scholarly journals The innovations in China’s primary health care reform: Development and characteristics of the community health services in Hangzhou

2015 ◽  
Vol 3 (3) ◽  
pp. 52-66 ◽  
Author(s):  
Feng Lin ◽  
Qihong Sun ◽  
Zhangping Peng ◽  
Jun Cai ◽  
Philip Geanacopoulos ◽  
...  
2009 ◽  
Vol 15 (4) ◽  
pp. 262 ◽  
Author(s):  
Julie McDonald ◽  
Gawaine Powell Davies ◽  
Mark Fort Harris

Improving collaboration and coordination in primary and community health is a national priority. Two major approaches have been taken: strengthening interorganisational and interprofessional collaboration. This paper reviews current and emerging models of partnerships: divisions of general practice and primary care partnerships (organisational models); and collaboration between general practitioners with practice nurses and with allied health professionals (interprofessional models). The models are reviewed in terms of the governance and formalisation of the partnership arrangements and the level of collaboration they achieve. The organisational models have had different purposes and taken different forms, the ‘hub and spoke’ model of divisions and decentralised ‘network’ relationships of primary care partnerships, both of which have broadly achieved their aims. Interprofessional collaboration involves a complex mix of allegiances and interests that influences the level of collaboration that is achieved. A combination of approaches is needed to achieve more coordinated and integrated primary health care. The implications for several current policy debates are discussed: the establishment of local integrated and comprehensive primary health care centres, regional level primary care organisations and alternative payment mechanisms.


2020 ◽  
Author(s):  
Yanwei Lin ◽  
Chengjing Chu ◽  
Qin Chen ◽  
Junhui Xiao ◽  
Chonghua Wan

Abstract Objective: To explore the influencing factors of the utilization of primary health care from the perspective of social contact among internal elderly migrants in China to provide further insights that might promote their utilization of primary health care. Methods: 1544 internal elderly migrants in eight cities participated in the survey. Whether to participate in the free health checkup organized by community health service institutions in the past year was adopted as an indicator of the utilization of primary health care, number of local friends and exercise time per day were measured for social contact. Multivariate binary logistic regression was used to understand the association of the variables with the likelihood of using community health services. Results: Internal elderly migrants who had more social contact were more inclined to use primary health care. Conclusion: The role of the community should be expanded, such as creating community-based promotions targeting internal elderly migrants or designing social or sports activities tailored to increase the opportunity for contact between local elders and internal elderly migrants.


2021 ◽  
pp. 136749352110058
Author(s):  
Helen J Nelson ◽  
Catherine Pienaar ◽  
Anne M Williams ◽  
Ailsa Munns ◽  
Katie McKenzie ◽  
...  

Patient experience surveys have a user focus and measure the quality of person-centered health care for hospital inpatients and consumers of community health services, providing a governance process to evaluate the quality of care and to action improvement. Experience of care has been described as effective communication, respect and dignity, and emotional support. Measurement criteria for these domains are not standardized, leading to inconsistent reporting of patient experience. The objective of this scoping review was to synthesize evidence for measuring experience of care in children’s community health services using the Joanna Briggs Institute framework for scoping review method. Three parent-reported surveys met the inclusion criteria, and 50 survey items were assessed by expert reviewers for fit to domains of healthcare experience. Conceptual domains of parent experience in children’s community health services included respect and dignity, effective communication, and emotional support. A gap was identified, in that few items in identified surveys measured emotional support. This contribution will promote consistent reporting of healthcare experience, informing policy and practice for person-centered health care.


2018 ◽  
Vol 71 (suppl 6) ◽  
pp. 2713-2719
Author(s):  
Daniela Cristina Moreira Marculino de Figueiredo ◽  
Helena Eri Shimizu ◽  
Walter Massa Ramalho ◽  
Alexandre Medeiros de Figueiredo ◽  
Kerle Dayana Tavares de Lucena

ABSTRACT Objective: To describe the evaluation of patients that participated in the National Program for Improving the Access and Quality in Primary Health Care (Programa Nacional de Melhoria do Acesso e da Qualidade na Atenção Básica) for the comprehensive healthcare, the bond and the coordination of care in the country's macro-regions. Method: A descriptive, transversal study, from interviews with 65,391 patients of Primary Health Care, in 3,944 municipalities regarding the use of health services. Results: The professionals seek to solve the patients' problems in their unit (73.1%) but focused mainly on the scope of the appointment (65.6%) and offering care away from the population's reality (69.4%). Difficulties in the rescue of clinical history were referred (50.3%) and in the care performed in other health services (29.2%). Conclusion: The comprehensive health care, the bond and the coordination of care remain challenges to the Primary Health Care in the country, requiring reflections on the implementation of national policies, especially considering the regional diversities in Brazil.


