Multimorbidity and Quality of Preventive Care in Swiss University Primary Care Cohorts
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{"title"=>"Multimorbidity and quality of preventive care in Swiss University primary care cohorts", "type"=>"journal", "authors"=>[{"first_name"=>"Sven", "last_name"=>"Streit", "scopus_author_id"=>"36742919100"}, {"first_name"=>"Bruno R.", "last_name"=>"Da Costa", "scopus_author_id"=>"36762938100"}, {"first_name"=>"Douglas C.", "last_name"=>"Bauer", "scopus_author_id"=>"7202231312"}, {"first_name"=>"Tinh Hai", "last_name"=>"Collet", "scopus_author_id"=>"36082515800"}, {"first_name"=>"Stefan", "last_name"=>"Weiler", "scopus_author_id"=>"14820053200"}, {"first_name"=>"Lukas", "last_name"=>"Zimmerli", "scopus_author_id"=>"24339669200"}, {"first_name"=>"Peter", "last_name"=>"Frey", "scopus_author_id"=>"56494302200"}, {"first_name"=>"Jacques", "last_name"=>"Cornuz", "scopus_author_id"=>"7006656677"}, {"first_name"=>"Jean Michel", "last_name"=>"Gaspoz", "scopus_author_id"=>"7005924732"}, {"first_name"=>"Edouard", "last_name"=>"Battegay", "scopus_author_id"=>"7003508959"}, {"first_name"=>"Eve", "last_name"=>"Kerr", "scopus_author_id"=>"7006610258"}, {"first_name"=>"Drahomir", "last_name"=>"Aujesky", "scopus_author_id"=>"6602653322"}, {"first_name"=>"Nicolas", "last_name"=>"Rodondi", "scopus_author_id"=>"6506335496"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"24760077", "doi"=>"10.1371/journal.pone.0096142", "pui"=>"373007701", "issn"=>"19326203", "sgr"=>"84899768930", "scopus"=>"2-s2.0-84899768930"}, "id"=>"635a891a-ea33-3e1b-9729-9dbcbe5a69c8", "abstract"=>"BACKGROUND Caring for patients with multimorbidity is common for generalists, although such patients are often excluded from clinical trials, and thus such trials lack of generalizability. Data on the association between multimorbidity and preventive care are limited. We aimed to assess whether comorbidity number, severity and type were associated with preventive care among patients receiving care in Swiss University primary care settings. METHODS We examined a retrospective cohort composed of a random sample of 1,002 patients aged 50-80 years attending four Swiss university primary care settings. Multimorbidity was defined according to the literature and the Charlson index. We assessed the quality of preventive care and cardiovascular preventive care with RAND's Quality Assessment Tool indicators. Aggregate scores of quality of provided care were calculated by taking into account the number of eligible patients for each indicator. RESULTS Participants (mean age 63.5 years, 44% women) had a mean of 2.6 (SD 1.9) comorbidities and 67.5% had 2 or more comorbidities. The mean Charlson index was 1.8 (SD 1.9). Overall, participants received 69% of recommended preventive care and 84% of cardiovascular preventive care. Quality of care was not associated with higher numbers of comorbidities, both for preventive care and for cardiovascular preventive care. Results were similar in analyses using the Charlson index and after adjusting for age, gender, occupation, center and number of visits. Some patients may receive less preventive care including those with dementia (47%) and those with schizophrenia (35%). CONCLUSIONS In Swiss university primary care settings, two thirds of patients had 2 or more comorbidities. The receipt of preventive and cardiovascular preventive care was not affected by comorbidity count or severity, although patients with certain comorbidities may receive lower levels of preventive care.", "link"=>"http://www.mendeley.com/research/multimorbidity-quality-preventive-care-swiss-university-primary-care-cohorts", "reader_count"=>19, "reader_count_by_academic_status"=>{"Librarian"=>2, "Researcher"=>3, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>1, "Student > Master"=>7, "Student > Bachelor"=>2, "Lecturer"=>2, "Unspecified"=>1}, "reader_count_by_user_role"=>{"Librarian"=>2, "Researcher"=>3, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>1, "Student > Master"=>7, "Student > Bachelor"=>2, "Lecturer"=>2, "Unspecified"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Nursing and Health Professions"=>2, "Medicine and Dentistry"=>7, "Agricultural and Biological Sciences"=>1, "Arts and Humanities"=>1, "Social Sciences"=>3, "Computer