Abstract:
BACKGROUND:From 2015 to 2016 Germany faced an influx of 1.16 million asylum seekers. In the state of Hamburg Primary Care walk-in clinics (PCWC) were commissioned at refugee camps because the high number of residents (57,000 individuals) could not be provided with access to regular healthcare services. Our study aims were (1) to describe the utilization of a PCWC by camp residents, (2) to compare episodes of continuous care with shorter care episodes and (3) to analyse which diagnoses predict episodes of continuous care in this setting. METHODS:A retrospective longitudinal observational study was conducted by reviewing all anonymized electronic medical records of a PCWC that operated from 4th November 2015 to 22nd July 2016 at a refugee camp in Hamburg. Episodes of care (EOC) were extracted based on the international classification of primary care-2nd edition (ICPC-2). Outcome parameters were episode duration, principal diagnoses, and medical procedures. RESULTS:We analysed 5547 consultations of 1467 patients and extracted 4006 EOC. Mean patient age was 22.7 ± 14.8 years, 37.3% were female. Most common diagnoses were infections (44.7%), non-communicable diseases (22.2%), non-definitive diagnoses describing symptoms (22.0%), and injuries (5.7%). Most patients (52.4%) had only single encounters, whereas 19.8% had at least one EOC with a duration of ≥ 28 days (defined as continuous care). Several procedures were more prevalent in EOC with continuous care: Blood tests (5.2 times higher), administrative procedures (4.3), imaging (3.1) and referrals to secondary care providers (3.0). Twenty prevalent ICPC-2-diagnosis groups were associated with continuous care. The strongest associations were endocrine/metabolic system and nutritional disorders (hazard ratio 5.538, p < 0.001), dermatitis/atopic eczema (4.279, p < 0.001) and psychological disorders (4.056, p < 0.001). CONCLUSION:A wide spectrum of acute and chronic health conditions could be treated at a GP-led PCWC with few referrals or use of medical resources. But we also observed episodes of continuous care with more use of medical resources and referrals. Therefore, we conclude that principles of primary care like continuity of care, coordination of care and management of symptomatic complaints could complement future healthcare concepts for refugee camps.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Oltrogge JH,Schäfer I,Schlichting D,Jahnke M,Rakebrandt A,Pruskil S,Wagner HO,Lühmann D,Scherer Mdoi
10.1186/s12875-020-01253-3subject
Has Abstractpub_date
2020-09-21 00:00:00pages
193issue
1issn
1471-2296pii
10.1186/s12875-020-01253-3journal_volume
21pub_type
杂志文章abstract:BACKGROUND:Physical activity (PA) counselling is an effective approach to promote PA in primary health care (PHC). Barriers to PA counselling in PHC include time constraints, lack of knowledge and skills of providers, and systemic barriers. Using electronic health (eHealth) has the potential to promote PA. This scoping...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01304-9
更新日期:2020-11-06 00:00:00
abstract:BACKGROUND:Assessing the cost effectiveness of training aimed at increasing general practitioners' (GP) work awareness and patients' work-related self-efficacy and quality of life. METHODS:A cluster randomized controlled trial in twenty-six GP practices in the southeast of the Netherlands with 32 participating GPs. GP...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12875-019-0924-9
更新日期:2019-03-02 00:00:00
abstract:BACKGROUND:In order to proceed from a paper based registration to a surveillance system that is based on extraction of electronic health records (EHR), knowledge is needed on the number and representativeness of sentinel GPs using a government-certified EHR system and the quality of EHR data for research, expressed in ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-50
更新日期:2010-06-25 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:'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:Since Huntington's Disease (HD) is a familial disease with an average onset in the mid-thirties, one might expect that spousal carers are concerned with providing care for off-spring who may turn out to be affected. METHODS:This study involved ten face-to-face interviews with carers of spouses affected by H...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-38
更新日期:2005-09-14 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:Multimorbidity is defined as suffering from coexistent chronic conditions. Multimorbid patients demand highly complex patient-centered care which often includes polypharmacy, taking an average of six different drugs per day. Adverse drug reactions, adverse drug events and medication errors are all potential ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-119
更新日期:2013-08-15 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:While trust in physicians has been rigorously investigated regarding its concept, measurement, and factors, the studies have mainly focused on the attributes of the physicians. This approach can lead to a limited understanding of trust in physicians as trust is based on the relationship, an interaction of bo...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0875-6
更新日期:2018-11-29 00:00:00
abstract:BACKGROUND:For people with hearing loss, the General Practitioner (GP) can play an instrumental role in early detection of hearing loss as well as guiding appropriate and timely choices for addressing hearing concerns. The aim of this study was to generate a conceptual framework for understanding the role of the GP in ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01157-2
更新日期:2020-05-14 00:00:00
abstract:BACKGROUND:People use a variety of means to find health information, including searching the Internet, seeking print sources, and talking to healthcare providers, family members, and friends. Doctors are considered the most trusted source of health information, but people may be underutilizing them in favor of searchin...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0805-7
更新日期:2018-08-29 00:00:00
abstract:BACKGROUND:Attention deficit hyperactivity disorder (ADHD) is underdiagnosed in the UK and the assessment and diagnosis pathway often involves a general practitioner (GP) referral to secondary care services. GPs' levels of knowledge and understanding about ADHD is often a significant barrier in patients accessing care....
