Patient experiences in rural Northern Ontario: small hospital utilization and perspectives on community paramedicine
Notice bibliographique
Résumé
This thesis adhered to an integrated article format with two distinct studies focusing on \nthe analysis of patient medical records from a rural hospital in north east Ontario (Study \n1) and a cross-sectional observational investigation of patient perspectives on community \nparamedicine (CP) (Study 2). The aim of Study 1 was to help hospital administrators \nidentify patients at high risk of frequent hospital resource utilization (emergency \ndepartment (ED) visit or admissions) so that if appropriate, they may be redirected to \nalternative services available in the community. Therefore, the two main research \nquestions for this study were: (1) Which types of patients are more prone to having repeat \nED visits and hospital admissions; and (2) What types of services could better serve or \nhelp improve the health of these patients? Study 2 aimed to evaluate patient and caregiver \nperspectives related to their involvement in three CP programs in rural communities \nacross Northern Ontario. There were two research questions guiding the evaluation of \npatient perspectives in this study: (1) How effective is CP at supporting patient-centered \ncare; and (2) How do perceptions differ between home visit (HV) and wellness clinic \n(WC) patients? In Study 1, twenty-six patients met the criteria for repeat ED visits (65% \nfemale; mean age 52 years) and accounted for a total of 623 ED visits. Seventeen patients \nmet the criteria for repeat admissions (41.2% female; mean age 73 years) and accounted \nfor 69 repeat hospital admissions. The most common reason cited for repeat ED visits \nwas dressing changes and the most common reason cited for repeat admissions was \nchronic obstructive pulmonary disease. For Study 2, 91.7% (n=55) of patients reported being satisfied with the CP services they received and 98.3% (n=59) of the patients \nindicated that they would recommend CP to others. Patient perspectives of CP suggest \nthat the service model is consistent with a patient-centered framework that includes \ninterpersonal, psychosocial, clinical, and structural dimensions. The patients also valued \nCP for the ease of access and the reassurance provided by the paramedics monitoring \ntheir health concerns. Our studies found that an older population with increased health \nneeds appear acceptable towards receiving alternative health care services outside of the \nhospital. Based on the perspectives of patients currently enrolled in CP programs across \nNorthern Ontario, the HV and WC services of CP appeared to be considered as an \nacceptable program that can provide patient-centered care in rural and northern \ncommunities. Collectively, these two studies provide important data related to the patient \nexperience in a rural and northern health care system context. These are encouraging \nsigns that alternative health care services, like the CP programs, can address non-urgent \nissues for residents of northern and rural communities in Ontario.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».