The European journal of general practice
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It has been shown previously that mortality from acute chronic obstructive pulmonary disease (COPD) is higher at small hospitals than at large teaching hospitals. ⋯ It is quite possible to treat acute exacerbations of COPD efficiently and safely in a health centre hospital ward. New treatment modalities and health service structures seem to have led to a decrease in acute exacerbations of COPD since the year 2000, even though the number of patients with this disease has increased as a consequence of ageing of the population. Further research is required on the efficacy of treatment by a general practitioner, e.g., with data on re-hospitalization.
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In Romania data on cardiovascular risk factors are sparse. ⋯ There were relevant gender differences in modifiable cardiovascular risk factors. Many patients failed to meet treatment targets.
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In the Irish Midland Health Service Executive (HSE) Diabetes Structured Care Project, additional resources were targeted at general practice in the absence of a local hospital-based specialized diabetes unit. ⋯ Primary-care-led structured care, with relatively limited but well-focused investment, can achieve quality of care for patients with diabetes, comparable to international best practice.
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To determine the prevalence of multimorbidity in primary care, by age, sex, and socio-economic class, and to analyse the trend in multimorbidity over the last 20 years. ⋯ The increasing amount of multimorbidity in primary care as well as the increasing number of chronic diseases per patient leads to more complex medical care. The general practitioner needs guidelines focusing on multimorbidity to support this care. The registration of chronic diseases by the general practitioner will become more complex and time-consuming.