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Service organization, utilization, and delivery of care

This section aims to publish studies looking at how health care is planned, organized, structured, and delivered in the context of primary care. This section covers, but is not limited to, service policy, access to services, referral processes, consultation practices, and early intervention strategies and services.

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  1. Children diagnosed with cancer often require extensive care for medical, psychosocial and educational problems during and after therapy. Part of this care is provided by family physicians and non-cancer specia...

    Authors: Marianne J. Heins, Maria F. Lorenzi, Joke C. Korevaar and Mary L. McBride

    Citation: BMC Family Practice 2016 17:60

    Content type: Research article

    Published on:

  2. Strong primary care systems are believed to have an important role in dealing with healthcare challenges. Strengthening primary care systems is therefore a common policy goal for many countries. This study aim...

    Authors: Tessa van Loenen, Michael J. van den Berg, Stephanie Heinemann, Richard Baker, Marjan J. Faber and Gert P. Westert

    Citation: BMC Family Practice 2016 17:59

    Content type: Research article

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  3. The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines colla...

    Authors: Jerôme Jean Jacques van Dongen, Stephanie Anna Lenzen, Marloes Amantia van Bokhoven, Ramon Daniëls, Trudy van der Weijden and Anna Beurskens

    Citation: BMC Family Practice 2016 17:58

    Content type: Research article

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  4. Elderly patients are particularly vulnerable to adverse drug reactions, especially if they are affected by additional risk factors such as multimorbidity, polypharmacy, impaired renal function and intake of dr...

    Authors: Julia Carolin Stingl, Katharina Luise Kaumanns, Katrin Claus, Marie-Louise Lehmann, Kathrin Kastenmüller, Markus Bleckwenn, Gunther Hartmann, Michael Steffens, Dorothee Wirtz, Ann-Kristin Leuchs, Norbert Benda, Florian Meier, Oliver Schöffski, Stefan Holdenrieder, Christoph Coch and Klaus Weckbecker

    Citation: BMC Family Practice 2016 17:49

    Content type: Study protocol

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  5. Improving the quality of care of at the medical primary-secondary care interface is both a national and a wider concern. In a qualitative exploration of clinicians’ relationship at the interface, we want to st...

    Authors: Rod Sampson, Rosaline Barbour and Philip Wilson

    Citation: BMC Family Practice 2016 17:45

    Content type: Research article

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  6. Low back pain (LBP) care is frequently discordant with research evidence. This pilot study evaluated changes in LBP care following a systematic, theory informed intervention in a rural Australian Aboriginal He...

    Authors: Ivan B. Lin, Juli Coffin and Peter B. O’Sullivan

    Citation: BMC Family Practice 2016 17:44

    Content type: Research article

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  7. The rising volume of referrals to secondary care is a continuing concern in the NHS in England, with considerable resource implications. Referral management centres (RMCs) are one of a range of initiatives bro...

    Authors: Sarah L. Ball, Joanne Greenhalgh and Martin Roland

    Citation: BMC Family Practice 2016 17:37

    Content type: Research article

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  8. Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is kno...

    Authors: Danielle F. Loeb, Elizabeth A. Bayliss, Carey Candrian, Frank V. deGruy and Ingrid A. Binswanger

    Citation: BMC Family Practice 2016 17:34

    Content type: Research article

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  9. In addiction care, urine drug screening tests are recommended to assess psychoactive substances use. While intrinsic diagnostic value of these tests is demonstrated, the consequences of carrying out these test...

    Authors:

    Citation: BMC Family Practice 2016 17:24

    Content type: Study protocol

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  10. Family Medicine Groups (FMG) were introduced in Quebec in 2002 to re-organize primary care practices and encourage inter-professional service delivery. We measured visits to the emergency department (ED) for a...

