RESUMO
BACKGROUND: Specialist physicians require clinical information for patient visits in ambulatory encounters, some of which they may access via digital health solutions. OBJECTIVE: This study explored the completeness of information for patient care and the consequences of gaps for ambulatory specialist services provided in ambulatory settings in Canada. METHODS: A sample of specialist physicians practising in outpatient clinics was recruited from a health care provider research panel. The study (n=1800 patient encounters) looked at the completeness of patient information experienced by physicians who work in environments with rich health information exchange (Connected) and a comparison cohort with less information available electronically (Unconnected). RESULTS: Unconnected physicians were significantly more likely to be missing information they needed for patient encounters (13% of encounters for Unconnected physicians vs 7% for Connected physicians). Unconnected physicians were also more likely to report that missing information had consequences (23% vs 13% of encounters). Lab results were the most common type of patient information missing for both Unconnected and Connected specialists (25% for Unconnected physicians vs 11% Connected physicians). CONCLUSIONS: The results from this study indicate that Canadian physicians commonly experience information gaps in ambulatory encounters, and that many of these gaps are of consequence to themselves, their patients, and the healthcare system. Wasting physician and patient time, as well as being forced to proceed with incomplete information, were the most common consequences of information gaps reported.
RESUMO
We use the Canadian General Social Surveys of 1999 and 2004 on victimization to examine regional variations in self-protection. Analyses based on 49,624 respondents reveal that residents of Western Canada--the Prairies and British Columbia--are more likely to own guns for protection, controlling for different measures of victimization, insecurity, and urbanization. Residents from British Columbia are also more likely to practice martial arts. Respondents from Eastern Canada--Quebec and the Atlantic region--are less likely to engage in self-protection in general. We observe strong evidence that measures of victimization and insecurity are related to self-protection. Our results suggest that regional variations in self-protection reflect a combination of adversary effects, urbanization effects, and possibly cultural differences.
