scholarly journals Quality of Primary Health Care in Brazil: patients'view

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
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Clinical History ◽  
Coordination Of Care ◽  
Primary Health ◽  
Comprehensive Health ◽  
Access And Quality ◽  
Transversal Study

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.

Neoliberal Reforms in Swedish Primary Health Care: For Whom and for What Purpose?

2008 ◽  
Vol 38 (4) ◽  
pp. 697-715 ◽  
Author(s):  
Göran Dahlgren
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Low Income ◽  
Health Sector ◽  
High Income ◽  
Public Hospitals ◽  
Primary Health ◽  
Access And Quality

The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. They are typically presented as “free choice models” in which “the money follows the patient.” The actual and likely effects of these reforms in terms of access and quality of care are discussed in this article. One main finding is that existing social inequities in geographic access to care not only are reinforced but also become very difficult to change by democratic political decisions. Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented.

scholarly journals Quality of Health Services in the First Level Health Facilities and the Role of Quality and Cost Control Team in Lampung Province

2020 ◽  
Vol 3 (1) ◽  
pp. 8
Author(s):  
Asep Sukohar ◽  
Arli Suryawinata ◽  
Aulian Mediansyah
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Cost Control ◽  
Health Facilities ◽  
Care Providers ◽  
Primary Health ◽  
Control Team ◽  
Quality Of Health Services

Background: The National Health Insurance/Jaminan Kesehatan Nasional (JKN) program is a public health protection guarantee held by the Social Securite Management Agency/Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) to ensure that all Indonesians receive comprehensive, fair, and equitable health care benefits. The health services are provided using a tiered service system with the first stage in the First Level Health Facilities/Fasilitas Kesehatan Tingkat Pertama (FKTP) acting as a gatekeeper. In conducting these duties, they must always be maintained with good cost-efficiency to be able to provide optimal health service quality. The audit function is imposed by the Quality and Cost Control Team/Tim Kendali Mutu Kendali Biaya (TKMKB) which partners with BPJS. Until now, various efforts to improve the quality of services continue to be developed, one of which is the capitation-based service commitment/Kapitasi Berbasis Komitmen Pelayanan (KBK) payment method. Quality of health services in FKTP can be seen through the high number of FKTP that are affected by the capitation-based service commitment (FKTP KBK-K) payment. Additionally, the high number of FKTP KBK-K can also be a measure of the success of the quality and cost control program implemented by the regional TKMKB. Objective: To assess the quality of health services in FKTP and the TKMKB performance of Lampung Province. Methods: This research was a descriptive-analytic study using data from the BPJS report of Lampung Province and TKMKB in the first and second quarters of 2019. Results: There was an increase in the number of FKTP KBK-K in Lampung Province in the second quarter of 2019, not achieving the minimum contact number, with a low ratio of Prolanis Routine Participants Visiting/Rasio Peserta Prolanis Rutin Berkunjung (RPPRB) especially at the FKTP non-Primary Health Care Centers (non-Puskesmas) in Lampung Province. Conclusion: An increase in the number of FKTP KBK-K that is not accompanied by an increase in the clinical ability of primary health care providers (such as family doctors/primary care doctors) can reflect suboptimal health services in FKTP. Also, this can further serve as a benchmark that the performance of the provincial TKMKB is not yet optimal.

scholarly journals Presence and extent of the primary health care attributes among children hospitalized for pneumonia

2015 ◽  
Vol 23 (3) ◽  
pp. 512-519 ◽  
Author(s):  
Juliana Coelho Pina ◽  
Suzana Alves de Moraes ◽  
Maria Cândida de Carvalho Furtado ◽  
Débora Falleiros de Mello
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Family Counseling ◽  
Coordination Of Care ◽  
Access To Health Services ◽  
Unified Health System ◽  
Primary Health ◽  
Access To Health