    Authors: Renee Carter, Amélie Quesnel-Vallée, Céline Plante, Philippe Gamache and Jean-Frédéric Lévesque

    Citation: BMC Family Practice 2016 17:23

    Content type: Research article

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  11. Living in a neighbourhood with a high density of livestock farms has been associated with adverse respiratory health effects, but less is known about healthcare utilisation. This study aimed at investigating t...

    Authors: Christel E. van Dijk, Lidwien A. M. Smit, Mariette Hooiveld, Jan-Paul Zock, Inge M. Wouters, Dick J. J. Heederik and C. Joris Yzermans

    Citation: BMC Family Practice 2016 17:22

    Content type: Research article

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  12. Despite improving evidence-based practice following clinical guidelines to optimise drug therapy, Type 2 diabetes (T2DM) still exerts a devastating toll from vascular complications and premature death. Biochem...

    Authors: Wilma S. Leslie, Ian Ford, Naveed Sattar, Kieren G. Hollingsworth, Ashley Adamson, Falko F. Sniehotta, Louise McCombie, Naomi Brosnahan, Hazel Ross, John C. Mathers, Carl Peters, George Thom, Alison Barnes, Sharon Kean, Yvonne McIlvenna, Angela Rodrigues…

    Citation: BMC Family Practice 2016 17:20

    Content type: Study protocol

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  13. General practices in the United Kingdom are encouraged to have a protocol for the identification of carers and a mechanism for social care referral. However, a minority of carers are identified and those carin...

    Authors: Emma Carduff, Alison Jarvis, Gill Highet, Anne Finucane, Marilyn Kendall, Nadine Harrison, Jane Greenacre and Scott A Murray

    Citation: BMC Family Practice 2016 17:18

    Content type: Research article

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    The Erratum to this article has been published in BMC Family Practice 2016 17:39

  14. In Singapore, subsidized primary care is provided by centralized polyclinics; since 2000, policies have allowed lower-income Singaporeans to utilize subsidies at private general-practitioner (GP) clinics. We s...

    Authors: Liang En Wee, Wen Qi Cher, David Sin, Zong Chen Li and Gerald Choon-Huat Koh

    Citation: BMC Family Practice 2016 17:16

    Content type: Research article

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  15. Over three-quarters of all suicides are men (England and Wales), this is despite higher levels of anxiety and depression being reported by women. This disparity may in part be explained by atypical presentatio...

    Authors: Anna Cheshire, David Peters and Damien Ridge

    Citation: BMC Family Practice 2016 17:13

    Content type: Research article

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  16. Specialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with dia...

    Authors: Enza Gucciardi, Sherry Espin, Antonia Morganti and Linda Dorado

    Citation: BMC Family Practice 2016 17:12

    Content type: Research article

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  17. In a gatekeeper system, primary care physicians and patients jointly decide whether or not medical specialist care is needed. However, it is the patient who decides to actually use the referral. Referral non-c...

    Authors: Christel E. van Dijk, Judith D. de Jong, Robert A. Verheij, Tessa Jansen, Joke C. Korevaar and Dinny H. de Bakker

    Citation: BMC Family Practice 2016 17:11

    Content type: Research article

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  18. Patient safety gained widespread public attention in the last 20 years. However, most patient safety research relied upon professionals’ exceptions and was realised especially in the hospital sector. Gradually...

    Authors: Sarah Lang, Marcial Velasco Garrido and Christoph Heintze

    Citation: BMC Family Practice 2016 17:6

    Content type: Research article

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  19. Particularly with ageing populations, dementia and stroke and their resultant disability are worldwide concerns. Much of the support for people with these conditions comes from unpaid carers or caregivers. The...

    Authors: Nan Greenwood, Ferruccio Pelone and Anne-Marie Hassenkamp

    Citation: BMC Family Practice 2016 17:3

    Content type: Research article

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  20. Rising demand for health care has prompted interest in new technologies to support a shift of care from hospital to community and primary care, which may require clinicians to undertake new working practices. ...

