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Biomedical subjects

B Paulsen

Publications and source records attributed to B Paulsen.

10 recordsLinked to original sources
PubMed2000

[Six years with the general practice system--what is the opinion of general practitioners?].

BACKGROUND: In 1993 a list patient system was introduced in four Norwegian municipalities: Trondheim, Tromsø, Lillehammer and Asnes. MATERIAL AND METHODS: Questionnaire surveys were conducted among all GPs in these four municipalities in 1996 and 1999 for the purpose of examining changes in their assessment of the list patient system. RESULTS: The number of GPs generally satisfied with the list patient system declined over the three-year period. Doctors found their workload heavier in 1999 than in 1996, but their confidence in the list patient system as a tool for enhancing quality in general practice did not change over the period. GPs with too long patient lists were the most dissatisfied. The decline in confidence in the new system was strongest in Trondheim, the largest of the four municipalities and that in which the average patient list is longest. In Tromsø, the second largest municipality, with moderate to average patient lists, there were no changes in GP attitudes. INTERPRETATION: The study demonstrates some important consequences of a shortage of medical manpower in a list patient system. Local authorities will have to deal with these challenges.

Attitude of Health Personnel↗
PubMed2000

List patient system: straitjacket or a tool for developing general practice? General practitioners' experiences from a pilot project in Norway.

OBJECTIVE: To investigate attitudes and experiences among general practitioners (GPs) taking part in an experiment with a list patient system in four municipalities in Norway. DESIGN: A questionnaire distributed to all 160 GPs in the four municipalities after 3 years' trial of the system. SETTING: Primary health care in Norway. MAIN OUTCOME MEASURES: The opinions of physicians on a list patient system after 3 years of trial. RESULTS: Most of the physicians held that the list patient system imposed more obligations than they were used to. However, the majority also held that the system enhanced preconditions for doing a good professional job; 68% wanted the system on a permanent basis, while 14% rejected it. CONCLUSION: Positive aspects outweigh negative aspects in the attitude of GPs to a list patient system.

Attitude of Health Personnel↗
PubMed1996

[Responsibility to the population in general practice. Three years experiences with a patient-list systems in Norway].

A list patient system has been tried out among general practitioners in four Norwegian municipalities for a period of three years. For some of the doctors involved the introduction of such a system led to increased work load due to mismatch between the doctor's work capacity and the number of patients on his/her list. However, the experience from the process of establishing the list provided useful knowledge and showed ways of avoiding similar problems if the system is introduced on a national basis. Waiting time for consultation has been reduced, and access to the doctor by telephone has improved. The demand for emergency on call services has been reduced because the doctors are easier to reach during the day. Patients are satisfied with the system and would like to see it become permanent. Two thirds of the GPs involved in the experiment share this standpoint.

Evaluation Studies as Topic↗
PubMed1995

[Patient listing system--grouping of patients and workload of physicians. Patterns in general practice in the municipality of Trondheim].

To assess the impact of patient mix on general practitioners' work-load within a list patient system, a "key" was constructed for computing expected use of general practitioners' services by patients on a doctor's list. The key was based on empirically observed variations in consultation rates for different age and sex-groups. Computations were made for 90 general practitioners in Trondheim. Expected patient weight varied in accordance with the proportion of women and of old patients on the doctor's list. The mean expected use of consultations was approx. 6% higher for patients on female doctor's lists relative to patients on male doctors' lists. The difference between the patients of male and female doctors respectively was far less than previously expected. This is explained by the fact that female doctors - compared with their male colleagues - usually have more children and fewer old people on their list of patients.

Adolescent↗
PubMed1994

[Physician and expert--a conflict situation? General practitioners work with disability pension's errands in a time of restraint policy].

OBJECTIVE: To study how general practitioners perceive their role and conduct their work as certifying physicians for patients applying for disability pension, with emphasis on effects of the revision of the law in 1991 which narrowed the medical criteria for eligibility. DESIGN: Personal in-depth interviews, tape recorded for qualitative analysis. SUBJECTS AND SETTING: 24 general practitioners in the city of Trondheim and rural communities in the county of Møre og Romsdal. OBSERVATIONS: Attitudes and behaviour varied considerably: On one side "the patient's advocate" strived for what he considered to be the best overall result for his patient--as opposed to "the consultant", who regarded himself as neutral and loyal to the policy makers. Narrowing the medical eligibility criteria for disability pension was perceived as reducing the doctor's influence on the outcome of an application. Many "consultants" welcomed the revision. Some "advocates" sought to counteract the loss of influence on the patient's situation through various coping strategies related to the medical certificate. Others intensified the search for alternative solutions to the patient's problems. A third strategy implied leaving the "advocate's" involvement in favour of a more disengaged role in order to make ideals meet with reality. CONCLUSIONS: Many certifying physicians seem to have been under considerable pressure, owing to the conflicting interests of patients and authorities, and we ask whether, under such conditions, the typical doctor tends to adopt a more "bureaucratic" and less "hippocratic" role.

Attitude of Health Personnel↗
PubMed1979

The association of obesity with socioeconomic factors in Missouri.

The prevalence of obesity and underweight was estimated for residents of Missouri more than 9 years old on the basis of age, sex, household income, educational attainment, and population density from the results of a survey conducted in 1973. The incidence of overweight was greatest among children 10 to 16 years old and the least for adults 17 to 35 years old. Four percent of the girls 10 to 16 were greater than 159% of average weight for height. Among women greater than 59 years old the incidence of overweight and underweight were high. The proportion of adult women who were overweight as defined by average weight for height and body mass index (W/H2) was inversely related to household income and education. The same was true for adult men in relation to income but the reverse results were observed for education. A larger proportion of urban men were overweight as defined by body mass index compared to rural men. The incidence of obesity among males of all ages and females greater than 59 years old appeared to be related to residence in specific types of communities.

Adolescent↗