Thomas C O'Dowd

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BACKGROUND Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than either primary or specialty care alone. It has been defined as the joint participation of primary care physicians and specialty care physicians in the planned delivery of care, informed by an enhanced information exchange(More)
BACKGROUND Estimating the supply of GPs into the future is important in forecasting shortages. The lengthy training process for medicine means that adjusting supply to meet demand in a timely fashion is problematic. This study uses Ireland as a case study to determine the future demand and supply of GPs and to assess the potential impact of several possible(More)
OBJECTIVES To determine exposure to violence by a partner or spouse among women attending general practice and its association with respondents' demographic and personal characteristics; frequency of inquiry about violence by general practitioners; and women's views on routine questioning about domestic violence by general practitioners. DESIGN Cross(More)
Multimorbidity is the coexistence of two or more chronic diseases in an individual. Prevalence studies indicate that it is the normal state of affairs, especially in patients over the age of 65 years. A smaller subgroup of patients are more severely affected by multimorbidity as the combination and severity of their conditions results in significant loss of(More)
OBJECTIVE To estimate the effect of a consultation charge on the health-seeking behaviour of patients. METHODS Cross-sectional survey of patients carried out in Northern Ireland, where services are free at the point of delivery, and the Republic of Ireland, where 70% of the population are charged a consultation fee to see the general practitioner (GP). (More)
BACKGROUND Multimorbidity is defined as the occurrence of two or more chronic diseases in one individual. Patients with multimorbidity generally have poorer health and functioning and higher rates of attendance in primary care and specialty settings. AIM To explore the views and attitudes of GPs and pharmacists managing patients with multimorbidity in(More)
BACKGROUND Low back pain is a common and persistent problem. Research studies seeking to improve the quality of management of this condition have tended to ignore the opinions of patients. There is a growing acceptance of the importance of taking patients' views into account in developing management and educational programmes for a variety of conditions. (More)
OBJECTIVE To determine the effectiveness of shared care interventions designed to improve the management of chronic disease across the primary-specialty care interface. STUDY DESIGN AND METHODS Systematic review using the Cochrane Collaboration method. RESULTS Twenty studies were identified, 19 of which were randomized controlled trials. The majority of(More)
In anticipation of major changes in medical manpower in Ireland, we surveyed all interns about their career plans. Three hundred (65% of those surveyed) responded. There were clear gender differences in career plans and overall, only 15% planned a career in general practice. There was a negative perception about the quality of postgraduate training in(More)