Predicting general practitioner utilisation at a small area level across Western Australia

2019 ◽  
Vol 25 (6) ◽  
pp. 570
Author(s):  
Greg Lyle ◽  
Delia Hendrie
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Small Area ◽  
Healthcare Systems ◽  
Fine Scale ◽  
Universal Healthcare ◽  
Primary Health ◽  
Small Area Level ◽  
Gp Services ◽  
Geographic Differences

Equitable delivery of GP services is a key goal in universal healthcare systems. In Australia, information to evaluate equitable delivery is limited, especially at finer geographic scales, leaving an information void that needs to be filled to inform, prioritise and target interventions. To fill this void, GP utilisation was estimated by combining responses on GP utilisation from a national survey differentiated by demographic and area-based socioeconomic and remoteness characteristics with similar characteristics represented geographically at a fine scale. These estimates were then compared to actual GP utilisation to evaluate their predictive reliability. Comparable estimates were found in the greater metropolitan area, with 76% of areas having estimated GP utilisation within ±10% of actual utilisation. Larger discrepancies were found as areas became remoter, with 84% of areas reporting estimated utilisation that was higher than actual utilisation. Comparing the geographic differences between estimated and actual utilisation allowed us to examine the reliability of our methodology. Given the identified limitations, a proxy for GP utilisation at a small area level can be created, a dataset that is not currently published at this geography. This approach has the potential to be applied Australia-wide, providing another valuable tool to evaluate the equitable delivery of primary health care nationally.

scholarly journals Commitment to Care for the Community and COVID-19: teaching-learning approach to medical education in primary health care in Brazil

2020 ◽  
Vol 1 (5) ◽  
pp. 351-358
Author(s):  
Bruno Bastos Godoi ◽  
Luiza Vilas Boas Freitas ◽  
Delba Fonseca Santos
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Primary Health Care ◽  
Healthcare Systems ◽  
Learning Approach ◽  
Collaborative Teams ◽  
Primary Health ◽  
Political Implications ◽  
Short Period ◽  
Teaching Learning

The major challenge of the COVID-19 pandemic to all countries has been to their healthcare systems and how to face it with excellence. Medical education can contribute in a short period so that the health system responds effectively to the current challenges imposed by the pandemic. Political implications identification and action are important to show that they can convert ideas into realities. In the middle of the COVID-19 pandemic, literacy in individual, community, and population health is more important than ever. As knowledge about COVID-19 grows rapidly, so does the opportunity to shape more effective interprofessional educational practices. During this pandemic, interprofessional collaborative teams are more crucial than ever in health promotion, mainly at the Primary Health Care.

scholarly journals Tolerance and acculturation

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Ursula Småland Goth
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Emergency Room ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Gp Services ◽  
Diverse Groups

Background: Since the 1970s, Norway has experienced a significant increase in population diversity. In 2001, a patient-list system, also referred to as the General Practitioner (GP) Scheme (Norwegian: Fastlegeordning), was introduced to ensure access to primary health care for the entire population. At the time of its introduction, the scheme, which was designed for a homogenous population, was intended to improve the quality of GP services. By facilitating stability and continuity in the doctor-patient relationship, the scheme aimed to ensure equitable access to, and use of, secondary health care. Despite the intention to facilitate stable doctor-patient relationships, employees in health care facilities report that many immigrants use the emergency room rather than GP services. Equity in health care is the absence of systematic disparities in health care. Since the provision of equitable health services is a priority in Norway, this study aimed to investigate the possible motives for immigrants’ choice of service provider and to propose measures to increase the uptake of GP services by this group.Purpose and approach: The aim of the article is to examine newly arrived immigrants' experiences with primary health care. The article attempts to shed light on why immigrants seek medical help at the emergency room and not from their assigned GPs in non-life-threatening situations.Methods and materials: We adopted an exploratory approach in order to investigate both the motives and experiences of diverse groups of immigrants. Semi-structured interviews were conducted with 12 Oslo GPs and 13 immigrant representatives, all living in Oslo. To illustrate patterns on a large scale, we adopted a quantitative approach based on data from health authorities’ registers of consultations. 1,935,000 primary health care consultations conducted in the Greater Oslo area over a two-year period were included in the regression analyses.Results and interpretation: The study shows a varied pattern of use of GP services among the diverse groups of foreign-born residents. Results suggest that immigrants are more likely to use emergency-room services during the first few years after arrival. Results also indicate that information about the patient-list system does not always reach newly arrived immigrants. Contrary to general understanding, non-visible immigrants (when considering factors such as skin color and clothing) diverge the most from the pattern of the majority. Immigrants originating from European countries, such as Sweden and Poland, use the emergency room most frequently. From the qualitative aspects of the study, we have also found that primary health care services are not perceived as equitable.Conclusion: Recently arrived immigrants’ utilization of primary health care services shows an unfavorable pattern. The choice of primary health care service providers is dependent on the individual’s preferences, expectations, experiences and/or actual obstacles. The observed utilization of services provided at emergency rooms is one more reason for monitoring and increasing tolerance and cultural sensitivity in primary health care.

