Integration of primary health care concepts in a children's hospital with limited resources

INTRODUCTION —Robert A. Hoekelman, MD This debate is one of a series entitled "Controversies in Child Health and Pediatric Practice." In 1978 and 1979, the Department of Pediatrics at the University of Rochester conducted 12 such debates, which were published in book form in 1981.1 It is interesting that of these 12 controversies, not one has been resolved. That may prove to be the case for the controversy presented in this debate, "Who should provide primary health care to children: pediatricians or family medicine physicians?" Our guest speakers are Dr Michael Klein and Dr James E. Strain. Dr Klein is Professor of Family Medicine and Assistant Professor of Pediatrics at McGill University School of Medicine. He is also Director of the Department of Family Medicine and of the Herzl Family Practice Center at the Sir Mortimer B. Davis Jewish General Hospital in Montreal. Dr Klein received his medical degree at Stanford University in 1966, and he was his class's recipient of the pediatric Harold K. Kaiser Award. Dr Klein served his internship at Bronx Municipal Hospital Center at Albert Einstein University and his pediatric residency at Montreal Children's Hospital. During his last year, he served as Senior Resident in Neonatology under Robert Usher at the Royal Victoria Hospital. He then became a fellow in biochemical genetics under Charles Scriver and the Chief Medical Resident at Montreal Children's Hospital under Mary Ellen Avery. In 1970, he came to Rochester as a Fellow in Ambulatory Pediatrics. Dr Klein's practice experience is extensive. He was the pediatric coordinator of the St Jacques Clinic in Montreal during the late 1960s and the medical director of the Westside Health Services in Rochester from 1971 to 1975, after which he assumed his current position.

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Aspects of the Primary Health Care Modernization Program: Problems and Trends

Economics and Management ◽

10.35854/1998-1627-2021-6-396-409 ◽

2021 ◽

Vol 27 (6) ◽

pp. 396-409

Author(s):

N. P. Sanina ◽

M. V. Kravtsova

Keyword(s):

Health Care ◽

Primary Health Care ◽

Medical Care ◽

State Regulation ◽

Moscow Region ◽

Limited Resources ◽

Medical Services ◽

Time Costs ◽

Primary Health ◽

The Impact

Aim. The presented study aims to identify problems in the implementation of the primary health care modernization program and to propose possible solutions through the example of the Moscow region.Tasks. The authors determine the role of modernization in the health care industry; analyze the experience of implementing the primary health care modernization program in the Moscow region; build a model of demand for medical services that reflects the impact of such factors as physical accessibility and time costs on the achievement of program goals.Methods. This study uses comparative analysis, description, generalization, systematization, and modeling to analyze program data for 2020-2021.Results. Human resources have the most potential for health care activities, which requires support through economic incentives and benefits to stimulate employees. The roles of stakeholders in the organizational management system of the departmental target program are determined, which affects the allocation of limited resources. The spending of budget funds during the unstable growth of modernization costs, where public procurement serves as the main means for achieving goals, is analyzed. Measures to monitor the progress of events and decision-making, engaging specialists and independent experts for a transparent modernization process, are proposed. A model of demand for medical services is built, where time costs are a factor limiting the accessibility of medical care for consumers with low income. It is determined that the demand for medical services becomes more sensitive to changes in time costs, which affects the accessibility of medical care.Conclusions. The health care modernization program is an instrument of state regulation of socio-economic policy in the field of medicine. The results of this study can be used by economic entities to effectively manage government programs with limited resources. Special attention should be paid to logistics, which is a functional area of project management. There is a need for an independent commission to independently evaluate the interim results of the program.

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Development, implementation, and evaluation of an integrated multidisciplinary Objective Structured Clinical Examination (OSCE) in primary health care settings within limited resources

Medical Teacher ◽

10.3109/0142159x.2015.1009018 ◽

2015 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Adel Abdelaziz ◽

Mohamed Hany ◽

Hani Atwa ◽

Wagdy Talaat ◽

Somaya Hosny

Keyword(s):

Health Care ◽

Primary Health Care ◽

Clinical Examination ◽

Objective Structured Clinical Examination ◽

Limited Resources ◽

Health Care Settings ◽

Primary Health ◽

Primary Health Care Settings

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Skin diseases in children in rural Kenya: long-term results of a dermatology project within the primary health care system

British Journal of Dermatology ◽

10.1046/j.1365-2133.2001.03962.x ◽

2001 ◽

Vol 144 (1) ◽

pp. 118 ◽

Cited By ~ 6

Author(s):

W. Schmeller

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care System ◽

Skin Diseases ◽

Long Term Results ◽

Primary Health Care System ◽

Primary Health ◽

Rural Kenya ◽

Care System

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Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽

10.1027/0227-5910/a000589 ◽

2019 ◽

Vol 40 (6) ◽

pp. 422-428 ◽

Cited By ~ 1

Author(s):

Chris Rouen ◽

Alan R. Clough ◽

Caryn West

Keyword(s):

Health Care ◽

Primary Health Care ◽

Care Center ◽

Indigenous Communities ◽

Indigenous Australians ◽

Deliberate Self Harm ◽

Health Care Center ◽

Far North ◽

Primary Health ◽

Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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