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Risk factors for repetitive doctor's consultations due to cough: a cross-sectional study in a Finnish employed population.

ABSTRACT: OBJECTIVES:Cough is the most common symptom prompting people to consult a doctor, thus representing a huge cost to the healthcare. This burden could be reduced by decreasing the number of repetitive consultations by the same individuals. Therefore, it would be valuable to recognise the factors that associate with repetitive doctor's consultations due to cough. DESIGN:A cross-sectional, email survey. SETTING:Public service employees in two Finnish towns. PARTICIPANTS:The questionnaire was sent to 13 980 subjects; 3695 (26.4 %) participated. INTERVENTIONS:The questionnaire sought detailed information about participant characteristics, all disorders diagnosed by a doctor, various symptoms and doctor's consultations. Those with current cough were inquired about cough characteristics and filled in the Leicester Cough Questionnaire (LCQ). PRIMARY OUTCOME:Repetitive (?3) doctor's consultations due to cough during the previous 12?months. RESULTS:There were 205 participants (5.5% of the participants) with repetitive consultations. They accounted for 848 out of the 1681 doctor's consultations (50.4%) due to cough. Among all participants, repetitive consultations were mainly related to the presence of asthma (adjusted OR (aOR) 2.90 (2.01 to 4.19)) and chronic rhinosinusitis (aOR 2.40 (1.74 to 3.32)). Among the 975 participants with current cough, repetitive consultations were mainly related to a low LCQ total score (aOR 3.84 (2.76 to 5.34) per tertile). Comorbidity, depressive symptoms and smoking were also associated with repetitive consultations. CONCLUSIONS:A modest proportion of subjects with repetitive consultations is responsible for every second doctor's consultation due to cough. The typical features of these subjects could be identified. These findings can help to focus on certain subpopulations in order to plan interventions to reduce the healthcare burden attributable to cough.

SUBMITTER: Koskela HO

PROVIDER: S-EPMC6576114 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Risk factors for repetitive doctor's consultations due to cough: a cross-sectional study in a Finnish employed population.

Koskela Heikki O HO Lätti Anne M AM Pekkanen Juha J

BMJ open 20190611 6

<h4>Objectives</h4>Cough is the most common symptom prompting people to consult a doctor, thus representing a huge cost to the healthcare. This burden could be reduced by decreasing the number of repetitive consultations by the same individuals. Therefore, it would be valuable to recognise the factors that associate with repetitive doctor's consultations due to cough.<h4>Design</h4>A cross-sectional, email survey.<h4>Setting</h4>Public service employees in two Finnish towns.<h4>Participants</h4> ...[more]

PMID: 31189685

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Project description:ObjectivesThe impact of presenteeism on doctors' health, quality of patient care and overall performance of health institutions has been reported. The study aimed to investigate the prevalence of presenteeism among doctors, the association between presenteeism and anxiety/depression, and aspects that can help alleviate presenteeism.DesignA cross-sectional anonymous survey study was conducted between 2017 and 2018.Setting30 hospitals in Hangzhou city, Zhejiang Province, China including 10 category 1 hospitals (20-99 beds), 10 category 2 hospitals (100-499 beds) and 10 category 3 hospitals (> 500 beds) which had the highest population coverage.ParticipantsAt least 3 doctors from each department in the studied hospitals participated. Each participant received a gift worth around US$5 at completion of the survey.Primary and secondary outcome measuresThe prevalence of presenteeism and its relationship with anxiety or depression were evaluated as the primary outcomes. Secondary outcomes included the prevalence of abnormal cases of anxiety and depression.ResultsThe survey was completed by 1153/1309 hospital doctors (response rate 88.1%). Presenteeism was reported by 66.4% of participants. Using the Hospital Anxiety and Depression Scale, 68.8% and 72.3% of participants had abnormal cases of anxiety and depression, respectively. Logistic regression analysis showed that participants with abnormal cases of anxiety, borderline cases of depression or abnormal cases of depression were more likely to practice presenteeism (all p<0.05). Other significant work-related contributing factors included: time working at the current hospital, management duty, monthly salary and ease of replacement (all p<0.05).ConclusionPresenteeism was prevalent among doctors in China and the association of presenteeism with abnormal cases of anxiety or depression was significant. Considering the modifiable work-related contributing factors, appropriate measures at the healthcare institutions to support doctors' mental health, help them develop and reinforce management skills, and ensure appropriate manpower are important to alleviate presenteeism behaviour.

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Project description:ObjectivesPoor indoor environmental quality (IEQ) in schools is related to higher respiratory symptoms of pupils, but little is known about the importance of other factors. This study examined the associations between different psychosocial factors and other pupils' individual and allergic characteristics, beyond school IEQ, and reporting of respiratory symptoms in pupil-administered and parent-administered questionnaires.SettingAll primary and secondary schools in two areas of Helsinki, Finland.ParticipantsPrimary school pupils (grade 3-6, n=8775, 99 school buildings) and secondary school pupils (grade 7-9, n=3410, 30 school buildings) reported their respiratory symptoms, as well as psychosocial factors and individual characteristics. Parents of primary school pupils (grade 1-6, n=3540, 88 school buildings) also filled in questionnaires, but the response rate was low (20% in 2017 and 13% in 2018).Main outcome measureRespiratory symptoms were reported in relation to the school environment and in general (without such relation) by pupils or parents.ResultsWorry about IEQ and low school satisfaction, and asthma and hay fever were related to higher reporting of respiratory symptoms in three samples. The variance between schools in respiratory symptoms was low (intraclass correlation=0.6%-2.4%). Psychosocial factors, especially worry about school's IEQ, explained more of the variance between schools in symptoms than IEQ among secondary school pupils and parents, but not among primary school pupils for symptoms in general. Worry about IEQ also modified the associations between IEQ and respiratory symptoms, but only in parental reports.ConclusionIn addition to IEQ, psychosocial factors and pupils' individual and allergic characteristics were related to higher reporting of respiratory symptoms in all three samples. Psychosocial factors explained more variance between schools than IEQ, although it was 2.4% at most. Other factors beyond IEQ should be considered when interpreting symptom reporting in indoor air questionnaires.

Dataset Information

Risk factors for repetitive doctor's consultations due to cough: a cross-sectional study in a Finnish employed population.

Publications

Risk factors for repetitive doctor's consultations due to cough: a cross-sectional study in a Finnish employed population.

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