    Authors: Alison Porter, Mark Rhys Kingston, Bridie Angela Evans, Hayley Hutchings, Shirley Whitman and Helen Snooks

    Citation: BMC Family Practice 2016 17:1

    Content type: Research article

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    The Erratum to this article has been published in BMC Family Practice 2016 17:14

  21. Mastitis is an acute, debilitating condition that occurs in approximately 20 % of breastfeeding women who experience a red, painful breast with fever. This paper describes the factors correlated with mastitis ...

    Authors: Meabh Cullinane, Lisa H. Amir, Susan M. Donath, Suzanne M. Garland, Sepehr N. Tabrizi, Matthew S. Payne and Catherine M. Bennett

    Citation: BMC Family Practice 2015 16:181

    Content type: Research article

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  22. Switzerland is facing a shortage of primary care physicians (PCPs); government organizations therefore suggested a broad variety of interventions to promote primary care. The aim of the study was to prioritize...

    Authors: Ryan Tandjung, Sima Djalali, Susann Hasler, Nathalie Scherz, Thomas Rosemann and Stefan Markun

    Citation: BMC Family Practice 2015 16:178

    Content type: Research article

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  23. Since 2012, all GP practices across Scotland have been supported to take a systematic approach to end-of-life care, by helping them to identify more patients for palliative care through a Palliative Care Direc...

    Authors: Bruce Mason, Susan Buckingham, Anne Finucane, Peter Hutchison, Marilyn Kendall, Hazel McCutcheon, Lorna Porteous and Scott A. Murray

    Citation: BMC Family Practice 2015 16:176

    Content type: Research article

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  24. Generalized Anxiety Disorder (GAD) is a common mental disorder in the primary care setting, marked by persistent anxiety and worries. The aims of this study were to: 1) examine mental health services utilisati...

    Authors: Pasquale Roberge, François Normand-Lauzière, Isabelle Raymond, Mireille Luc, Marie-Michèle Tanguay-Bernard, Arnaud Duhoux, Christian Bocti and Louise Fournier

    Citation: BMC Family Practice 2015 16:146

    Content type: Research article

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  25. The general practice (GP) workforce in England is in crisis, reflected in increasing rates of early retirement and intentions to reduce hours of working. This study aimed to investigate underlying factors and ...

    Authors: Jeremy Dale, Rachel Potter, Katherine Owen, Nicholas Parsons, Alba Realpe and Jonathan Leach

    Citation: BMC Family Practice 2015 16:140

    Content type: Research article

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  26. Sexual dysfunction is prevalent in patients with type 2 diabetes mellitus, but remains one of the most frequently neglected complications in diabetes care. Both patients and care providers appear to have diffi...

    Authors: Anne Rutte, Patricia van Oppen, Giel Nijpels, Frank J. Snoek, Paul Enzlin, Peter Leusink and Petra J. M. Elders

    Citation: BMC Family Practice 2015 16:69

    Content type: Study protocol

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  27. Developing integrated service models in a primary care setting is considered an essential strategy for establishing a sustainable and affordable health care system. The Rainbow Model of Integrated Care (RMIC) ...

    Authors: Pim P. Valentijn, Hubertus J. M. Vrijhoef, Dirk Ruwaard, Inge Boesveld, Rosa Y. Arends and Marc A. Bruijnzeels

    Citation: BMC Family Practice 2015 16:64

    Content type: Research article

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  28. Socioeconomic deprivation is associated with inequalities in health care and outcomes. Despite concerns that the Quality and Outcomes Framework pay-for-performance scheme in the UK would exacerbate inequalitie...

    Authors: Liz Glidewell, Robert West, Julia EC Hackett, Paul Carder, Tim Doran and Robbie Foy

    Citation: BMC Family Practice 2015 16:61

    Content type: Research article

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  29. We investigated the effectiveness of an occupational therapy led self-management support programme, OPTIMAL, designed to address the challenges of living with multiple chronic conditions or multimorbidity in a...

