scholarly journals A korkorrigált fejkvóta (kapitáció) a háziorvosi (alapellátási) finanszírozás alapja

2019 ◽  
Vol 160 (27) ◽  
pp. 1057-1063
Author(s):  
Sándor Balogh
Keyword(s):  
Health Care ◽  
Social Security ◽  
Free Choice ◽  
Mixed System ◽  
Present Patient ◽  
Minimal Weight ◽  
Primary Health ◽  
Underlying Principle ◽  
Characteristics Analysis ◽  
Pros And Cons

Abstract: The health care renumeration poses a great challenge for both politicians and policymakers. During the beginning of the 1990s, following the end of communism in Hungary, the reform of health care began with the introduction of the primary health care (PHC), specifically with general practitioner (GPP)/family medicine (FM) care. The basis of the renumeration was the age-adjusted capitation built upon the free choice of doctors, while social security renumeration was built on a mixed system. Several pros and cons have been highlighted, but the underlying principle has proved to be simple and effective. Comparison of the European and Hungarian characteristics, analysis of data in the present patient care report as well as in the years preceding the release of the aforementioned document, these confirm that the method of capitation-based remuneration is a fundamental, easy, and unmanipulable method. It places minimal weight on social security and comes with little costs. Orv Hetil. 2019; 160(27): 1057–1063.

scholarly journals Men's health in question: seeking assistance in primary health care

2015 ◽  
Vol 20 (1) ◽  
pp. 273-278 ◽  
Author(s):  
Max Moura de Oliveira ◽  
Donizete Vago Daher ◽  
Jorge Luiz Lima da Silva ◽  
Silvânia Suely Caribé de Araújo Andrade
Keyword(s):  
Health Care ◽  
Social Security ◽  
Family Doctor ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Adult Men ◽  
Primary Health ◽  
Data Files ◽  
Population Segment

The scope of this study was to analyze the socio-demographic profile, morbidity and frequency of seeking of adult men enrolled in a Family Doctor Program for health care in Niterói in the State of Rio de Janeiro. It is a cross-sectional study using secondary data, files and records of the first care visit in November 2003 through August 2009. The frequencies of the variables studied and the prevalence rates among those who sought and those who did not seek attention were calculated. Among the 323 men registered, 56% sought attendance. The main reason given for the first visit was a routine appointment. It was observed that 43 men were overweight, 26 were obese and 44 had abnormal blood pressure. The profile of the men who sought and those who did not seek care presented statistically significant differences (p< 0.05) for: age, education level, social security and reference to morbidity at the time of registration. Older men with social security reporting some morbidity sought health services more often. It is necessary to broaden the studies to acquire more input for public health actions and policies that contemplate this population segment and its specificities.

scholarly journals Integration of Community pharmacy and pharmacists in primary health care policies in Argentina

2020 ◽  
Vol 18 (4) ◽  
pp. 2173
Author(s):  
Pedro D. Armando ◽  
Sonia A. Uema ◽  
Elena M. Vega
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Social Security ◽  
Health System ◽  
Pharmaceutical Services ◽  
Community Pharmacies ◽  
Population Total ◽  
Care Level ◽  
Primary Health ◽  
Product Sales

Argentina is a federal republic with approximately 44 million people, divided into 23 provinces and an autonomous city, Buenos Aires. The health system is segmented into public, social security and private subsystems. The social security and private sectors cover more than 60% of the population. Total health expenditure in 2017 was 9.4% of gross domestic product. Primary health care (PHC) was considered as the principal strategy for universal coverage policy for health system reform in Latin America at the end of 20th century. The most remarkable characteristics of the Argentinian health system are its fragmentation and disorganization. An increase of public sector demands, due to a socioeconomic crisis, led to the subsequent collapse of the system, caused primarily by a sustained lack of investment. First care level decentralization to the Integral Health Service Delivery Networks (IHSDN) becomes the cornerstone of a PHC-based system. Pharmacists and community pharmacies are not formally mentioned in PHC policies or IHSDN. However, pharmacies are recognized as healthcare establishments as part of the first care level. Community pharmacists are the only health care professional whose profit comes from the margin on product sales. Contracts with social security and private insurances provide small margins which reduce the viability of community pharmacies. There is a preference by community pharmacies to diversify product sales instead of providing professional services. This is driven by marketing and economic pressures rather than patient care and health policies. Dispensing is the main professional activity followed by management of minor illness and associated product recommendations. Currently, there are no national practice guidelines or standard operating procedures for the provision of pharmaceutical services and there is no nationally agreed portfolio of services. National pharmacy organizations appear to have no official strategic statements or plans which would guide community pharmacies. There are some isolated experiences in community pharmacies and in public first care level pharmacies that demonstrate the possibilities and opportunities for implementing pharmaceutical services under the PHC approach. There is a real lack of integration of community pharmacies and pharmacists in the healthcare system.

