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Does the configuration of a primary care system impact on care quality - an exploratory assessment
Gerrard Abi-Aad, Y-Ling Chi, 2012, review article

Abstract: Primary health care systems (PHCS) can be highly effective at meeting the healthcare needs of people with chronic or multiple morbidity. Under the right conditions it is also the best setting to assess health more generally and to intervene when health risks are identified. For people with an established chronic disease, primary care is also the natural setting to coordinate care and to ensure that patients receive the right balance of specialist vs. generalist input - care that is effectively coordinated can improve the overall quality of care by minimising the need for unnecessary and costly acute care, and by improving patient satisfaction. But how is it possible to measure the configuration of a health system and how do the essential features of health systems relate to quality of care? This paper provides an overview of how this might be approached and discusses the challenges therein.
Keywords: sistem primarnega zdravstvenega varstva, kakovost, večkratna obolevnost, kronična bolezen
Published in RUP: 15.10.2013; Views: 2764; Downloads: 84
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24.
The presence of anxiety and depression in the adult population of family practice patients with chronic diseases
Zalika Klemenc-Ketiš, Janko Kersnik, Erika Tratnik, 2009, original scientific article

Abstract: Background: The prevalence of multimorbidity in family practice is rising and psychiatric comorbidity presents a risk factor for premature mortality. Objective: The aim of this study was to determine the prevalence of anxiety and depression in the adult population of family practice patients with chronic somatic diseases, aged between 18 and 64 years old. Methods: We performed a cross sectional study in 500 consecutive patients from twelve family practices. Zung's self-assessment inventories for anxiety and depression were used to determine the presence of psychiatric comorbidity. The main outcome measures were depression and anxiety scores in patients with various comorbidities. Results: The response rate was 90.4 %. 8.4 % of family practice visitors suffered from anxiety symptoms and 15.2 % from depressive symptoms. At least one chronic disease was present in 40.7 % of the patients. Significantly higher rates of depression and anxiety were found among patientswith chronic somatic disease (p=0.001, P<0.001, respectively; ?2 test)or chronic pain (p<0.001, p<0.001, respectively; ?2 test). Significantly more patients with rheumatic diseases had depression in comparison to those without them (p=0.018; ?2 test). Significantly more patients with migraine or rheumatic diseases had anxiety in comparison to those without them (p=0.010, p=0.030, respectively; ?2 test). Chronic pain was present in significantly more patients with a particular chronic disease in comparison to the patients without it (p<0.050; ?2 test). Conclusions: Family doctors should actively search and treat psychiatric comorbidity also in the population of patients with chronic somatic diseases, aged between 18 and 64 years old.
Keywords: družinske medicina, anksioznost, depresija, kronična bolezen, bolečina
Published in RUP: 15.10.2013; Views: 3556; Downloads: 48
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