Bypass of Local Primary Care in Rural Counties: Effect of Patient and Community Characteristics

ABSTRACT The purpose of this report is to examine Ontario's geographic variation in emergency department (ED) visits for conditions that may be treated in alternative primary care settings. We studied all visits to Ontario EDs in 2002/03 and calculated county-specific age-standardized rates. Overall in Ontario, there were 3174 ED visits per 100 000 population aged 1-74 for conditions that could be treated in alternate primary care settings, but rates varied widely across counties. They were higher in rural counties with rates up to 7-fold higher than the provincial average. Urban counties had lower rates, some were less than one-third of the provincial average. Further research is needed to determine the relationship between ED utilization and primary care capacity.

Download Full-text

Transformation of primary care during the COVID-19 pandemic: experiences of healthcare professionals in eight European countries

British Journal of General Practice ◽

10.3399/bjgp.2020.1112 ◽

2021 ◽

pp. BJGP.2020.1112

Author(s):

Marta Wanat ◽

Melanie Hoste ◽

Nina Gobat ◽

Marilena Anastasaki ◽

Femke Boehmer ◽

...

Keyword(s):

Primary Care ◽

Secondary Care ◽

Healthcare Professionals ◽

Care Delivery ◽

Practical Training ◽

Structured Interviews ◽

New Ways Of Working ◽

Primary Care Delivery ◽

Local Primary Care ◽

Remote Care

Background: Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care. Aim: To understand the experiences of European PCPs working during the first peak of the COVID-19 pandemic. Design and Setting: An exploratory qualitative study, using semi-structured interviews in primary care in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece and Sweden, between April and July 2020. Method: Interviews were audio recorded, transcribed and analysed using a combination of inductive and deductive thematic analysis techniques. Results: Eighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance, they often lacked access to practical training. Consequently, PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care, and deal with uncertainty. Conclusion: PCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions will facilitate easy and coordinated access to practical information on how to adapt services, ongoing training and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery.

Download Full-text

FAKTOR-FAKTOR YANG MEMPENGARUHI EFEKTIVITAS PENCEGAHAN PENULARAN HIV DARI IBU KE ANAK (PPIA) DI KOTA JAYAPURA

Unnes Journal of Public Health ◽

10.15294/ujph.v6i4.17733 ◽

2017 ◽

Vol 6 (4) ◽

pp. 260-265

Author(s):

Hesty Tumangke ◽

Melkior Tappy ◽

Rispan Kendek

Keyword(s):

Primary Care ◽

Hiv Prevention ◽

Pregnant Women ◽

Health Department ◽

Total Sample ◽

Pregnant Mother ◽

High Prevalence ◽

Local Primary Care ◽

Report System ◽

Hiv Aids

Abstrak Provinsi Papua memiliki prevalensi HIV/AIDS tinggi, dimana terdapat 6957 wanita usia 15-49 tahun menderita HIV/AIDS. Masalah ini dapat menyebabkan penularan HIV/AIDS ke bayi bahkan kematian bayi karena HIV. Penelitian ini bertujuan menganalisa faktor yang mempengaruhi keberlangsungan program PPIA. Penelitian menggunakan metode kualitatif dengan pengumpulan data melalui wawancara mendalam. Penelitian dilakukan di Jayapura, Dinas Kesehatan Kota Jayapura dari Januari 2015 sampai Juni 2015. Populasi penelitian adalah semua tenaga kesehatan di dinas kesehatan kota Jayapura, dan sampel nya adalah 12 orang mencakup kepala UPT AIDS TB, kepala seksi P2PL, kepala puksesmas, kepala KIA, staf KIA dan penanggung jawab HIV puskesmas. Pengambilan sampel adalah purposif sampling dan data dianalisis dengan triangulasi. PPIA tidak berhasil karena rendah nya K1 dan juga K4, dimana ada puskesmas yang memiliki K4 hanya 58%. Di rumah sakit Abepura ditemukan 8 kelahiran bayi dengan HIV, hal ini karena ibu hamil positif yang tidak menkonsumsi ARV secara rutin sampai melahirkan. Rendah nya K1 juga disebabkan oleh beberapa faktor yaitu ibu hamil lebih tertarik ke dokter praktek, suami yang tidak setuju bila istri nya mendapatkan tes VCT, dan rendah nya kesadaran ibu hamil akan pentingnya K1 sampai K4 dan juga VCT. Begitu juga dengan SIHA yang tidak berjalan dengan baik. Kata kunci : Pencegahan HIV, Ibu hamil, bayi, Jayapura Papua province has high prevalence of HIV/AIDS where there was 6957 cases among women age 15-49 years old. Moreover, this increasedthe number of infants with HIV and impact the rise of infant mortality rate.This study aims to analize factors that affected this HIV prevention from mother to child. This study is qualitative using indeep interview, and located in Jayapura City from January 2015 to June 2015. The population is all staffs in Jayapura’s Health Department, and the total sample is 12 including head of this program, staff of local primary care, staf of hospital, and staffs that have responsibily to run this program. This is purposive sampling, and data will analize with triangulation. HIV prevention is not success due to the low rate of pregnant women visit to local primary care. There was a local primary care that only has 58% of pregnant women visit. In Abepura hospital 2015, there was 8 cases of childborn with HIV. This is because many positive mothers did not consum ARV. The low visit in local primary care has several causes such as mother more willing to go to private obsetric, treat from husband where husband didn’t allow VCT to his wive, and the low self efficacy of pregnant mother. The HIV report system is not well implemented. Key words : HIV Prevention, pregnant mother, infant, Jayapura

Download Full-text

P28 The Use Of Smartphone Application (copd Assist) To Support The Implementation Of Local Primary Care Guidelines On The Management Of Patients With Copd

Thorax ◽

10.1136/thoraxjnl-2014-206260.178 ◽

2014 ◽

Vol 69 (Suppl 2) ◽

pp. A89-A90

Author(s):

N. D. Bakerly ◽

S. McCorkindale ◽

G. Patel

Keyword(s):

Primary Care ◽

Smartphone Application ◽

Local Primary Care ◽

Care Guidelines

Download Full-text

The WestView Primary Care Network in the First Six Months: Defragmenting the System

Healthcare Management Forum ◽

10.1016/s0840-4704(10)60513-3 ◽

2007 ◽

Vol 20 (2) ◽

pp. 34-37

Author(s):

Allan L. Bailey ◽

Grace Moe ◽

Joy Myskiw

Keyword(s):

Primary Care ◽

Health Care ◽

Local Health ◽

Care Network ◽

Care Services ◽

Primary Care Services ◽

Primary Care Teams ◽

Health Care Context ◽

Local Primary Care ◽

Local Health Care

The objective of this article is to describe the integration of local primary care services through the development of a primary care network in Alberta. WestView Primary Care Network (WPCN) has the vision of integrating primary care teams into the health system. As a result, WPCN has incorporated integrative primary care teams into its clinical programs. Through its strategy of “defragmentation,” WPCN is accomplishing the beginnings of service integration in the local health care context.

Download Full-text