scholarly journals Integration, Coordination and Multidisciplinary Care: What can These Approaches Offer to Australian Primary Health Care?

2007 ◽  
Vol 13 (2) ◽  
pp. 56 ◽  
Author(s):  
J. Tieman ◽  
G. Mitchell ◽  
T. Shelby-James ◽  
D. Currow ◽  
B. Fazekas ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Complex Interventions ◽  
Multidisciplinary Care ◽  
Chronically Ill ◽  
Multidisciplinary Teams ◽  
Coordinated Care ◽  
Care Needs ◽  
Primary Health

Australia's population is ageing and the consequential burden of chronic disease increasingly challenges the health system. This has raised interest in, and awareness of, approaches built on multidisciplinary teams and integrated and coordinated care in managing the complex care needs of patient groups such as the chronically ill or frail aged. A systematic investigation of the literature relating to these approaches provided the opportunity to explore the meaning of these terms and their potential application and relevance to the Australian primary health care setting. Five systematic reviews of a sentinel condition and an exemplar approach to coordinated and multidisciplinary care were completed. Common learnings from the individual reviews were identified. The literature suggests that approaches encouraging a coordinated and multidisciplinary plan of care for individual patients and/or particular populations may improve a variety of outcomes. There are many methodological considerations in conducting reviews of complex interventions and in assessing their applicability to the Australian health system.

scholarly journals Assessment Of Treatment For Hypertension In Primary Care

10.3823/2379 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Ana Lívia Araújo Girão ◽  
Glória Yanne Martins Oliveira ◽  
Rodrigo Jacób Moreira De Freitas ◽  
Emiliana Bezerra Gomes ◽  
Rhanna Emanuela Fontenele Lima De Carvalho ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Risk Classification ◽  
Multidisciplinary Teams ◽  
Free Access ◽  
Care Needs ◽  
Qualitative Approaches ◽  
Primary Health ◽  
Evaluative Research

Background: Because hypertension is a multifactorial clinical condition, primary care in this  context consists in strategies for detecting and controlling the disease. Programs emphasizing  this level of care incentive evaluative research as fundamental to generate mechanisms for quality assessment and control, as well as to provide information on the functioning and effectiveness of the health system. The present study aimed to evaluate the quality of health  care provided for hypertensive users in primary health care.  Methods and findings: This is an evaluative research conducted by triangulation of methods  in which the quantitative and qualitative approaches were simultaneously used through  observation, application of questionnaires, interviews and focus group data including  managers, workers and users of a primary health care unit. The study showed that the health  service has fulfilled its role of welcoming users through multidisciplinary teams as a gateway  to the public system. However, the link between the health team and the community has been  gradually undermined by the implementation of spontaneous demand with risk classification,  compromising the continuity of treatment for hypertension.   Conclusions: Multidisciplinary team and empowerment of individuals are fundamental for  the qualification of care. However, the care provided for hypertensive users in primary care  has in most cases been fragmented after the implementation of the system of free access with  risk classification. This fact points to the need to adapt the care needs of hypertensive users to  the new health care model.  

scholarly journals The Reform of Primary Health Care / PHC in Algeria : A First Step Towards a More Equitable and Efficient Health System

2021 ◽  
Vol 2 ◽  
Author(s):  
Nasreddine AISSAOUI
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Care Service ◽  
Quality Care ◽  
Health Care Service ◽  
Chronically Ill ◽  
Poor Quality ◽  
Primary Health ◽  
Mother And Child

Primary care in the national health care service in Algeria plays an important role: the execution of the National Immunization Schedule for infants, the care of mother and child, the monitoring of chronically ill patients, etc. However, offering modern primary health care to cover the real health needs of the population requires responsible and courageous self-criticism, either by health officials or by health economists.This is a descriptive and analytical study that highlights the reality of primary health care in the Algerian health system, which aims to make a constructive critique in relation to the pillars and principles of modern and effective primary health care. We have arrived that the sine qua none conditions must be realized in order to boost the role of primary health care in Algeria, among them: organizational non-accessibility, medium or poor quality care, non-availability of resources early detection of some pathologies… are recurring problems which push the care-seeker to desert primary health care structures, as well as non-compliance with the organization of care.