scholarly journals Toleranse, kultursensitivitet og akkulturasjon: Interkulturelle utfordringer for primærhelsetjenesten og nyankomne innvandrere i Norge

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Ursula Småland Goth
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Emergency Room ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Gp Services ◽  
Diverse Groups

Background: Since the 1970s, Norway has experienced a significant increase in population diversity. In 2001, a patient-list system, also referred to as the General Practitioner (GP) Scheme (Norwegian: Fastlegeordning), was introduced to ensure access to primary health care for the entire population. At the time of its introduction, the scheme, which was designed for a homogenous population, was intended to improve the quality of GP services. By facilitating stability and continuity in the doctor-patient relationship, the scheme aimed to ensure equitable access to, and use of, secondary health care. Despite the intention to facilitate stable doctor-patient relationships, employees in health care facilities report that many immigrants use the emergency room rather than GP services. Equity in health care is the absence of systematic disparities in health care. Since the provision of equitable health services is a priority in Norway, this study aimed to investigate the possible motives for immigrants’ choice of service provider and to propose measures to increase the uptake of GP services by this group.Purpose and approach: The aim of the article is to examine newly arrived immigrants' experiences with primary health care. The article attempts to shed light on why immigrants seek medical help at the emergency room and not from their assigned GPs in non-life-threatening situations.Methods and materials: We adopted an exploratory approach in order to investigate both the motives and experiences of diverse groups of immigrants. Semi-structured interviews were conducted with 12 Oslo GPs and 13 immigrant representatives, all living in Oslo. To illustrate patterns on a large scale, we adopted a quantitative approach based on data from health authorities’ registers of consultations. 1,935,000 primary health care consultations conducted in the Greater Oslo area over a two-year period were included in the regression analyses.Results and interpretation: The study shows a varied pattern of use of GP services among the diverse groups of foreign-born residents. Results suggest that immigrants are more likely to use emergency-room services during the first few years after arrival. Results also indicate that information about the patient-list system does not always reach newly arrived immigrants. Contrary to general understanding, non-visible immigrants (when considering factors such as skin color and clothing) diverge the most from the pattern of the majority. Immigrants originating from European countries, such as Sweden and Poland, use the emergency room most frequently. From the qualitative aspects of the study, we have also found that primary health care services are not perceived as equitable.Conclusion: Recently arrived immigrants’ utilization of primary health care services shows an unfavorable pattern. The choice of primary health care service providers is dependent on the individual’s preferences, expectations, experiences and/or actual obstacles. The observed utilization of services provided at emergency rooms is one more reason for monitoring and increasing tolerance and cultural sensitivity in primary health care.

scholarly journals Challenges for National Deworming Policy in Indonesia: Experience From Bandung District West Java Province

2020 ◽  
Author(s):  
Riyadi Adrizain ◽  
Djatnika Setiabudi ◽  
Lia Faridah ◽  
Nisa Fauziah ◽  
Budi Setiabudiawan
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Primary Health Care ◽  
Control Strategy ◽  
Small Area ◽  
Group Discussion ◽  
District Health Office ◽  
District Health ◽  
Primary Health ◽  
Irregular Mass

Abstract Background The strategy of regular deworming has been the main STH control strategy recommended by the WHO for over a decade. In 2017, Indonesian government has also adapted this strategy by launching the Ministry of Health (MoH) Regulation No. 15 year 2017 regarding helminthiasis control. However, deworming effort is often hindered by various factors including poor hygiene, habits, and irregular mass drug administration in developing countries. To obtain a picture of how the deworming regulation is carried out and key challenges in Indonesia, this study investigated deworming conduct in Bandung District – one of the densest areas in Indonesia. Methods The main methodology was qualitative using published documents, interview and focus group discussion with related agencies such as MoH, Bandung District Health Office, primary health care and cadres (community participants). Results From this study, we discovered incompleteness and inconsistency of conduct – even within a relatively small area such as Bandung District. Moreover, this study also found that deworming is combined with stunting programs in some areas without proper study directly correlating the improvement of nutritional status with reduced incidence of STH. Conclusions This study has demonstrated the challenges sustaining a consistent nationwide campaign over a wide area such as in Indonesia. In the end, we recommended that further nationwide evaluation is required – placing emphasis on dissemination of policy to ensure more standardized conduct.

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

Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 422-428 ◽  
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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