Objectives: To determine whether a voluntary referral-based interprofessional team-based primary care programme reached its target population and to assess the representativeness of referring primary care physicians.
Design: Cross-sectional analysis of administrative health data.
Setting: Ontario, Canada.
Intervention: TeamCare provides access to Community Health Centre services for patients of non-team physicians with complex health and social needs.
Participants: All adult patients who participated in TeamCare between 1 April 2015 and 31 March 2017 (n=1148), and as comparators, all non-referred adult patients of the primary care providers who shared patients in TeamCare (n=546 989), and a 1% random sample of the adult Ontario population (n=117 753).
Results: TeamCare patients were more likely to live in lower income neighbourhoods with a higher degree of marginalisation relative to comparison groups. TeamCare patients had a higher mean number of diagnoses, higher prevalence of all chronic conditions and had more frequent encounters with the healthcare system in the year prior to participation.
Conclusions: TeamCare reached a target population and fills an important gap in the Ontario primary care landscape, serving a population of patients with complex needs that did not previously have access to interprofessional team-based care.
Strengths And Limitations: This study used population-level administrative health data. Data constraints limited the ability to identify patients referred to the programme but did not receive services, and data could not capture all relevant patient characteristics.
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http://dx.doi.org/10.1136/bmjopen-2022-065362 | DOI Listing |
Int J Surg
January 2025
Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: Microsurgery demands an intensive period of skill acquisition due to its inherent complexity. The development and implementation of innovative training methods are essential for enhancing microsurgical outcomes. This study aimed to evaluate the impact of a simulation training program on the clinical results of fingertip replantation surgeries.
View Article and Find Full Text PDFInt J Surg
January 2025
Department of Cardiovascular Surgery, Nanchong Central Hospital, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong Hospital of Beijing Anzhen Hospital Capital Medical University, Nanchong, China.
Objective: This systematic review and meta-analysis aimed to evaluate and compare the efficacy of endovascular versus open repair for the treatment of patients with descending thoracic aortic aneurysm (DTAA).
Methods: A systematic search of the PubMed, Embase, and Cochrane Library databases for relevant studies was performed. Outcome data, including postoperative mortality and morbidity, operative details, all-cause survival, freedom from aortic-related survival and freedom from aortic-related re-intervention, were independently extracted by two authors in a standardized way.
JAMA Intern Med
January 2025
Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington.
Importance: SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) contribute to many hospitalizations and deaths each year. Understanding relative disease severity can help to inform vaccination guidance.
Objective: To compare disease severity of COVID-19, influenza, and RSV among US veterans.
JAMA Pediatr
January 2025
Vascular Assessment and Management Service, Department of Anaesthesia and Pain, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Queensland, Australia.
Importance: Pediatric peripheral intravenous catheter (PIVC) insertion can be difficult and time-consuming, frequently requiring multiple insertion attempts and often resulting in increased anxiety, distress, and treatment avoidance among children and their families. Ultrasound-guided PIVC insertion is a superior alternative to standard technique (palpation and visualization) in high-risk patients.
Objective: To compare first-time insertion success of PIVCs inserted with ultrasound guidance compared with standard technique (palpation and visualization) across all risk categories in the general pediatric hospital population.
JAMA Intern Med
January 2025
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Importance: There are no validated decision rules for terminating resuscitation during in-hospital cardiac arrest. Decision rules may guide termination and prevent inappropriate early termination of resuscitation.
Objective: To develop and validate termination of resuscitation rules for in-hospital cardiac arrest.
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