Science"=>1, "Decision Sciences"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>7}, "Social Sciences"=>{"Social Sciences"=>3}, "Decision Sciences"=>{"Decision Sciences"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Unspecified"=>{"Unspecified"=>3}, "Arts and Humanities"=>{"Arts and Humanities"=>1}}, "reader_count_by_country"=>{"United States"=>1, "Brazil"=>1}, "group_count"=>0}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1472303"], "description"=>"a<p>Data adjusted for these patients characteristics: age, sex, civil status, legal status, occupation and center. In a 2nd model we adjusted also for the number of outpatient visits by performing a Sensitivity analyses, which showed similar results.</p>b<p>Based on previous studies<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0096142#pone.0096142-Collet1\" target=\"_blank\">[16]</a> and the Charlson index <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0096142#pone.0096142-Charlson1\" target=\"_blank\">[20]</a>.</p>c<p>p for trend.</p>d<p>If the patient has a record of ever having the listed condition or risk factor.</p>e<p>History of transient ischemic attack, cerebral vascular accident, coronary artery disease, angina, myocardial infarction, congestive heart failure or peripheral vascular disease.</p>f<p>p-value comparing adjusted data for each subgroup to patients with 0 comorbidities.</p>g<p>Chronic obstructive pulmonary disease (COPD), asthma, sleep apnea syndrome, sarcoidosis, pulmonary hypertension, bronchiectases, interstitial pulmonary disease or global respiratory insufficiency.</p>h<p>Depression, bipolar disorder, psychosis, schizophrenia, pervasive development disorder.</p>i<p>Not further adjusted for legal status because of low number of patients with data on legal status (n = 10 of 19 patients with schizophrenia).</p>j<p>Solid metastatic, solid non-metastatic cancer, lymphoma, leukemia.</p>k<p>Lower care when metastatic cancer only (data not shown, due to small number of 16 patients).</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health care policy", "Health systems strengthening", "Health care quality", "Health services research", "Health statistics", "Long-term care", "Primary care", "Quality of care", "Database and informatics methods", "Health informatics", "research design", "Clinical research design", "Retrospective studies", "charlson", "preventive", "cardiovascular"], "article_id"=>1005584, "categories"=>["Biological Sciences"], "users"=>["Sven Streit", "Bruno R. da Costa", "Douglas C. Bauer", "Tinh-Hai Collet", "Stefan Weiler", "Lukas Zimmerli", "Peter Frey", "Jacques Cornuz", "Jean-Michel Gaspoz", "Edouard Battegay", "Eve Kerr", "Drahomir Aujesky", "Nicolas Rodondi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0096142.t002", "stats"=>{"downloads"=>3, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Number_of_comorbidities_Charlson_index_and_quality_of_preventive_care_and_cardiovascular_preventive_care_analyzed_also_for_specific_subgroups_/1005584", "title"=>"Number of comorbidities, Charlson index and quality of preventive care and cardiovascular preventive care, analyzed also for specific subgroups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-23 15:14:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1472299"], "description"=>"<p>Left part: Number of comorbidities and percent of provided care for preventive care (blue line) and cardiovascular preventive care (red line), bars showing 95% confidence intervals. Right part: Respective analysis with the Charlson index. Data adjusted for age, sex, civil status, legal status, occupation and treatment center. In a second model we adjusted for number outpatient visits and found similar results.</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health care policy", "Health systems strengthening", "Health care quality", "Health services research", "Health statistics", "Long-term care", "Primary care", "Quality of care", "Database and informatics methods", "Health informatics", "research design", "Clinical research design", "Retrospective studies", "multimorbidity", "preventive"], "article_id"=>1005582, "categories"=>["Biological Sciences"], "users"=>["Sven Streit", "Bruno R. da Costa", "Douglas C. Bauer", "Tinh-Hai Collet", "Stefan Weiler", "Lukas Zimmerli", "Peter Frey", "Jacques Cornuz", "Jean-Michel Gaspoz", "Edouard Battegay", "Eve Kerr", "Drahomir Aujesky", "Nicolas Rodondi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0096142.g001", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Measures_of_multimorbidity_and_association_with_quality_of_preventive_care_/1005582", "title"=>"Measures of multimorbidity and association with quality of preventive care.