scholarly journals Scheduling models and primary health care quality

2019 ◽  
Vol 53 ◽  
pp. 38
Author(s):  
Tiago Barra Vidal ◽  
Suelen Alves Rocha ◽  
Erno Harzheim ◽  
Lisiane Hauser ◽  
Charles Dalcanale Tesser
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Centers ◽  
Health Team ◽  
Scheduling Model ◽  
Primary Health ◽  
Care Assessment ◽  
One Year ◽  
Advanced Access

OBJECTIVE: To evaluate whether the scheduling model influences the perception of the user about the quality of primary health care centers. METHODS: This is a cross-sectional and population-based study that measured the quality of centers by the Primary Care Assessment Tool (PCATool-Brazil), applied to adult users (n = 409) from 11 health centers in Florianópolis, state of Santa Catarina. Multilevel analysis was used to verify the relationship between the score of general quality of the primary health care and the scheduling model. The independent variables (age, skin color, scheduling model, panel size by primary health team, poverty ratio as income proxy, number of health teams, presence of economically interest areas, number of medical appointments in one year per primary health team, number of people treated in one year per health team), with p < 0.20 were selected for the multilevel model, which was adjusted with aggregates of information from users and health centers. RESULTS: The health center that used advanced access had a general score of 7.04, while those using a weekly carve-out had a score of 6.26; the carve-out every 15 days, score of 5.87; and the traditional carve-out, score of 6.29. CONCLUSIONS: The scheduling model of advanced access had a positive effect on the quality of primary health care, in the perception of users.

scholarly journals Advanced Access in Primary Health Care: experiences from Brazil and Canada

2021 ◽  
Vol 10 (16) ◽  
pp. e568101624209
Author(s):  
Isabela Oliveira de Almeida ◽  
Débora de Souza Santos ◽  
Dalvani Marques ◽  
Fernanda Mota Rocha ◽  
Nathalia de Souza Monezi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Selection Criteria ◽  
Health Care Experiences ◽  
Canadian Experience ◽  
Primary Health ◽  
Physical Infrastructure ◽  
Use Of Services ◽  
Advanced Access

Access is the timely use of services in order to meet the needs of the user. As an alternative to the traditional model, the Advanced Access (AA) model appears in Canada , with schedules restricted to specific cases. Objectives: The purpose of this article is to analyze the existing scientific production about the Advanced Access model in Primary Health Care. Methods: Integrative literature review using the descriptors (1) “Health Care Accessibility” OR “Primary Health Care” AND and (2) "Advanced Access" in the PubMed, Scopus and BIREME databases. Selection criteria were studies published in the last five years, available in Portuguese, English or Spanish and dealing with the theme. Results: Eight studies were selected, six were grouped into two categories of analysis: “The Canadian experience with AA : a model in consolidation”; and “The Brazilian experience with AA: local experiments” and the other two contributed to enrich the discussion. The AA stands out to balance capacity and demand with physical infrastructure and adequate staff, both in the international arena, as the experiences of municipalities, improving the quality of APS. Conclusion: Studies that detail the AA in its practice, as well as the challenges and needs, can inspire other health units to study it and consider its implementation if it is appropriate for its context, aiming to improve the health and care of its population.

scholarly journals Impact of patient-perceived quality of primary health care on the patients' bypass behaviour in China

2020 ◽  
Author(s):  
WeiWei Zhang ◽  
Yuankai Huang ◽  
Gaojie Li ◽  
Hongjie Zhou ◽  
Xiaoyu Xi
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Perceived Quality ◽  
Health Care Facilities ◽  
Primary Health ◽  
Care Assessment ◽  
The Impact