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01289-5
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The Charlson comorbidity index is widely used in ICD-9 administrative data, however, there is no translation for Read/OXMIS coded data despite increasing use of the General Practice Research Database (GPRD). Our main objective was to translate the Charlson index for use with Read/OXMIS coded data such as the...
journal_title:BMC family practice
pub_type: 历史文章,杂志文章
doi:10.1186/1471-2296-11-1
更新日期:2010-01-05 00:00:00
abstract:BACKGROUND:There are a substantial number of instruments for primary-care clinicians to assess physical-activity (PA). However, there are few studies that have explored the views of clinicians regarding comparative acceptability and ease of use. A better understanding of how clinicians perceive instruments could help o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0536-6
更新日期:2016-09-22 00:00:00
abstract:BACKGROUND:Ultrasound imaging is utilized in Swiss primary care; however, little is known regarding the extent to which it is performed. With this study, we aim to (1) provide an overview of ultrasound use by general practitioners (GPs), and (2) determine the clinical indications of ultrasound in Swiss general practice...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01209-7
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:A well-functioning general practice sector that has a strong research component is recognised as a key foundation of any modern health system. General practitioners (GPs) are more likely to collaborate in research if they are part of an established research network. The primary aims of this study are to desc...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1100-y
更新日期:2020-02-05 00:00:00
abstract:BACKGROUND:The benefit of a "diagnosis" of pre-diabetes in very elderly patients is debated. How clinicians manage pre-diabetic blood results in these patients is unknown. This study aims to understand how clinicians are "diagnosing" older patients with pre-diabetic blood parameters. METHODS:Semi-structured interviews...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-0981-0
更新日期:2019-06-29 00:00:00
abstract:BACKGROUND:The way GPs work does not appear to be adapted to the needs of depressive patients. Therefore we wanted to examine Swedish GPs' conceptions of depressive disorders and their treatment and GPs' ideas of factors that may influence their manner of work with depressive patients. METHODS:A postal questionnaire t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-21
更新日期:2005-05-16 00:00:00
abstract:BACKGROUND:Practice accreditation is a widely used method to assess and improve the quality of healthcare services. In the Netherlands, a practice accreditation program was implemented in primary medical care. We aimed to identify determinants of impact of a practice accreditation program, building on the experiences o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0294-x
更新日期:2015-07-03 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:Organisational problems contribute to many errors in healthcare delivery. Our objective was to identify the most important organisational items in primary care which could be targeted by programs to improve patient safety. METHODS:A web-based survey was undertaken in an international panel of 65 experts on ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-145
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Chronic meningitis is defined as symptoms and signs of meningeal inflammation and persisting cerebrospinal fluid abnormalities such as elevated protein level and pleocytosis for at least one month. CASE PRESENTATION:A 62-year-old woman, of unremarkable past medical history, was admitted to hospital for inve...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-5-21
更新日期:2004-10-06 00:00:00
abstract:BACKGROUND:Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0224-y
更新日期:2015-01-29 00:00:00
abstract:BACKGROUND:There is extensive evidence of health inequality across ethnic groups. Inequity is a complex social phenomenon involving several underlying factors, including ethnic discrimination. In the field of health care, it has been established that ethnic discrimination stems partially from bias or prejudice on the p...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-15-89
更新日期:2014-05-09 00:00:00
abstract::Multimorbidity is a growing issue and poses a major challenge to health care systems around the world. Multimorbidity is related to ageing but many studies have now shown that it is also socially patterned, being more common and occurring at an earlier age in areas of high socioeconomic deprivation. There is lack of r...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0344-4
更新日期:2015-10-14 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: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: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:Prevalence of insomnia symptoms in the general population is high. Insomnia is linked with high health care use and within primary care there are a number of treatment options available. The objective of this study was to determine the association of persistence and remission of insomnia with primary health ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-8
更新日期:2012-02-16 00:00:00