKGROUND:Interpersonal Psychotherapy (IPT) is recommended in most depression treatment guidelines and proved to be a suitable treatment for elderly depressed patients. Despite the favorable results of IPT in research populations, the dissemination to general practice is surprisingly limited. Little is known about upt...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-8-52
更新日期:2007-09-13 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: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 ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-100
更新日期:2011-09-26 00:00:00
abstract:BACKGROUND:The role of primary care professionals in lifestyle counseling for smoking, alcohol consumption, physical activity, and diet is receiving attention at the national level in many countries. The U. S. and Sweden are two countries currently establishing priorities in these areas. A previously existing internati...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-83
更新日期:2014-05-03 00:00:00
abstract:BACKGROUND:Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-37
更新日期:2005-09-09 00:00:00
abstract:BACKGROUND:Medication review is often recommended to optimize medication use. In clinical practice it is mostly operationalized as an intervention without co-interventions during a short term intervention period. However, most systematic reviews also included co-interventions and prolonged medication optimization inter...
journal_title:BMC family practice
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12875-016-0577-x
更新日期:2017-01-17 00:00:00
abstract:BACKGROUND:The majority of patient contacts occur in general practice but general practice patient safety has been poorly described and under-researched to date compared to hospital settings. Our objective was to produce a set of patient safety tools and indicators that can be used in general practices in any healthcar...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-110
更新日期:2014-06-05 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:The aim here was to explore trends in patient satisfaction with primary health care and its accessibility and continuity, and to explore whether through reforms and improvements some of the essential goals had been achieved over a 14-year period of time in Finland. METHODS:Nine questionnaire surveys were co...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2296-15-98
更新日期:2014-05-15 00:00:00
abstract:BACKGROUND:Chronically ill patients often experience psychosocial problems in everyday life. A biopsychosocial approach is considered to be essential in chronic care. In Dutch primary health care the current biomedically oriented clinical practice may conflict with the biopsychosocial approach. This study is aimed to e...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-14
更新日期:2012-03-12 00:00:00
abstract:BACKGROUND:Urinary tract infections are one of the most common reasons for prescribing antibiotics in primary care. Current guidelines recommend fosfomycin, nitrofurantoin, or trimethoprim - sulfamethoxazol as empiric first line antimicrobial agents in uncomplicated infections. However, there is evidence that the use o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01201-1
更新日期:2020-07-01 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:Cooperatives delivering out of hours care in the Netherlands are hesitant about the use of expert systems during triage. Apart from the extra costs, cooperatives are not sure that quality of triage is sufficiently enhanced by these systems and believe that call duration will be prolonged drastically. No figu...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-9-11
更新日期:2008-02-13 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: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
abstract:BACKGROUND:Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0773-y
更新日期:2018-06-19 00:00:00
abstract:BACKGROUND:Self-management support is widely accepted for the management of chronic conditions. Self-management often requires behaviour change in patients, in which primary care nurses play a pivotal role. To support patients in changing their behaviour, the structured behaviour change Activate intervention was develo...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12875-018-0888-1
更新日期:2018-12-12 00:00:00
abstract:BACKGROUND:Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the c...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-52
更新日期:2014-03-25 00:00:00
abstract:BACKGROUND:General practitioners (GPs) often lack time and resources to invest in health education; audiovisual messages broadcast in the waiting room may be a useful educational tool. This work was designed to assess the effect of a message inviting patients to ask for a tetanus booster vaccination. METHODS:A quasi e...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-12-104
更新日期:2011-09-28 00:00:00
abstract:BACKGROUND:The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9) involved the development of a new survey instrume...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-57
更新日期:2009-08-22 00:00:00
abstract:BACKGROUND:When medically unexplained physical symptoms (MUPS) become persistent, it may have major implications for the patient, the general practitioner (GP) and for society.Early identification of patients with MUPS in electronic medical records (EMRs) might contribute to prevention of persistent MUPS by creating aw...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-109
更新日期:2014-06-05 00:00:00
abstract:BACKGROUND:The purpose of this study is to better understand differences in diabetes self-management, specifically needs, barriers and challenges among men and women living with type 2 diabetes mellitus (T2DM). METHODS:35 participants were recruited from a diabetes education center (DEC) in Toronto, Canada. Five focus...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-122
更新日期:2012-12-19 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:Identification of perinatal mental health problems and effective care for women who experience them are important considering the potentially serious impact that they may have on the wellbeing of the woman, her baby, family and wider society. General practitioners (GPs) play a central role in identifying and...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0884-5
更新日期:2018-12-13 00:00:00