Abstract Background Patient bypass often occurs under the loose gatekeeper system. Additionally, patients’ perceived quality of primary health care (PHC) is one of the important factors affecting bypass behaviour. Objective to explore individuals’ bypass behaviour in China and the associations between patients’ perceived quality of PHC and their bypass behaviour. MethodIn 2019, this study investigated Chinese bypass behaviour and the potential influencing factors. The questionnaire that was used assessed the following: the perceived quality of primary care using the Primary Care Assessment Tool; bypass experience; age; health insurance; and other factors. A logit regression model was used to analyse the impact of perceived quality of PHC on bypass behaviour. Results The data of 2070 residents in 706 health care facilities in China were collected. The results show that perceived quality of PHC is significantly associated with bypass behaviour in China. After adjustments were made for patients’ sociodemographic and other characteristics, an increase of one standard deviation (SD; odds ratio (OR) per 1-SD increase) in the PCAT scores led to a 2% decrease in bypass behaviour (OR 0.98, p<0.05). Gender, hukou and cold fee for PHC were negatively associated with bypass behaviour. Conclusion Patients' perceptions of PHC service quality play an active role in reducing their bypass behaviour, which may provide a new perspective for the design of PHC health policies.

Depression screening program tailored to the primary health care settings

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Strkic ◽  
J Niskanovic
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Screening Program ◽  
Health Centers ◽  
Primary Health ◽  
The Government ◽  
Mental Health Centers

Abstract Issue Depression is the leading cause of disability worldwide. People with mental health problems often do not feel comfortable to seek help from mental health professionals. Depression is often 'covered' with physical symptoms and patients first seek help from family medicine doctors. Description of the Problem Primary health care organized through mental health centers and family medicine service was base for planning of depression screening program. Program is supported by the Ministry of Health and Social Welfare in the Government of Republic of Srpska and the Mental Health Project in BiH (implemented by Association XY with support of the Government of Switzerland). Methodology and promotional materials were developed in the Public Health Institute. Outcome was improved health of the adult population at increased risk of depression. Program was implemented from June 2018 till December 2019 in ten primary health care centers. Mental health centers (MHC) sensitized and trained family medicine teams (FMT) for screening. FMT used Patient Health Questionnaire 9 (PHQ 9), MHC used the Hamilton scale for confirmation. Confirmed cases were measured for quality of life with the Q-LES-Q-SF. Both of questionnaires were used for control measurement after three months of treatment. Results Screening of 1037 patients resulted in 445 of them were referred, of which 310 patients came to the MHC, where depression was confirmed in 289 patients. In control measuring, 30% of the patients showed the absence of depression, with a significant improvement in the self assessment of the overall quality of life. Lessons Clear methodological guidelines and program adjusted to the organization of health care services, along with monitoring and evaluation, was crucial, and appreciated from health professionals involved. Regular communication of mental health centers and family medicine services was important in overcoming obstacles to get patients in the program, and maintain them. Key messages Stigma still prevents patients who need help to get to the mental health services. Sensitized and trained family medicine doctors, as first contact with patients, are crucial in early detection of depression and convincing patients to accept help and stick to treatment.

scholarly journals Quality of Primary Health Care models for brazilian children

2021 ◽  
Vol 10 (8) ◽  
pp. e48610817584
Author(s):  
Beatriz Díaz-Fabregat ◽  
Wilmer Ramírez-Carmona ◽  
Eliane Cristina Gava Pizi ◽  
Juliane Avansini Marsicano ◽  
Rosana Leal do Prado
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Statistical Tests ◽  
Family Health ◽  
The Public ◽  
Primary Health ◽  
Care Assessment ◽  
Brazilian Children

Aim. To evaluate the quality of Primary Health Care (PHC) models for Brazilian children. Methods. A cross-sectional study was performed with 516 parents or guardian of children in the public preschools from a city in São Paulo State, Brazil. The participants completed the questionnaires on the perception of the quality of the PHC (Primary Care Assessment Tool-PCATool), and the socioeconomic conditions in their families. The data were analyzed by statistical tests (95% confidence level). Results. Private services, Family Health Strategies (FHS), and Conventional Health Care (CHC) were the modalities of PHC used by children. Among the three modalities, in all groups were observed statistically significant differences (p<0.001), the best quality of care was provided by FHS (8.22±1.69). The CHC (5.69±1.34) and the private service (6.65±0.99) need improvement in accessibility, continuity of care, integrality, family, and community orientation. The socioeconomic class of the families was associated with modalities of PHC (p<0.001).  Conclusions. The quality of primary care for children in the public health system still requires much improvement, primarily in conventional model. However, the Family Health Strategies was the model that presented the best quality of primary health care for children.  

