ORCID Profile
0000-0002-6260-8148
Current Organisations
University of Zurich
,
EMH Schweizerischer Ärzteverlag AG
,
ETH-Bereich Hochschulen
,
Swiss College of Primary Care Physicians
,
University of Luzern
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Publications
Factors associated with patients’ and GPs’ assessment of the burden of treatment in multimorbid patients: a cross-sectional study in primary care
Publisher: Springer Science and Business Media LLC
Date: 28-06-2019
Family practitioners' top medical priorities when managing patients with multimorbidity: a cross-sectional study
Publisher: Royal College of General Practitioners
Date: 23-01-2019
DOI: 10.3399/BJGPOPEN18X101622
Abstract: Managing multiple chronic and acute conditions in patients with multimorbidity requires setting medical priorities. How family practitioners (FPs) rank medical priorities between highly, moderately, or rarely prevalent chronic conditions (CCs) has never been described. The authors hypothesised that there was no relationship between the prevalence of CCs and their medical priority ranking in in idual patients with multimorbidity. To describe FPs’ medical priority ranking of conditions relative to their prevalence in patients with multimorbidity. This cross-sectional study of 100 FPs in Switzerland included patients with ≥3 CCs on a predefined list of 75 items from the International Classification of Primary Care 2 (ICPC-2) other conditions could be added. FPs ranked all conditions by their medical priority. Priority ranking and distribution were calculated for each condition separately and for the top three priorities together. The s le contained 888 patients aged 28–98 years (mean 73), of which 48.2% were male. Included patients had 3–19 conditions (median 7 interquantile range [IQR] 6–9). FPs used 74/75 CCs from the predefined list, of which 27 were highly prevalent ( %). In total, 336 different conditions were recorded. Highly prevalent CCs were only the top medical priority in 66%, and the first three priorities in 33%, of cases. No correlation was found between prevalence and the ranking of medical priorities. FPs faced a great ersity of different conditions in their patients with multimorbidity, with nearly every condition being found at nearly every rank of medical priority, depending on the patient. Medical priority ranking was independent of the prevalence of CCs.
Determinants associated with deprivation in multimorbid patients in primary care—A cross-sectional study in Switzerland
Publisher: Public Library of Science (PLoS)
Date: 24-07-2017
Multimorbidity: can general practitioners identify the health conditions most important to their patients? Results from a national cross-sectional study in Switzerland
Publisher: Springer Science and Business Media LLC
Date: 17-05-2018
A cross-sectional study of Swiss ambulatory care services use by multimorbid patients in primary care in the light of the Andersen model
Publisher: Springer Science and Business Media LLC
Date: 27-07-2020
DOI: 10.1186/S12875-020-01221-X
Abstract: Multimorbidity is frequently encountered in primary care and is associated with increasing use of healthcare services. The Andersen Behavioral Model of Health Services Use is a multilevel framework classifying societal, contextual, and in idual characteristics about the use of healthcare services into three categories: 1. predisposing factors, 2. enabling factors, and 3. need factors. The present study aimed to explore multimorbid patients’ use of ambulatory healthcare in terms of homecare and other allied health services, visits to GPs, and number of specialists involved. A secondary aim was to apply Andersen’s model to explore factors associated with this use. In a cross-sectional study, 100 Swiss GPs enrolled up to 10 multimorbid patients each. After descriptive analyses, we tested the associations of each determinant and outcome variable of healthcare use, according to the Andersen model: predisposing factors (patient’s demographics), enabling factors (health literacy (HLS-EU-Q6), deprivation (DipCare)), and need factors (patient’s quality of life (EQ-5D-3L), treatment burden (TBQ), severity index (CIRS), number of chronic conditions, and of medications). Logistic regressions (dichotomous variables) and negative binomial regressions (count variables) were calculated to identify predictors of multimorbid patients’ healthcare use. Analyses included 843 multimorbid patients mean age 73.0 (SD 12.0), 28–98 years old 48.3% men 15.1% (127/843) used homecare. Social deprivation (OR 0.75, 95%CI 0.62–0.89) and absence of an informal caregiver (OR 0.50, 95%CI 0.28–0.88) were related to less homecare services use. The use of other allied health services (34.9% (294/843)) was associated with experiencing pain (OR 2.49, 95%CI 1.59–3.90). The number of contacts with a GP (median 11 (IQR 7–16)) was, among other factors, related to the absence of an informal caregiver (IRR 0.90, 95%CI 0.83–0.98). The number of specialists involved (mean 1.9 (SD 1.4)) was linked to the treatment burden (IRR 1.06, 95%CI 1.02–1.10). Multimorbid patients in primary care reported high use of ambulatory healthcare services variably associated with the Andersen model’s factors: healthcare use was associated with objective medical needs but also with contextual or in idual predisposing or enabling factors. These findings emphasize the importance of adapting care coordination to in idual patient profiles.
Le programme Multi Morbidité en Médecine de Famille
Publisher: EMH Swiss Medical Publishers, Ltd.
Date: 15-08-2018
Related Organisations
Related Funding Activities
No related grants have been discovered for Stefan Neuner-Jehle.