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1.
BMJ Open ; 12(5): e056868, 2022 05 09.
Article in English | MEDLINE | ID: mdl-35534055

ABSTRACT

PURPOSE: We sought to understand patients' care-seeking behaviours early in the pandemic, their use and views of different virtual care modalities, and whether these differed by sociodemographic factors. METHODS: We conducted a multisite cross-sectional patient experience survey at 13 academic primary care teaching practices between May and June 2020. An anonymised link to an electronic survey was sent to a subset of patients with a valid email address on file; sampling was based on birth month. For each question, the proportion of respondents who selected each response was calculated, followed by a comparison by sociodemographic characteristics using χ2 tests. RESULTS: In total, 7532 participants responded to the survey. Most received care from their primary care clinic during the pandemic (67.7%, 5068/7482), the majority via phone (82.5%, 4195/5086). Among those who received care, 30.53% (1509/4943) stated that they delayed seeking care because of the pandemic. Most participants reported a high degree of comfort with phone (92.4%, 3824/4139), video (95.2%, 238/250) and email or messaging (91.3%, 794/870). However, those reporting difficulty making ends meet, poor or fair health and arriving in Canada in the last 10 years reported lower levels of comfort with virtual care and fewer wanted their practice to continue offering virtual options after the pandemic. CONCLUSIONS: Our study suggests that newcomers, people living with a lower income and those reporting poor or fair health have a stronger preference and comfort for in-person primary care. Further research should explore potential barriers to virtual care and how these could be addressed.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/therapy , Cross-Sectional Studies , Humans , Ontario/epidemiology , Patient Outcome Assessment , Primary Health Care
2.
J Obstet Gynaecol Can ; 33(9): 944-51, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21923992

ABSTRACT

OBJECTIVE: We sought to determine the incidence of cancer and to compare pathologic outcomes in bleeding and non-bleeding postmenopausal patients who underwent hysteroscopy. METHODS: We conducted a retrospective chart review of 294 postmenopausal women with abnormal uterine bleeding and 142 postmenopausal women without symptoms who underwent hysteroscopy. An 11 mm cut-off for asymptomatic women was applied to determine whether this endometrial thickness threshold would differentiate women with and without endometrial cancer in the asymptomatic group. RESULTS: In symptomatic patients, 14 were found to have endometrial cancer and 10 were found to have endometrial hyperplasia. In the asymptomatic group, two women (1.4%) were found to have endometrial cancer with average thickness 17.5 mm, and one (0.71%) was found to have endometrial hyperplasia. Logistic regression models showed the risk of a bleeding patient developing endometrial cancer at an endometrial thickness of 4 mm was the same as the risk in a non-bleeding patient at a thickness of 15 mm. CONCLUSION: Asymptomatic postmenopausal women have a low risk of having significant endometrial pathology. Cancer was approximately four times more prevalent in women with bleeding than in women with no bleeding.


Subject(s)
Endometrial Neoplasms/diagnosis , Endometrium/diagnostic imaging , Postmenopause , Uterine Hemorrhage , Aged , Endometrial Hyperplasia/diagnosis , Endometrial Neoplasms/pathology , Endometrial Neoplasms/physiopathology , Endometrium/pathology , Female , Humans , Hysteroscopy , Logistic Models , Middle Aged , Retrospective Studies , Risk Factors , Ultrasonography
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