scholarly journals Assessing the care of children under one year old in Primary Health Care

2013 ◽  
Vol 21 (2) ◽  
pp. 554-561 ◽  
Author(s):  
Maria Cândida de Carvalho Furtado ◽  
Janaina Carvalho Braz ◽  
Juliana Coelho Pina ◽  
Débora Falleiros de Mello ◽  
Regina Aparecida Garcia de Lima
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Family Health ◽  
Health Care Team ◽  
Cross Sectional ◽  
Primary Health ◽  
Care Assessment ◽  
One Year ◽  
Primary Care Assessment Tool

OBJECTIVE: to analyze the presence and extent of Primary Health Care attributes and the strength of affiliation of children under one year old in a Family Health Unit. METHOD: cross-sectional, descriptive study conducted between October 25, 2010 and May 14, 2011 with 44 mothers, using the Primary Care Assessment Tool to collect data. Data were analyzed by calculating the Essential Primary Health Care and General Primary Health Care scores. RESULTS: mothers recognized and experienced aspects of accessibility, comprehensive care and coordination of care, as well as community guidance, marked by a concern and involvement on the part of the health team in the children's care, their families and community. CONCLUSION: The Primary Health Care team makes efforts to approach the community and meet their health needs, seeking instruments that aid the promotion of qualified care to children.

scholarly journals Impact of patient-perceived quality of primary health care on the patients' bypass behaviour in China

2020 ◽  
Author(s):  
WeiWei Zhang ◽  
Yuankai Huang ◽  
Gaojie Li ◽  
Hongjie Zhou ◽  
Xiaoyu Xi
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Active Role ◽  
Perceived Quality ◽  
Primary Health ◽  
Care Assessment ◽  
The Impact

Abstract Background: Bypass behaviour is a phenomenon that an individual visits an higher-level and farther health institution instead of one with an acceptable quality of care that is closer. Patient bypass often occurs under the loose rules of first diagnosis. Additionally, patients’ perceived quality of primary health care is one of the important factors affecting their bypass behaviours. Objective: to explore individuals’ bypass behaviour in China and the impact of patients’ perceived quality of primary health care on their bypass behaviour. Method: in 2019, a national wide sampling survey was conducted to collect data of Chinese residents’ bypass behaviours and its potential influencing factors. The questionnaire that was used assessed the following: the perceived quality of primary care using the Primary Care Assessment Tool; bypass experience; age; health insurance; and other factors. A logit regression model was used to analyse the impact of perceived quality of PHC on bypass behaviour. Results: the data of 2070 residents sampled in 706 secondary/tertiary hospitals in China were collected. The results show that perceived quality of PHC is significantly associated with bypass behaviour in China. Per increase of one the PCAT mean score had an odds ratio of 0.98 (p<0.05) for bypass behaviour. Gender, household registration and cold fee for PHC were negatively associated with bypass behaviour. Conclusion: patients' perceived quality of primary health care plays an active role in reducing their bypass behaviours, which may provide a new perspective for the design of primary health care policies.

scholarly journals FACTORS ASSOCIATED WITH PNEUMONIA AND DIARRHEA IN CHILDREN AND QUALITY OF PRIMARY HEALTH CARE

2019 ◽  
Vol 28 ◽  
Author(s):  
Janaina Carvalho Braz Macedo ◽  
Ricardo Alexandre Arcêncio ◽  
Paula Carolina Bejo Wolkers ◽  
Antônio Carlos Vieira Ramos ◽  
Ana Paula Contiero Toninato ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Protective Factors ◽  
Family Income ◽  
Assessment Tool ◽  
Factors Associated ◽  
Primary Health ◽  
Care Assessment

