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Biomedical subjects

P F Hjort

Publications and source records attributed to P F Hjort.

At least 19 recordsLinked to original sources
PubMed1992

[Cooperation between regional and central hospitals--how to achieve the best results?].

The authors reviews a recent governmental analysis of cooperation between third-line university clinics and local and central hospitals. The hospitals are owned by the government (mainly by the counties), and the various Acts and regulation permit the central authorities to make decisions on all aspects of highly specialized medicine. The analysis concludes that a limited number of problems should be solved by decision of the central government, but only those where national concerns are involved. The counties within a health region should cooperate within a Regional Health Policy Board, to create plans for flow of patients through the health care system, specified for each field of medicine. When such plans have been approved by the Regional Health Policy Board, each county should be willing to accept them. In the event of local disagreement, the central government should decide.

Health Policy↗
PubMed1992

[Highly specialized medicine. How to assign the tasks?].

Norway has four million inhabitants and five university hospitals, each serving one health region. The authors describe the work of a governmental medical committee, whose mandate is to advise on where to locate the various highly specialized medical services. Important questions have been the relationship between experience and quality, and the desire of each university clinic to be able to provide treatment within its own region for most health problems. Their reasons are concern about research and specialist training, and the preference of patients for treatment near to home. A list of proposed national and over-regional centers for certain treatments has been prepared on the basis of the experts' report and comments from all university clinics. These recommendations have provided a medical basis for later economic and political analyses prior to final decision by the Government. Norwegian legislation permits strong governmental regulation of the highly specialized health services.

Health Planning↗
PubMed1992

[The child with bronchial obstruction in general practice. Need for better follow-up].

Early diagnosis and adequate follow-up routines are important in giving children with bronchial asthma good care and treatment. The aim of this study was to evaluate how children with bronchial obstruction and possible asthma were detected and treated in general practice. Children with bronchial obstruction (78) were registered in two municipalities in Nord-Trøndelag county, Norway. The data were supplemented by data from children with asthma (392) describing the situation before they received the diagnosis. In regard to frequency of symptoms and symptoms without infection, too few reported having bronchial asthma. Most children with repeated contacts because of bronchial obstruction had been examined by different doctors, and only seldom was a follow-up appointment made. Not all children with bronchial asthma had been referred to a paediatrician. The study shows that follow-up routines for children with bronchial obstruction are inadequate.

Adolescent↗
PubMed1991

[Good physicians--how will the students turn out?].

Good medical practice requires the amalgamation of two worlds, the world of medical science and the world of sick people. Medical science has seen unbelievable progress, but criticism from patients has nevertheless increased. There is also an increasing gap between the direction of medical science and sick people's problems. The curriculum needs reforming in most medical schools. But the teachers are probably more important than the curriculum. The teachers, at least a few of them, should serve as role models and influence the students for life. I describe my three role models as an illustration. The medical schools must therefore work along two lines, they must reform the curriculum and make the teachers good role models.

Curriculum↗
PubMed1991

Detecting hypertension: screening versus case finding in Norway.

OBJECTIVE: Evaluation of detection of hypertension in adults in the county of Nord-Trøndelag, Norway. DESIGN: Cross sectional survey with clinical follow up examinations. SETTING: Health survey by screening teams from the national health screening service, and examinations by all 106 general practitioners in the county. SUBJECTS: During 1984-6, 74,977 persons (88.1% of those aged 20 years and over) participated in the health survey. MAIN OUTCOME MEASURES: Hypertension (when assessed by standardised recording and by questionnaires on drug treatment for hypertension) according to the blood pressure thresholds used in the Norwegian treatment programme. Subjects positive on screening were grouped after clinical examination into treatment groups. RESULTS: In all, 2399 subjects were positive for hypertension. Before screening 6210 (8.3%) patients reported taking antihypertensive drugs and another 3849 (5.1%) had their blood pressure monitored regularly. All who screened positive were referred to their general practitioner and evaluated according to a standard programme. As a result, drug treatment was started in 406 (0.5%) participants screened and blood pressure monitoring in another 1007 (1.3%). Of all patients taking antihypertensive drugs after the screening, 6399 (94.0%) had been diagnosed before screening, and of those whose blood pressure was monitored after the screening, 79.3% had been diagnosed before screening. CONCLUSIONS: At the blood pressure screening thresholds used, and when hypertension is defined by an overall clinical diagnosis, the results indicate that general practitioners can find and diagnose hypertensive patients with the case finding strategy.

Adult↗
PubMed1991

[Ambulance helicopters in the mountains. An evaluation of the 1-year activity at the Dombås base].

On 1 January 1988 the Norwegian Air Ambulance Plan was put into effect. The operational base for the regional counties Oppland, parts of South Trøndelag, Møre and Romsdal and Hedmark was established in the township of Dombås. The base had a helicopter staffed with a specialist in emergency medicine. The operation of this base was evaluated for the period 1 February 1988 to 1 February 1989. 242 missions were undertaken. In 27 of 184 primary missions (15%) and in 11 of 32 secondary missions (33%) the service was judged to have given health benefit. It may have prevented the death of 13 patients. The service costs during the year were approximately NOK 10 million. The cost-benefit ratio is judged to be too high. In inland-Norway, with a widely scattered population, it is probably better to improve the quality of the emergency services offered by general practitioners and ordinary road ambulances than to use a helicopter staffed with a specialist in emergency medicine.

Aircraft↗
PubMed1990

[The role of internal medicine in health services--time for retirement?].

Internal medicine is more than a hundred years old, even in Norway. Its intellectual fundament originates from nineteenth century medicine in Germany. Traditionally, these German physicians covered the entire field of medicine. However, due to lack of therapeutic remedies their main emphasis was on diagnosis and prognosis. During the last sixty years the tremendous increase in medical knowledge has led to a strong tendency towards organ specialization. The generalists in hospitals have met competition from general practitioners and specialists in geriatrics. At the same time their domain has steadily shrunk as the number of medical hospital beds has been reduced. Although not to the advantage of the patients, progress is wiping out the hospital generalists. Most (90%) hospital doctors are now organ specialists, although the majority of patients admitted to medical departments have diseases in more than one organ system. Therefore, generalists should be at least as equally appreciated as the organ specialists. To save the generalists the educational system must be changed. The two types of specialists should follow their own educational paths qualifying to separate and independent competence areas (general or organ-specific). Medical departments should be encouraged to maintain general sections in addition to the organ-specific sections. The generalist and the organ specialist should be professionally united in their efforts to develop internal medicine as a discipline.

Family Practice↗
PubMed1990

[Treatment of myocardial infarction--current status at Norwegian hospitals].

Present routines for examination, treatment and follow-up of myocardial infarction were registered at all hospitals in Norway. Heparin and salicylic acid are given as standard treatment. Streptokinase is given regularly to patients with a short case-history, while beta-blockers are used mostly in secondary prevention. Patients with unstable angina pectoris are offered acute coronary by-pass operation in 90% of the hospitals. The hospitalization period is short, varying from approximately ten days for patients with large myocardial infarctions, to seven days for patients with small infarctions. Most hospitals have a progressive rehabilitation program which stimulates early discharge of the patients. In general, Norwegian hospitals follow "modern" principles in the treatment of myocardial infarction. The routines are fairly similar in small and large hospitals, and in various parts of the country.

Humans↗