    Authors: Jess Garvey, Deirdre Connolly, Fiona Boland and Susan M Smith

    Citation: BMC Family Practice 2015 16:59

    Content type: Research article

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  30. In the Netherlands, primary out-of-hours (OOH) care is provided by large scale General Practitioner (GP) cooperatives. GP cooperatives can be contacted by patients living in the area surrounding the GP coopera...

    Authors: Tessa Jansen, Marieke Zwaanswijk, Karin Hek and Dinny de Bakker

    Citation: BMC Family Practice 2015 16:54

    Content type: Research article

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  31. Teleradiology entails attainment of x-rays in one location, transfer over some distance and assessment at another location for diagnosis or consultation. This study documents fracture diagnostics, unnecessary ...

    Authors: Jac JWM Jacobs, Jan PAM Jacobs, Eric van Sonderen, Thys van der Molen and Robbert Sanderman

    Citation: BMC Family Practice 2015 16:53

    Content type: Research article

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  32. The use of out-of-hours healthcare services for non-urgent health problems is believed to be related to the organisation of daytime primary care but insight into underlying mechanisms is limited. Our objective...

    Authors: Marleen Smits, Yvonne Peters, Sanne Broers, Ellen Keizer, Michel Wensing and Paul Giesen

    Citation: BMC Family Practice 2015 16:52

    Content type: Research article

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  33. Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. However, limited evidence exists of the challenges GP practices face in implementing telephone triage...

    Authors: Jamie Murdoch, Anna Varley, Emily Fletcher, Nicky Britten, Linnie Price, Raff Calitri, Colin Green, Valerie Lattimer, Suzanne H Richards, David A Richards, Chris Salisbury, Rod S Taylor and John L Campbell

    Citation: BMC Family Practice 2015 16:47

    Content type: Research article

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  34. The working relationship between client and therapist can be important to enhance outcomes from vocational rehabilitation for women with stress-related disorders in primary health care. The aim was to investig...

    Authors: Mona Eklund, Lena-Karin Erlandsson and Birgitta A Wästberg

    Citation: BMC Family Practice 2015 16:46

    Content type: Research article

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  35. To assess the contribution of physician-related factors, especially their influenza vaccine status, in the vaccination coverage of their patients.

    Authors: Pere Godoy, Jesús Castilla, José María Mayoral, Vicente Martín, Jenaro Astray, Núria Torner, Diana Toledo, Núria Soldevila, Fernando González-Candelas, Susana García, José Diaz-Borrego, Sonia Tamames and Angela Domínguez

    Citation: BMC Family Practice 2015 16:44

    Content type: Research article

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  36. The impact of physical inactivity and unhealthy diet on health is increasingly profound. Lifestyle interventions targeting both behaviors simultaneously might decrease the prevalence of overweight and comorbid...

    Authors: Brenda AJ Berendsen, Stef PJ Kremers, Hans HCM Savelberg, Nicolaas C Schaper and Marike RC Hendriks

    Citation: BMC Family Practice 2015 16:37

    Content type: Research article

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  37. The NHS Cardiovascular Health Check (NHSHC) programme was introduced in England in 2009 to reduce cardiovascular disease mortality and morbidity for all patients aged 40 to 74 years old. Programme cost-effecti...

    Authors: Caroline E Jenkinson, Anthea Asprey, Christopher E Clark and Suzanne H Richards

    Citation: BMC Family Practice 2015 16:33

    Content type: Research article

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  38. Patients with comorbid depression and physical health problems have poorer outcomes compared with those with single long term conditions (LTCs), or multiple LTCs without depression. Primary care has traditiona...

    Authors: Sarah E Knowles, Carolyn Chew-Graham, Isabel Adeyemi, Nia Coupe and Peter A Coventry

    Citation: BMC Family Practice 2015 16:32

    Content type: Research article

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  39. Geriatric screening tools are increasingly implemented in daily practice, especially in the oncology setting, but also in primary care in some countries such as the Netherlands. Nonetheless, validation of thes...