ABSTRACT Objective: to investigate factors associated with the use and quality of Primary Health Care, as well as the occurrence of pneumonia and diarrhea in children under one year. Method: cross-sectional study conducted with 317 caregivers of 56 Family Health teams from Juazeiro do Norte, Ceará, from August 2014 to October 2015, using the child version of the Primary Care Assessment Tool, child version. Results: in the logistic adjustment, children received assistance (OR: 0.54; 0.32-0.91) and accessibility to the Primary Health Care Unit (OR: 0.49; 0.31-0.76). identified as possible protective factors for episodes of diarrhea. The variables associated with pneumonia were unsatisfactory access (ORaj: 2.13; 95% CI 1.18-3.82), a likely risk factor, and coordination (ORaj: 0.33, 95% CI 0.12-0,94), as a probable protection factor. Conclusion: primary care attendance resulted in a higher chance of avoiding hospitalization for pneumonia, a condition considered sensitive to care in this care model. Complementing family income and children's accessibility to the health unit were protective factors for episodes of diarrhea. The search to ensure the presence and extension of the Primary Health Care attributes has the potential to positively modify the child's health and, therefore, both should be ensured as rights of this population.

Client characteristics and satisfaction with the quality of primary health-care services in Calabar, Nigeria

2020 ◽  
Vol 3 ◽  
pp. 1-8
Author(s):  
H. C. Okeke ◽  
P. Bassey ◽  
O. A. Oduwole ◽  
A. Adindu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Client Satisfaction ◽  
Demographic Characteristics ◽  
Care Providers ◽  
Client Characteristics ◽  
Study Objective ◽  
Primary Health

Different mix of clients visit primary health care (PHC) facilities, and the quality of services is critical even in rural communities. The study objective was to determine the relationship between socio-demographic characteristics and client satisfaction with the quality of PHC services in Calabar Municipality, Cross River State, Nigeria. Specifically to describe aspects of the health facilities that affect client satisfaction; determine the health-care providers’ attitude that influences client satisfaction; and determine the socio-demographic characteristics that influence client satisfaction with PHC services. A cross-sectional survey was adopted. Ten PHCs and 500 clients utilizing services in PHC centers in Calabar Municipality were randomly selected. Clients overall satisfaction with PHC services was high (80.8%). Divorced clients were less (75.0%) satisfied than the singles and the married counterparts (81%), respectively. Clients that were more literate as well as those with higher income were less satisfied, 68.0% and 50.0%, respectively, compared to the less educated and lower-income clients, 92.0% and 85.0% respectively. These differences in satisfaction were statistically significant (P = 0.001). Hence, it was shown that client characteristics such as income and literacy level show a significant negative relationship with the clients satisfaction with the quality of PHC services in Calabar Municipality.

Quality of life and adherence to mediterranean diet among type 2 diabetes mellitus patients of a primary health care clinic in Hebron city, Palestine

2021 ◽  
pp. 1-10
Author(s):  
Manal Badrasawi ◽  
May Hamdan ◽  
Mohammad Al Tamimi
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Health Care ◽  
Primary Health Care ◽  
Mediterranean Diet ◽  
Well Being ◽  
Care Clinic ◽  
Primary Health Care Clinic ◽  
Primary Health

BACKGROUND: Diabetes mellitus (DM) is a lifelong metabolic disease with a high rate of mortality and morbidity. Uncontrolled and untreated diabetes results in serious complications that subsequently cause patients’ quality of life (QoL) to deteriorate. Adherence to Mediterranean diet (MD) may relieve the complications of diabetes, thereby improving the quality of life for these patients. OBJECTIVE: The aim of this study was to assess the QoL of DM patients who adhered to MD. METHODS: In this cross-sectional study, we examined the QoL and MD data of 106 DM II patients being treated at a primary health care clinic in Hebron. We used the SF-36 questionnaire to measure the patients’ QoL and the MEDAS tool to assess their MD adherence. We also recorded their anthropometric measurements, abdominal obesity, lifestyle habits and blood biochemical results. RESULTS: The sample comprised male and female DM II patients between the ages of 35 and 72, with their mean age being 55.8±10.24. Patients’ QoL scores showed a significant relationship with three BMI categories, i.e., total QoL score, physical function, and pain domains (p <  0.05). In terms of diet, high adherence to MD had a positive impact on all domains and on patients’ total QoL with significant differences in physical functioning, emotional well-being, social functioning and pain domains. CONCLUSION: Patients’ QoL domains were relatively low and highly affected by DM II. Patients with greater MD adherence reported higher scores in all QoL domains. Significantly higher scores were noted for the physical, social and pain domains. Hence, MD is a recommended dietary pattern for DM II patients to achieve a better QoL.

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