1997 ◽  
Vol 2 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Rosemare Troskie

The Reconstruction and Development Plan as well as the National Health Plan of the ANC supports the reorganisation of health services. OpsommingDie Heropbou en Ontwikkelingsprogram sowel as die Nasionale Gesondheidsplan van die ANC staan die herorganisasie van gesondheidsdienste voor. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.


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 ◽  
...  

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.


Author(s):  
Ahmad Hajebi ◽  
Vandad Sharifi ◽  
Maryam Abbasinejad ◽  
Ali Asadi ◽  
Nahid Jafari ◽  
...  

Objective: The main objective of this study was to review aspects of the current situation and structure of the integrated mental health care services for planning a reform. Aspects of the newly designed infrastructure, along with specification of duties of the various human resources, and its relation with Iran’s Comprehensive Mental and Social Health Services (the SERAJ Program), will also be presented Method: This is a study on service design and three methods of literature review, deep interview with stakeholders, and focused group discussions. In the literature review, national and international official documents, including official reports of the World Health Organization (WHO) and consultant field visits, were reviewed. Deep semi-structured interviews with 9 stakeholders were performed and results were gathered and categorized into 3 main questions were analyzed using the responsibility and effectiveness matrix method. The Final results were discussed with experts, during which the main five-domain questions were asked and the experts’ opinions were observed. Results: In this study, the main gaps of the public mental health care (PHC) services in Iran were identified, which included reduction of risk factors for mental disorders, training the general population, early recognition and treatment of patients with mental disorders, educating patients and their families, and rehabilitation services. The new model was then proposed to fill these gaps focusing on increasing access, continuity of care, coordination in service delivery, and comprehensiveness of care. A mental health worker was placed besides general healthcare workers and general practitioners (GPs). Services were prioritized and the master flowchart for mental health service delivery was designed. Conclusion: A reform was indeed necessary in the integrated mental health services in Iran, but regarding the infrastructure needed for this reform, including human and financial resources, support of the senior authorities of the Ministry of Health (MOH) is necessary for the continuity and enhancement of services. In this model, attention has been given to the principles of integrating mental health services into primary health care. Current experience shows that the primary health care system has been facing many executive challenges, and mental health services are not exclusion to this issue. Monitoring and evaluation of this model of service and efforts for maintaining sustainable financial resources is recommended to make a reform in this system and to stabilize it.


2020 ◽  
Author(s):  
Homayoun Sadeghi Bazargani ◽  
Mohammad Saadati ◽  
Jafar Sadegh Tabrizi ◽  
Mostafa Farahbakhsh ◽  
Mina Golestani

Abstract Background: Primary Health Care (PHC) was introduced as the first level of health services delivery after Alma Ata declaration. PHC as a first level of health services delivery needs to be more trustfulness to achieve its defined goals. Public trust in PHC is one of the ignored issues in the context. The aim of this study was to explore public trust in PHC in Iran.Methods: This was a household survey study conducted in 2016 in East Azerbaijan Province, Iran. Two-stage cluster sampling method with probability proportional to size (PPS) approach was used. Totally 1178 households were enrolled in the study. PHC trust questionnaire and Ultra-short version of socio-economic status assessment questionnaire (SES-Iran) was used for data collection. Data were analyzed using STATA 15 through descriptive statistics and linear regression.Results: The mean age of the participants was 41.2, (SD: 15.1) and most of them (53.7%) were female. Mean score of PHC trust was 56.9±24.7 (out of 100). It was significantly different between inhabitants of Tabriz (the province capital city) and other cities in the province (p<0.001). Linear regression showed that younger age, gender, insurance type, being married and households higher socio-economic situation had a significant positive influence on PHC trust level with R2 = 0.14383 .Conclusions: Public trust in PHC system in Iran needs to be improved. Individual variables had a small but significant share in trust level. PHC trust not only influenced by individual variables and experience but also by health system and health providers characteristics and public sphere about PHC system. PHC trust level could be used as a public indicator in health systems especially in Low and Middle income countries to lead system strengthening policies in national and international levels.


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