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-04-23 15:14:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1472304"], "description"=>"a<p>Data were adjusted for age, sex, civil status, legal status, occupation and treatment center. In a second model we adjusted also for the number of outpatient visits by performing a sensitivity analyses and found similar results. Detailed numbers for each indicator are provided in the <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0096142#pone-0096142-t002\" target=\"_blank\">Table 2</a> by <i>Collet et al</i><a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0096142#pone.0096142-Collet1\" target=\"_blank\">[16]</a>.</p>b<p>If care was refused by eligible patients, it was counted as provided care to measure physician-initiated care. When care was provided less frequently than specified (i.e., once a year instead of twice a year or only once instead of annually), it was counted as unprovided care to measure physician adherence to recommendations.</p>c<p>When care was contraindicated, the patient was not counted as eligible, thus reducing the denominator.</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health care policy", "Health systems strengthening", "Health care quality", "Health services research", "Health statistics", "Long-term care", "Primary care", "Quality of care", "Database and informatics methods", "Health informatics", "research design", "Clinical research design", "Retrospective studies", "aggregate", "scores", "recommended", "preventive", "cardiovascular", "adjusted"], "article_id"=>1005585, "categories"=>["Biological Sciences"], "users"=>["Sven Streit", "Bruno R. da Costa", "Douglas C. Bauer", "Tinh-Hai Collet", "Stefan Weiler", "Lukas Zimmerli", "Peter Frey", "Jacques Cornuz", "Jean-Michel Gaspoz", "Edouard Battegay", "Eve Kerr", "Drahomir Aujesky", "Nicolas Rodondi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0096142.t003", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Adjusted_aggregate_scores_of_provided_as_recommended_preventive_care_and_cardiovascular_preventive_carea_adjusted_data_a_/1005585", "title"=>"Adjusted aggregate scores of provided as recommended preventive care and cardiovascular preventive carea: adjusted data<sup>a</sup>.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-23 15:14:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1472305", "https://ndownloader.figshare.com/files/1472306", "https://ndownloader.figshare.com/files/1472307"], "description"=>"<div><p>Background</p><p>Caring for patients with multimorbidity is common for generalists, although such patients are often excluded from clinical trials, and thus such trials lack of generalizability. Data on the association between multimorbidity and preventive care are limited. We aimed to assess whether comorbidity number, severity and type were associated with preventive care among patients receiving care in Swiss University primary care settings.</p><p>Methods</p><p>We examined a retrospective cohort composed of a random sample of 1,002 patients aged 50–80 years attending four Swiss university primary care settings. Multimorbidity was defined according to the literature and the Charlson index. We assessed the quality of preventive care and cardiovascular preventive care with RAND’s Quality Assessment Tool indicators. Aggregate scores of quality of provided care were calculated by taking into account the number of eligible patients for each indicator.</p><p>Results</p><p>Participants (mean age 63.5 years, 44% women) had a mean of 2.6 (SD 1.9) comorbidities and 67.5% had 2 or more comorbidities. The mean Charlson index was 1.8 (SD 1.9). Overall, participants received 69% of recommended preventive care and 84% of cardiovascular preventive care. Quality of care was not associated with higher numbers of comorbidities, both for preventive care and for cardiovascular preventive care. Results were similar in analyses using the Charlson index and after adjusting for age, gender, occupation, center and number of visits. Some patients may receive less preventive care including those with dementia (47%) and those with schizophrenia (35%).