scholarly journals The Reform of Primary Health Care / PHC in Algeria : A First Step Towards a More Equitable and Efficient Health System

2021 ◽  
Vol 2021 ◽  
Author(s):  
Nasreddine AISSAOUI
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Care Service ◽  
Quality Care ◽  
Health Care Service ◽  
Chronically Ill ◽  
Poor Quality ◽  
Primary Health ◽  
Mother And Child

Primary care in the national health care service in Algeria plays an important role: the execution of the National Immunization Schedule for infants, the care of mother and child, the monitoring of chronically ill patients, etc. However, offering modern primary health care to cover the real health needs of the population requires responsible and courageous self-criticism, either by health officials or by health economists.This is a descriptive and analytical study that highlights the reality of primary health care in the Algerian health system, which aims to make a constructive critique in relation to the pillars and principles of modern and effective primary health care. We have arrived that the sine qua none conditions must be realized in order to boost the role of primary health care in Algeria, among them: organizational non-accessibility, medium or poor quality care, non-availability of resources early detection of some pathologies… are recurring problems which push the care-seeker to desert primary health care structures, as well as non-compliance with the organization of care.

scholarly journals Continuing Education in Health: interprofessional practices in the field of Collective Health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A P N Fornereto ◽  
M N Ogata ◽  
T A Santos ◽  
A B C Franceschini ◽  
MCRLR Pinto ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Continuing Education ◽  
Technical Assistance ◽  
Health Management ◽  
Multidisciplinary Teams ◽  
Target Area ◽  
Clinic Management ◽  
Primary Health ◽  
Health Support

Abstract Family Health Support Centres (NASFs, in Portuguese) aim to develop interprofessional practices anchored in the assumptions of Primary Health Care, guided by the criteria of shared care specific professional interventions, management processes, interdisciplinarity, intersectoriality, Continuing Education in Health and health promotion. This health management methodology (Matrix Support) still represents a challenge to workers and managers, as it switches the logic of clinical thought from individual-centred, ambulatory and disciplinary care to collective, territory and interdisciplinary care. This study might illustrate and allow sharing of experiences about a work management format for multidisciplinary teams in Primary Health Care. A partnership between the University and the state health department was established in order to elaborate a collaborative, educational and supportive action. We formed a group of workers in the target area (24 municipalities and 18 teams) who had a focus on Continuing Education in Health using Institutional Analysis as theoretical reference. The main goal of the action was to provide spaces to share experiences and learning in the perspective of Continuing Education in Health. How does Continuing Education in Health support interprofessional practices in the field of Collective Health? Among the main results, we list: reflection about organisation practices of multiprofessional work, reflection about care practices and clinic management in the technical-assistance and pedagogic perspectives of Matrix Support; encouragement to improve the services offered in this level of care and their relationship with other points of the network. This experience showed us the importance of three main aspects: Continuing Education in Health, as a strategy of critical analysis about work and workers; the partnership and integration between teaching and service; and interprofessional formation processes (necessary to NASF and Collective Health). Key messages Continuing Education in Health is a strategy to deal with challenges and possibilities of interprofessional practices in the field of Collective Health. Enabling experiences and providing spaces for health professionals to share experience and learning.

scholarly journals Management of pharmaceutical services in the Brazilian primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Letícia Farias Gerlack ◽  
Margô Gomes de Oliveira Karnikowski ◽  
Camila Alves Areda ◽  
Dayani Galato ◽  
Aline Gomes de Oliveira ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Pharmaceutical Services ◽  
Limiting Factors ◽  
Health Board ◽  
Complex Samples ◽  
Financial Autonomy ◽  
Unified Health System ◽  
Primary Health

