Primary Care General Practice

Transcription

1 Primary Care General Practice

2 General Practice in Denmark is similar to the NHS in Britain. The GP is the gatekeeper to the health system and treats approx 9 out of 10 contacts in the clinic. The GP works with her own staff, usually in small clinics with 2-4 people. Other professionals in the primary care are ; physioterapists, foot terapists, kiropractors, counsel nurses, midwifes and nurses for infants.

3 Population approx. 5,2 mill. The Danish Health Care System Free health care - both primary, specialists and hospital, payed through taxes. Small private hospital Sector. Out of hours system is run in a cooperation between GP s and The Regional Counsel. Guarantee for an diagnosis and treatment within approx. 2 months after referral.

4 In Denmark - 3,578 practitioners in general practice Approx 60 in Randers Municipality. Each GP has approx patients in the computer.

5 The GPs provide approximately 42 million consultation services pr. year. On average every dane has contact with her doctor almost seven - 7 times a year. Only about 15 percent of the population has no contact with their doctor within a year.

6 Today general practice finalize about 90 % of the nearly 42 million. queries per year We further refer approximately 10%.If the GPs just refer 1% more, it means a 10% increased load in the hospital system.

7 The total cost of Primary medical care including the out of hours medical service is about 7.5 billion kr. corresponding to approx. 1,350 kr. Per. capita per year. It corresponds to about 6 percent of the health budget.

8 You can get acess to general practice via phone, mail, and appointment. Everything is built on the danish CPR system, which gives you the yellow health card. If you don t have a cpr nr you need to show a health card from your national health care system or insurance company. If you don t have that either - you have to pay in cash.

9 A walk through - Sally phones her GP because her daughter Anne is poorly fever, pain swallowing and cough. She gets an appointment the same day. Arrives in the waiting room and uses her yellow card to register arrival. The Doctor fetches the family in the waiting room and after examination and bed side testing concludes tonsillitis a throat infection and she makes an electronic prescription for penicillin. Sally og Anne go to the farmacy, uses the yellow card to confim identity in the apotek. The apotek finds the prescription electronicly and within minutes the medication is delivered often via a robot, with a name, dose and tablets a day tag.

10 Case nr 2. Henrik 65 years old calls the secretary - out of breath again. Gets an acute appointment. Arrives with fever, cough og sputum pneumonia he also recives an prescription for penicillin. Seen again 3 days later not any better wheezing despite his normal medication for smokers lung ( KOL) still fever and is admitted to Hospital.

11 Beryl,82, wakes up on night with chest pain that irradiate to her throat and left arm. She has high blood pressure. Her husband phones the lægevagt and the doctor suspects angina or a Heart Attack. Doctor phones the hospital and the ambulance service at Beryl is admitted to hospital immidiatly. Luckily it was only a case of angina and she is sent home the next day with an appointment with the local specialist for a heart examination ( Ecco).

12 John 56 comes because his left arm feels tired. He has noticed that the arm has started to shiver a little when he is resting. Examination confirmes tremor and reduces power in the left arm. The GP referres John to a local neurologist on the suspicion of Parkinsons Disease. John waits for about a month the neurologist sends John for extra testing including af MR scan and veryfies the diagnosis. John starts training at a physioterapist and after a couple of years also recieves daily medication for his condition.

13 Despite the treatment John s sick leave at work increases gradually, so after som paper work between the GP, Counsil and work place John gets a 56 agreement that compensates John s employer for the extra sick leave as long as John is employed. Physiotherapy is now free of charge due to the Chronic Condition.

14 A good home page to know: Questions -??????

15 Pause. pause and questions. Bodil Clemensen. Herefter slides til 2 runde.

16 General Practice has a central role as the primary contact with the Health system. The GP assumes the different roles of: Generalist. Gatekeeper. Coordinator. The basic function is providing independent investigation, assesment and treatment of the vast majority of symtoms, diseases and health problems that people present to the healthcare services.

17 SHARED CARE

18 HEALTH CARE CHALLENGES

19 The Challenges The amount of Lifestyle diseases and chronic diseases are growing. Increasing proportion of senior citizens Citizens with disease / psychosocial conditions hold them temporarily / permanently inactive. Increased demand for health services. Tight Economy for All.

20 Goals Primary Health Care. Ensure consistent treatment, follow-up and rehabilitation across sectors. Preventing disease and unnecessary admissions and ensure early detection of diseases. Perform treatment via the LEON principle. ( Lowest effective care level). Management - coordinated across sectors.

21 Thank you to the organisers!! Thanks for coming. Hope you enjoyed the show. Come home safely. Svend Kier