scholarly journals Performing Through Privatization: An Ecological Natural Experiment of the Impact of the Swedish Free Choice Reform on Ambulatory Care Sensitive Conditions

2021 ◽  
Vol 9 ◽  
Author(s):  
Paola A. Mosquera ◽  
Miguel San Sebastian ◽  
Bo Burström ◽  
Anna-Karin Hurtig ◽  
Per E. Gustafsson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Free Choice ◽  
Primary Care Providers ◽  
Ambulatory Care Sensitive Conditions ◽  
Care Providers ◽  
Intervention Period ◽  
Private Provision ◽  
Primary Health

Background: In 2010, Sweden opened up for establishment of privately owned primary health care providers, as part of a national Free Choice in Primary Health Care reform. The reform has been highly debated, and evidence on its effects is scarce. The present study therefore sought to evaluate whether the reform have impacted on primary health care service performance.Methods: This ecological register-based study used a natural experimental approach through an interrupted time series design. Data comprised the total adult population of the 21 counties of Sweden 2001–2009 (pre-intervention period) and 2010–2016 (post-intervention period). Hospitalizations and emergency department visits for ambulatory care sensitive conditions (ACSC) were used as indicators of primary health care performance. Segmented regression analysis was used to assess the effects of the reform, in Sweden as a whole, as well as compared between counties grouped by (i) change in private provision pre- to post reform; (ii) the timing of the implementation; and (iii) sustained presence of private providers both pre- and post-reform.Results: The results suggest that, following the introduction of the reform in Sweden as a whole, the trends in total hospitalizations rates were slowed down by 1.0% albeit acute emergency visits increased 1.1% more rapidly after the introduction of the reform. However, we found no evidence of more beneficial effects in counties where the reform had been implemented more ambitiously, specifically those with a larger increase in private primary care providers, or where the reform was introduced early and thus had longer time effects to emerge. Lastly, counties with a sustained high presence of private primary care providers displayed the least favorable development when it comes to ACSC.Conclusion: Taken together, the present study does not support that the Swedish Free Choice reform has improved performance of the primary care delivery system in Sweden, and suggests that high degree of private provision may involve worse performance and higher care burden for specialized health care. Further evaluations of the consequences of the reform are dire needed to provide a comprehensive picture of its intended and unintended impact on health care provision, delivery and results.

scholarly journals Introduction of an Appointment System in Primary Health Care Setting in Baghdad: Views of Patients and Health Care Providers

2021 ◽  
Vol 17 (1) ◽  
pp. 45-49
Author(s):  
Ahmed Khairi Mishari ◽  
Suhair Aboud Essa ◽  
Ammar Noori Muhammed
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Care Setting ◽  
Health Care Setting ◽  
Mixed System ◽  
Care Providers ◽  
Primary Health Care Setting ◽  
Primary Health ◽  
Appointment System

Background: The appointment system is a common practice in primary health care clinics in developed countries. The patients and health care providers in the primary health care setting perceived the appointment system as an indicator of good quality service. Objective: The aim of this study was to survey patients’ and health care providers’ attitudes towards the introduction of an appointment system and their satisfaction with the existing ‘walk-in’ system in the primary health care setting. Subjects and Methods: A questionnaire survey was conducted included a convenient sample of 234 patients as well as 76 health care providers from two primary health care centers in Al-Karkh district, Baghdad governorate. The study used two separate questionnaires, for patients and staff. Results: Approximately half of the patients (51.7%) and the majority of the health care providers (85.5%) agreed on the introduction of the appointment system. The employee’s patients, highly educated patients, and patients with chronic illness showed a significant agreement to this idea. Most participants, patients, and providers agreed that reduction of workload, provision of quality care to the patient, and improvement of patient-provider relationship are the most important advantages of the application of an appointment system. While the lack of flexibility of this system was the main perceived disadvantage. Conclusion: Respondents showed great acceptance to the idea of introduction of the appointment system to be run concurrently with the existing walk-in system (mixed system) in the primary care setting in Iraq, and they preferred this system to be flexible and responsive to the needs and preferences of the patients as well as health care providers.

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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