OBJECTIVE: To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). METHODS: This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. RESULTS: We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. CONCLUSIONS: Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening

scholarly journals Access to medicines by patients of the primary health care in the Brazilian Unified Health System

2017 ◽  
Vol 51 ◽  
pp. 20s ◽  
Author(s):  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Vânia Eloisa de Araújo ◽  
Alessandra Maciel Almeida ◽  
Carolina Zampirolli Dias ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Developed Countries ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Unified Health System ◽  
Primary Health ◽  
Significant Difference ◽  
Good For

OBJECTIVE: To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients’ perspective. METHODS: This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Services, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. RESULTS: For the “availability” dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For “accessibility,” 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For “accommodation,” UBS was evaluated as very good/good for the items “comfort” (74.2%) and “cleanliness” (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For “acceptability,” 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units’ service was very good/good. For “affordability,” 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. CONCLUSIONS: Results show 70%–90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally, and decisively to the population

scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

scholarly journals The influence of primary health care organizational models on patients’ experience of care in different chronic disease situations

2011 ◽  
Vol 31 (3) ◽  
pp. 109-120 ◽  
Author(s):  
R Pineault ◽  
S Provost ◽  
M Hamel ◽  
A Couture ◽  
JF Levesque
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Chronically Ill ◽  
Organizational Models ◽  
Experience Of Care ◽  
Primary Health

Objectives To examine the extent to which experience of care varies across chronic diseases, and to analyze the relationship of primary health care (PHC) organizational models with the experience of care reported by patients in different chronic disease situations. Methods We linked a population survey and a PHC organizational survey conducted in two regions of Quebec. We identified five groups of chronic diseases and contrasted these with a no–chronic-disease group. Results Accessibility of care is low for all chronic conditions and shows little variation across diseases. The contact and the coordination-integrated models are the most accessible, whereas the single-provider model is the least. Process and outcome indices of care experience are much higher than accessibility for all conditions and vary across diseases, with the highest being for cardiovascular-risk-factors and the lowest for respiratory diseases (for people aged 44 and under). However, as we move from risk factors to more severe chronic conditions, the coordination-integrated and community models are more likely to generate better process of care, highlighting the greater potential of these two models to meet the needs of more severely chronically ill individuals within the Canadian health care system.

scholarly journals 8.2. Prospects for the use of a comprehensive assessment of the resource potential of medical organizations

2020 ◽  
Author(s):  
С.С. Бударин ◽  
Ю.В. Эльбек
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Comprehensive Assessment ◽  
State Health ◽  
Resource Potential ◽  
Primary Health ◽  
Potential Use

Статья посвящена рассмотрению методики комплексной оценки ресурсного потенциала медицинских организаций, оказывающих населению первичную медико-санитарную помощь. Предложена система показателей оценки эффективности использования ресурсного потенциала по трем направлениям – экономичность, продуктивность, результативность, – сформированная с использованием элементов методологии аудита эффективности. На основании данных медицинских организаций государственной системы здравоохранения г. Москвы, выбранных для исследования, рассчитана комплексная оценка их ресурсного потенциала. The article is devoted to the method of complex assessment of the resource potential of medical organizations that provide primary health care to the population. A system of indicators for evaluating the effectiveness of resource potential use in three areas: Efficiency, Productivity, and Effectiveness, formed using elements of the efficiency audit methodology. A comprehensive assessment of their resource potential is calculated, based on the data of medical organizations of the Moscow state health system selected for the study.

Resolution And Continuity Of Primary Health Care: Reference And Counter-Reference In The Sus (Unified Health System)

2017 ◽  
Vol 04 (01) ◽  
Author(s):  
Maria Beatriz Rodrigues Criscuolo ◽  
Duane Ferreira Melo ◽  
Selma Maria da Fonseca Viegas
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Unified Health System ◽  
Primary Health
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