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Intensified primary health care for cancer patients: Utilisation of medical services
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of the present thesis is to evaluate the effects of an Intensified Primary Health Care (IPHC) intervention on GPs' and home care nurses' possibilities to monitor and support cancer patients, and on cancer patients utilisation of medical services. A further aim is to identify determinants of cancer patients' utilisation of such services. A total of 485 patients newly diagnosed with breast, colorectal, gastric or prostate cancer were randomised to the intervention or to a control group. The follow-up period was 24 months for all patients.

Patients randomised to the IPHC were referred to the home care nurse. The home care nurse and the GP received copies of the medical record each time the patient was discharged from hospital after a period of in-patient care, or had visited a specialist out-patient clinic. In addition to this, recurrent education and supervision in cancer care were arranged.

The IPHC resulted in a marked increase of home care nurse follow-up contacts. The majority of control patients (74%) reported no such contacts, while 89% of IPHC patients reported this. High age (=80 yr) was the strongest predictor within the IPHC group for reporting a continuing home care nurse contact. Furthermore, the IPHC increased GPs' knowledge about patients' disease and treatments, and appeared to facilitate their possibilities to support the patients. The IPHC reduced the utilisation of specialist care among elderly cancer patients. The number of days of hospitalisation for older patients (=70 yr) randomised to the IPHC were 393 less than for older control patients during the 3 first months after inclusion. Regression analyses defined diagnosis, extensive treatment, comorbidity, low functional status, pain and socio-economic factors as predictors of a high utilisation of medical services.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2000. , p. 67
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 0282-7492 ; 94
Keywords [en]
Medical sciences, Cancer, home care services, general practitioner, utilisation of medical services, prediction
Keywords [sv]
MEDICIN OCH VÅRD
National Category
Medical and Health Sciences
Research subject
Caring Sciences
Identifiers
URN: urn:nbn:se:uu:diva-512ISBN: 91-554-4820-8 (print)OAI: oai:DiVA.org:uu-512DiVA, id: diva2:166002
Public defence
2000-10-20, Sal X, Universitetshuset, Uppsala, 10:00
Available from: 2000-09-29 Created: 2000-09-29Bibliographically approved

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CiteExportLink to record
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Citation style
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