Family practice
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We aimed to explore the relative impact of medical and other situational motives on GP's decisions to refer patients to specialist care in a general hospital, and to assess whether having access to a GP hospital influences the decisions. ⋯ Medical motives dominate the decision to refer patients to general hospitals, but access to a GP hospital, in cases where nursing needs and long distances to the general hospital are supplementary considerations, reduces the proportion of patients being referred to general hospitals.
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Multicenter Study Comparative Study Clinical Trial
Do GPs prescribe antidepressants differently for South Asian patients?
In spite of evidence from controlled trials and published guidelines, general practitioners prescribe antidepressants in lower doses and for shorter courses than are recommended [2]. However, these studies have not examined the effect of ethnicity on antidepressant prescribing by general practitioners. ⋯ The results suggest that successful drug treatment of depressed South Asian patients may be less likely than in White patients.
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Comparative Study
A comparison of a Patient Enablement Instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations.
We aimed to compare a new primary care outcome measure-the Patient Enablement Instrument (PEI)-against two established satisfaction measures [the Medical Interview Satisfaction Scale (MISS) and the Consultation Satisfaction Questionnaire (CSQ)]. Specifically, we sought (i) to test whether enablement and satisfaction are related or separate concepts; and (ii) to assess whether the internal consistency of the PEI might be enhanced by the inclusion of items from the satisfaction instruments. ⋯ The study shows that 'enablement' is a primary care outcome measure which is related to but is different from general satisfaction.
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We aimed to analyse factors influencing referral of patients by primary care physicians to specialist consultants at the beginning of the era of direct access to specialists in Israel. ⋯ The results of this study can be used as an aid for decision makers in the health services for determining policy. Direct access to some specialties might be appropriate, but not to all. Adoption of a policy based on these findings could lead to reduced health care costs by reducing the burden on hospital emergency rooms. It might also increase patient satisfaction in that the patients will have greater freedom of choice. On the other hand, more appropriate training of family physicians and more extensive self- and peer-quality assurance will increase the primary physician's knowledge and ability to diagnose and treat a broad range of problems and improve the level of care.