Impact of the Swine flu pandemic on General Practitioner (GP) visits in Finland: sex and age differences.

Background: Swine flu might serve as a model for challenges that primary care faces during pandemics. This study examined changes in the numbers and diagnoses of general practitioner (GP) visits during and after the Swine flu pandemic in Vantaa, a Finnish city, and how GP activities recovered after the pandemic. Putative sex and age group differences were also evaluated.

Changes in location and number of nurse consultations as the supply of general practitioners decreases in primary health care: six-year register-based follow-up cohort study in the city of Vantaa, Finland.

Objective: To investigate whether the location and the number of nurse consultations have changed in response to the continuously decreasing number of GP consultations in the fourth-largest city in Finland. It has been suggested that nurse consultations are replacing GP consultations.

Design: A retrospective register-based follow-up cohort study.

Comparing the effectiveness of competition as a method of reminding primary oral health care dentists to record diagnoses with two alternative methods used to enhance the recording of diagnoses in primary health care.

The purpose of this study was to investigate whether competition is an effective method to remind primary oral health care dentists to record diagnoses (RRD). The effectiveness of competition was examined in comparison with financial group bonuses (FGBs) and electronic reminders (ERs) of the electronic health record, together with superior-subordinate or development discussions. Putative differences in the diagnosis recording cultures of Finnish public health care physicians and dentists were studied.

Development of the use of primary health care emergency departments after interventions aimed at decreasing overcrowding: a longitudinal follow-up study.

Background: This study, conducted in a Finnish city, examined whether decreasing emergency department (ED) services in an overcrowded primary care ED and corresponding direction to office-hours primary care would modify service usage for specific gender, age or diagnosis groups.

Methods: This was an observational retrospective study carried out by gradually decreasing ED services in primary care. The interventions aimed at decreasing use of EDs were a) application of ABCDE-triage combined with public guidance on the proper use of EDs, b) closure of a minor supplementary ED, and finally, c) application of "reverse triage" with enhanced direction of the public to office-hours services and away from the remaining ED The annual number of visits to office-hours primary care GPs in different gender, age and diagnosis groups (International Classification of Diseases (ICD - 10) were recorded during a 13-year follow-up period.

Development of office-hours use of primary health centers in the early years of the 21 century: a 13-year longitudinal follow-up study.

This study, conducted in a Finnish city, examined whether a long-lasting observed trend in Finnish primary health care, namely, a decreasing rate of office-hour visits to general practitioners (GPs), would lead to reduced services for specific gender, diagnosis or age groups. This was an observational retrospective follow-up study. The annual number of visits to office-hour primary care GPs in different gender, diagnosis and age groups was recorded during a 13-year follow-up period.

Do electronic reminders alter recorded diagnoses in primary care office-hours practices of health centers: A register-based study in a Finnish city.

Objectives: One purpose of electronic reminders is improvement of the quality of documentation in office-hours primary care. The aim of this study was to evaluate how implementation of electronic reminders alters the rate and/or content of diagnostic data recorded by primary care physicians in office-hours practices in primary care health centers.

Methods: The present work is a register-based longitudinal follow-up study with a before-and-after design.

Differences between recorded diagnoses of patients of an emergency department and office-hours primary care doctors: a register-based study in a Finnish town.

To determine the extent to which it is possible to provide continuity of primary care for those who visit Emergency Departments (EDs) we studied how recorded diagnoses in primary care differ, depending on whether the patient is met in an ED or a primary care office-hours practice. In the present, 12-year follow-up study a report generator of the Electronic Health Record-system provided monthly figures for the number of different recorded diagnoses using the International Classification of Diagnoses (10edition, ICD-10) and the total number of ED doctors and office-hour visits to General Practitioners (GPs). The 20 most common diagnoses covered 48.

The influence of electronic reminders on recording diagnoses in a primary health care emergency department: a register-based study in a Finnish town.

Objective: This study examines whether implementation of electronic reminders is associated with a change in the amount and content of diagnostic data recorded in primary health care emergency departments (ED).

Design: A register-based 12-year follow-up study with a before-and-after design.

Setting: This study was performed in a primary health care ED in Finland.

A longitudinal follow-up study of a type 2 diabetes "lost to follow-up" cohort - positive effect on glycaemic control after changes in medication.

The aim of this study was to evaluate whether patients with type 2 diabetes (T2D) who had stopped attending their diabetes treatment system (referred to as "lost to follow-up", LTF) but who succeeded in improving their glycaemic control after returning to the diabetes treatment system had changes in their diabetes medication when compared with similar patients who did not show improvement. "LTFs" who had baseline haemoglobin A  (HbA ) ≥53 mmol/mol and succeeded in reducing HbA  ≥ 6 mmol/mol during a 12-30 month follow-up period after adhering again to their diabetes treatment system were compared with "LTFs" who had an unsatisfactory change in HbA  or with "LTFs" who maintained good glycaemic control throughout the 12-30 month follow-up period. Unsatisfactory change in HbA  was determined as HbA  ≥ 53 mmol/mol and change <6 mmol/mol after the 12-30 month follow-up period in their diabetes treatment system or HbA  < 53 mmol/mol when returning to the diabetes treatment system but ≥53 mmol/mol at the end of the 12-30 month follow-up period.

