Enter Your Search:
Results 1-2 (2)
Go to page number:
Select a Filter Below
BMC Family Practice (1)
CMAJ: Canadian Medical Association Journal (1)
Kapetanakis, Costas (2)
Beck, Eduard J. (1)
Déry, Véronique (1)
Feldman, Debbie Ehrmann (1)
Guérard, Lise (1)
Hamel, Marjolaine (1)
Lavoie, Gilles (1)
Levesque, Jean-Frédéric (1)
Pineault, Raynald (1)
Prud’homme, Alexandre (1)
Roberge, Danièle (1)
Simard, Brigitte (1)
Thivierge, Claude (1)
Year of Publication
Did you mean:
Emerging organisational models of primary healthcare and unmet needs for care: insights from a population-based survey in Quebec province
BMC Family Practice
Reform of primary healthcare (PHC) organisations is underway in Canada. The capacity of various types of PHC organizations to respond to populations’ needs remains to be assessed. The main objective of this study was to evaluate the association of PHC affiliation with unmet needs for care.
Population-based survey of 9205 randomly selected adults in two regions of Quebec, Canada. Outcomes Self-reported unmet needs for care and identification of the usual source of PHC.
Among eligible adults, 18 % reported unmet needs for care in the last six months. Reasons reported for unmet needs were: waiting times (59 % of cases); unavailability of usual doctor (42 %); impossibility to obtain an appointment (36 %); doctors not accepting new patients (31 %). Regression models showed that unmet needs were decreasing with age and was lower among males, the least educated, and unemployed or retired. Controlling for other factors, unmet needs were higher among the poor and those with worse health status. Having a family doctor was associated with fewer unmet needs. People reporting a usual source of care in the last two-years were more likely to report unmet need for care. There were no differences in unmet needs for care across types of PHC organisations when controlling for affiliation with a family physician.
Reform models of primary healthcare consistent with the medical home concept did not differ from other types of organisations in our study. Further research looking at primary healthcare reform models at other levels of implementation should be done.
Primary care; Unmet needs for care; Primary healthcare organization; Vulnerability
Changing trends in mortality and admissions to hospital for elderly patients with congestive heart failure in Montreal
Feldman, Debbie Ehrmann
Beck, Eduard J.
CMAJ: Canadian Medical Association Journal
Congestive heart failure (CHF) is a common disease requiring admission to hospital among elderly people and is associated with a high mortality rate. The objective of this study was to examine trends in CHF mortality and admissions to hospital in Montreal between 1990 and 1997 for individuals aged 65 years or more.
We obtained information about deaths from the Quebec Death Certificate Registry database and information about admissions to hospital from the Québec Med-Écho database. Patients with a primary diagnosis that was classified as ICD-9 code 428 were considered cases of CHF.
Although age-adjusted rates of mortality from CHF did not change significantly between 1990 and 1997, the annual rate of admission to hospital for CHF increased from 92 per 10 000 population in 1990/91 to 124 per 10 000 population in 1997/98 (p < 0.01). Deaths due to CHF, expressed as a proportion of all cardiovascular deaths, increased among women from 5.6% in 1990 to 6.2% in 1997 (p = 0.01). The rate of readmission for all causes following a first admission for CHF during that year rose over the study period from 16.6% to 22.0% within one month (p < 0.001) and from 46.7% to 49.4% within 6 months (p = 0.03). Conversely, mean annual length of stay per admission decreased from 16.4 days in 1990/91 to 12.2 days in 1997/98.
The increase in rates of admission to hospital for CHF and the stable rates of CHF mortality suggest that the management of CHF and its antecedents has improved in recent years.
Results 1-2 (2)
Go to page number:
Remove citation from clipboard
Add citation to clipboard
This will clear all selections from your clipboard. Do you wish proceed?
Clipboard is full! Please remove an item and try again.
PubMed Central Canada is a service of the
Canadian Institutes of Health Research
(CIHR) working in partnership with the National Research Council's
Canada Institute for Scientific and Technical Information
in cooperation with the
National Center for Biotechnology Information
U.S. National Library of Medicine
(NCBI/NLM). It includes content provided to the
PubMed Central International archive
by participating publishers.