    Authors: Laura Deckx, Marjan van den Akker, Liesbeth Daniels, Eric T De Jonge, Paul Bulens, Vivianne CG Tjan-Heijnen, Doris L van Abbema and Frank Buntinx

    Citation: BMC Family Practice 2015 16:30

    Content type: Research article

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  40. A Reference Framework for Hypertension Care was recently developed by Hong Kong government to emphasise the importance of primary care for subjects with high blood pressure (BP). The Dietary Approaches to Stop...

    Authors: Harry HX Wang, Martin CS Wong, Rosina Y Mok, Mandy WM Kwan, Wai Man Chan, Carmen KM Fan, Catherine LS Lee and Sian M Griffiths

    Citation: BMC Family Practice 2015 16:26

    Content type: Research article

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  41. Many physicians in Sweden, as well as in other countries, find the matter of certification of sickness absence (COSA) particularly burdensome. The issuing of COSAs has also been perceived as a work-environment...

    Authors: Lars Carlsson, Linda Lännerström, Thorne Wallman and Inger K Holmström

    Citation: BMC Family Practice 2015 16:21

    Content type: Research article

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  42. The visions of more integrated care have created new roles and accountabilities for organizations and professionals. Thus, professionals are increasingly expected to engage in boundary spanning activities in o...

    Authors: Marius Brostrøm Kousgaard, Anne Sofie Kjær Joensen and Thorkil Thorsen

    Citation: BMC Family Practice 2015 16:17

    Content type: Research article

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  43. North American patients are experiencing difficulties in securing affiliations with family physicians. Centralized waiting lists are increasingly being used in Organisation for Economic Co-operation and Develo...

    Authors: Mylaine Breton, Astrid Brousselle, Antoine Boivin, Danièle Roberge, Raynald Pineault and Djamal Berbiche

    Citation: BMC Family Practice 2015 16:10

    Content type: Research article

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  44. Point-of-care (POC) tests are devices or test strips that can be used near or at the site where care is delivered to patients, enabling a relatively fast diagnosis. Although many general practitioners (GPs) in...

    Authors: Claudette de Vries, Carine Doggen, Ellen Hilbers, Robert Verheij, Maarten IJzerman, Robert Geertsma and Ron Kusters

    Citation: BMC Family Practice 2015 16:9

    Content type: Research article

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  45. 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 exp...

    Authors: Gloria Cordoba, Volkert Siersma, Beatriz Lopez-Valcarcel, Lars Bjerrum, Carl Llor, Rune Aabenhus and Marjukka Makela

    Citation: BMC Family Practice 2015 16:7

    Content type: Research article

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  46. Geriatric assessments are established tools in institutional care since they enable standardized detection of relevant age-related disorders. Geriatric assessments could also be helpful in general practice. Ho...

    Authors: Tanja Barkhausen, Ulrike Junius-Walker, Eva Hummers-Pradier, Christiane A Mueller and Gudrun Theile

    Citation: BMC Family Practice 2015 16:4

    Content type: Research article

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  47. Strategies to improve care coordination between primary and hospital care do not always have the desired results. This is partly due to incomplete understanding of the key concepts of care coordination. An in-...

    Authors: Sabine Van Houdt, Walter Sermeus, Kris Vanhaecht and Jan De Lepeleire

    Citation: BMC Family Practice 2014 15:177

    Content type: Research article

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  48. Integration of lifestyle promotion in routine primary care has been suboptimal. Coordinated care models (e.g. screening, brief advice and referral to in-house specialized staff) could facilitate lifestyle prom...

    Authors: Kristin Thomas, Barbro Krevers and Preben Bendtsen

    Citation: BMC Family Practice 2014 15:201

    Content type: Research article

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