The effect of electronic reminders on the recording of diagnoses in primary care: A quasi-experimental before and after study.

This study examined whether using electronic reminders leads to an increase in the rate of diagnosis recordings in the electronic health record system following visits to a general practitioner. The impact of electronic reminders was studied in the primary health care of a Finnish city. This observational quasi-experimental study based on a before-and-after design was carried out by installing an electronic reminder to improve the recording of diagnoses in the computerized electronic health record system.

Variations in older people's use of general practitioner consultations and the relationship with mortality rate in Vantaa, Finland in 2003-2014.

It is generally expected that the growth of the older population will lead to an increase in the use of health care services. The aim was to examine the changes in the number of visits made to general practitioners (GP) by the older age groups, and whether such changes were associated with changes in mortality rates. A register-based observational study in a Finnish city where a significant increase in the older population took place from 2003 to 2014.

A Primary Care Emergency Service Reduction Did Not Increase Office-Hour Service Use: A Longitudinal Follow-up Study.

This study, conducted in a Finnish city, examined whether decreasing emergency department (ED) services in an overcrowded primary care ED and corresponding direction to office-hour primary care would guide patients to office-hour visits to general practitioners (GP). This was an observational retrospective study based on a before-and-after design carried out by gradually decreasing ED services in primary care. The interventions were () application of ABCDE-triage combined with public guidance on the proper use of EDs, () cessation of a minor supplementary ED, and finally () application of "reverse triage" with enhanced direction of the public to office-hour services from the remaining ED.

Relationship between number of contacts between previous dropouts with type 2 diabetes and health care professionals on glycaemic control: A cohort study in public primary health care.

Aim: Previous study findings have shown that more frequent contacts with the diabetes care team predict better diabetes control. It is unknown whether this is true also for previous dropouts with type 2 diabetes (T2D). The aim of this study was to evaluate if those previous dropouts with T2D who succeeded to improve their glycaemic control had more frequent contacts with health care professionals in the public primary diabetes health care system than those dropouts who did not show improvement.

Impact of maternal height and gestational diabetes mellitus on offspring birthweight.

Aims: To evaluate the impact of gestational diabetes mellitus (GDM) and maternal height on offspring birthweight.

Methods: This is an observational cohort study, encompassing 4 111 Finnish primiparous women from Vantaa city, Finland, with singleton deliveries between 2009 and 2015. Data were obtained from the Finnish Medical Birth Register.

Improving the Recording of Diagnoses in Primary Care with Team Incentives: A Controlled Longitudinal Follow-Up Study.

Introduction: We studied whether primary care teams respond to financial group bonuses by improving the recording of diagnoses, whether this intervention leads to diagnoses reflecting the anticipated distribution of diseases, and how the recording of a significant chronic disease, diabetes, alters after the application of these bonuses.

Methods: We performed an observational register-based retrospective quasi-experimental follow-up study with before-and-after setting and two control groups in primary healthcare of a Finnish town. We studied the rate of recorded diagnoses in visits to general practitioners with interrupted time series analysis.

A comparison of the effects of electronic reminders and group bonuses on the recording of diagnoses in primary care: a longitudinal follow-up study.

Objective: To improve the recording of diagnoses in visits to general practitioners, an observational retrospective study based on a before-after design was performed by installing an electronic reminder in the computerized patient chart system, reinforced in feedback delivered in superior-subordinate or development discussions with the general practitioners. The monthly rate of recording diagnoses was observed before and after the intervention. The effect of this intervention on recording of diagnoses was compared with the effects of financial group bonuses on the same parameter in a neighbouring city.

Gestational diabetes in primiparous women-impact of age and adiposity: a register-based cohort study.

Introduction: Data on risk factors for gestational diabetes mellitus (GDM) in primiparous women is limited. The aim of this study was to assess the prevalence of GDM and simultaneously evaluate the impact of age and adiposity in primiparous women at risk of GDM risk.

Material And Methods: This observational register-based cohort study from the city of Vantaa, Finland, included all 7750 primiparous women giving birth between 2009 and 2015 without previously diagnosed diabetes mellitus.

Impact of intervention on metabolic outcomes among dropouts with type 2 diabetes.

Purpose: The aim of this study was to evaluate the effect of an individual intervention given by health care professionals to dropouts with type 2 diabetes (T2D) on their metabolic profile.

Materials/methods: In 2010, we identified 356 T2D dropouts in Vantaa Health Centre, Finland. At the baseline visit the participants' status was assessed including laboratory tests.

Contacting dropouts from type 2 diabetes care in public primary health care: description of the patient population.

Objective: To characterize dropouts from type-2 diabetes (T2D) care in communal primary health care.

Design: An observational study.

Setting: In a Finnish city, patients with T2D who had not contacted the public primary health care system during the past 12 months were identified with a computer based search and contacted by a trained diabetes nurse.

Financial team incentives improved recording of diagnoses in primary care: a quasi-experimental longitudinal follow-up study with controls.

Background: In primary care, financial incentives have usually been directed to physicians because they are thought to make the key decisions in order to change the functions of a medical organization. There are no studies regarding the impact that directing these incentives to all disciplines of the care team (e.g.