Scandinavian journal of primary health care
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Scand J Prim Health Care · Jun 1991
General practitioners' attitudes to a recent change in their remuneration system.
The study examines the attitudes of general practitioners in Copenhagen to a recent change in their remuneration system from capitation to a mixed capitation and fee-for-service system. The study was based on two questionnaires, one before and one 18 months after the change, distributed to a primarily self-selected sample of 100 general practioners in Copenhagen City. ⋯ Attitudes to secondary versus primary care responsibilities also changed little. The majority felt that there had been an increase in their total work load, but also an improved economic situation in their practice. 21% felt that there was more competition with colleagues and 30% that doctor-patient relationships had suffered as a result of the introduction of a fee-for-service.
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Scand J Prim Health Care · Jun 1991
Perception of health and use of health care services in a Swedish primary care district. A ten year's perspective.
In a study that covered ten years a questionnaire about perceived health and use of health care services was mailed each autumn to 1/60 representative samples of the population in Sollentuna, a Swedish primary care district. The majority of respondents thought that their health was good, and only a small minority reported themselves as quite, or very sick. ⋯ This increase was most marked in the case of visits to emergency departments and visits by appointment at hospitals, and least in the case of visits to private doctors and company/school physicians, while visits to doctors at health centres and to district nurses occupied an intermediate position. Thus, by including a simple question about perceived health in a questionnaire designed to measure use of health care services, important information about the relations between use of health services and health conditions could be obtained.
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Scand J Prim Health Care · Dec 1990
Home-voided urine specimens in women. Diagnostic agreement with clean-catch midstream specimens.
One hundred and fifty women who brought a home-voided urine sample to a general practitioner were asked at the same consultation to provide another sample under controlled conditions. Seventy-three women had lower urinary tract symptoms and 77 were asymptomatic. The two samples were analysed for pyuria (greater than or equal to 5 leucocytes/HPF) and bacteriuria (greater than or equal to 10(4) v. greater than or equal to 10(5) cfu/ml). ⋯ There was, however, no difference in the distribution of pyuria or bacteriuria between the paired samples. Agreement, which was high for the diagnosis of pyuria (K = 0.80), was significantly lower for the diagnosis of bacteriuria (K = 0.52, P less than 0.01). A home-voided sample seems sufficient in the diagnosis of the dysuria-pyuria syndrome in women.
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Scand J Prim Health Care · Jul 1990
A three-year training programme for primary health care physicians in Poland.
A three-year training programme was developed and implemented by the Medical Centre of Postgraduate Education in Poland with the aim of improving the knowledge and skills of primary health care physicians working in the State Health Services' community centres. The programme creates several learning and self-assessment opportunities with the general principle of not distracting a doctor from his daily duties in a community health centre for more than one day a month. ⋯ It increased health authorities' activity in creating new learning opportunities and doctors' motivation to learn. Self-assessment made by the first group of trainees who completed the three-year programme (results obtained by means of a questionnaire) revealed substantial increase in professional competence resulting from the participation in the programme.
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Scand J Prim Health Care · Jul 1990
Doctors in a white coat--what do patients think and what do doctors do?
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 patients' preferences were to some extent related to their own doctors' use of a white coat, and there was a significant increase in the demand for a white coat with increasing age of the patients.