</p><p>Conclusions</p><p>In Swiss university primary care settings, two thirds of patients had 2 or more comorbidities. The receipt of preventive and cardiovascular preventive care was not affected by comorbidity count or severity, although patients with certain comorbidities may receive lower levels of preventive care.</p></div>", "links"=>[], "tags"=>["geriatrics", "health care", "Health care policy", "Health systems strengthening", "Health care quality", "Health services research", "Health statistics", "Long-term care", "Primary care", "Quality of care", "Database and informatics methods", "Health informatics", "research design", "Clinical research design", "Retrospective studies", "preventive", "swiss"], "article_id"=>1005586, "categories"=>["Biological Sciences"], "users"=>["Sven Streit", "Bruno R. da Costa", "Douglas C. Bauer", "Tinh-Hai Collet", "Stefan Weiler", "Lukas Zimmerli", "Peter Frey", "Jacques Cornuz", "Jean-Michel Gaspoz", "Edouard Battegay", "Eve Kerr", "Drahomir Aujesky", "Nicolas Rodondi"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0096142.s001", "https://dx.doi.org/10.1371/journal.pone.0096142.s002", "https://dx.doi.org/10.1371/journal.pone.0096142.s003"], "stats"=>{"downloads"=>13, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Multimorbidity_and_Quality_of_Preventive_Care_in_Swiss_University_Primary_Care_Cohorts_/1005586", "title"=>"Multimorbidity and Quality of Preventive Care in Swiss University Primary Care Cohorts", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-04-23 15:14:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1472302"], "description"=>"a<p>Defined as a coronary heart disease (CHD) event in male first-degree relatives <55 years or in female first-degree relatives <65 years.</p>b<p>A former smoker had stopped smoking ≥6 months before baseline and a current smoker was smoking at baseline or had stopped<6 months before baseline.</p>c<p>If the patient has a record of ever having the listed condition or risk factor.</p>d<p>History of transient ischemic attack, cerebral vascular accident, coronary artery disease, angina, myocardial infarction, congestive heart failure or peripheral vascular disease.</p>e<p>Depression, bipolar disorder, psychosis, schizophrenia, pervasive development disorder.</p>f<p>Chronic obstructive pulmonary disease (COPD), asthma, sleep apnea syndrome, sarcoidosis, pulmonary hypertension, bronchiectases, interstitial pulmonary disease or global respiratory insufficiency.</p>g<p>Solid metastatic, solid non-metastatic cancer, lymphoma, leukemia.</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health care policy", "Health systems strengthening", "Health care quality", "Health services research", "Health statistics", "Long-term care", "Primary care", "Quality of care", "Database and informatics methods", "Health informatics", "research design", "Clinical research design", "Retrospective studies", "1002", "adults", "aged", "years", "swiss"], "article_id"=>1005583, "categories"=>["Biological Sciences"], "users"=>["Sven Streit", "Bruno R. da Costa", "Douglas C. Bauer", "Tinh-Hai Collet", "Stefan Weiler", "Lukas Zimmerli", "Peter Frey", "Jacques Cornuz", "Jean-Michel Gaspoz", "Edouard Battegay", "Eve Kerr", "Drahomir Aujesky", "Nicolas Rodondi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0096142.t001", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Patient_characteristics_Random_sample_of_1002_adults_aged_50_8211_80_years_in_four_Swiss_university_primary_care_settings_/1005583", "title"=>"Patient characteristics: Random sample of 1002 adults aged 50–80 years in four Swiss university primary care settings.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-23 15:14:19"}

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Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Medicine and health sciences/Mental health and psychiatry", "average_usage"=>[299, 481]}, {"subject_area"=>"/Medicine and health sciences/Metabolic disorders", "average_usage"=>[252, 402]}]}
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