OBJECTIVE: to analyze the presence and extent of the primary health care attributes among children hospitalized for pneumonia.METHOD: observational and retrospective study with hospital-based case-control design, developed in three hospitals associated to the Brazilian Unified Health System, located in a city of the State of São Paulo, Brazil. The study included 690 children under five years old, with 345 cases and 345 controls.RESULTS: both groups scored high for access to health services. In contrast, high scores for attributes such as longitudinality and coordination of care were observed for the controls. Despite low scores, integrality and family counseling were also high for the controls.CONCLUSION: knowledge of the aspects involving the primary health care attributes and its provision for child care are very important because they have the potential to support professionals and managers of the Brazilian Unified Health System in the organization of health services.

scholarly journals Práticas de enfermagem em cuidados de saúde primários com base num referencial de competências

2019 ◽  
Vol 9 (27) ◽  
pp. 23
Author(s):  
Virgínia Maria Sousa Guedes ◽  
Maria Henriqueta Jesus Silva Figueiredo ◽  
João Luís Alves Apóstolo ◽  
Marlene Lebreiro Silva ◽  
Palmira Conceição Martins Oliveira ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Nursing Practice ◽  
Care Plan ◽  
Care Nurse ◽  
Primary Health ◽  
General Care

O objetivo deste estudo é identificar ações desenvolvidas por enfermeiros nos cuidados primários, com base no referencial de competências do enfermeiro de cuidados gerais da Ordem dos Enfermeiros Portuguesa. Estudo exploratório descritivo, em uma amostra de 46 enfermeiros de cuidados gerais, que trabalham em cuidados de saúde primários. As ações mais realizadas pelo enfermeiro de cuidados gerais mais comuns em CSP são: proteger o direito do cliente, atuar de acordo com linhas de orientação, solicitar colaboração de serviços de saúde, documentar processamento de informação, avaliar plano de cuidados em grupo, colaborar com serviços de saúde e estabelecer a confiança. Os princípios éticos profissionais parecem estar claramente presentes na prática do enfermeiro de cuidados gerais em cuidados primários. O conhecimento sobre as ações de enfermagem desenvolvidas em determinado contexto permitirá uma melhor avaliação de competências, dos planos formativos e da qualidade dos cuidados.Descritores: Cuidados de Saúde Primários, Prática de Enfermagem, Competências. Nursing practice in primary health care based on a competency frameworkAbstract: This study aims to identify actions developed by nurses in primary care which translate competencies of the general care nurse based on the Portuguese Order of Nurses competency framework. Descriptive exploratory study in a sample of 46 general care nurses, who exercise their functions in primary care. The most common actions performed by participants are: to protect the client's right, to act according to the guidelines, to request collaboration from health services, to document information processing, to evaluate a group care plan, to collaborate with health services. The professional values and guiding principles seem to be clearly present in the practice of general nurses in primary care. The knowledge about the actions that nurses use in a given context of their practice may allow for a better monitoring of competencies, an improvement in the training plans as well as a consequent continuous improvement of the quality of care services.Descriptors: Primary Health Care, Nursing Practice, Competencies. Práctica de enfermería en atención primaria de salud basada en un marco de competenciasResumen: Este estudio tiene como objetivo identificar las acciones desarrolladas por las enfermeras en atención primaria que traducen las competencias de la enfermera de atención general según el marco de competencias de la Orden de Enfermeras de Portugal. Estudio descriptivo exploratorio en una muestra de 46 enfermeras de cuidados generales, que trabajan en atención primaria. Las acciones más comunes son: proteger el derecho del cliente, actuar de acuerdo con las pautas, solicitar la colaboración de los servicios de salud, documentar el procesamiento de la información, evaluar un plan de atención grupal, colaborar con los servicios de salud. Los valores profesionales y los principios rectores parecen estar claramente presentes en la práctica de las enfermeras generales en atención primaria. El conocimiento sobre las acciones que las enfermeras utilizan en un contexto dado de su práctica puede permitir un mejor monitoreo de las competencias, una mejora en los planes de capacitación y una mejora continua en la calidad de los servicios de atención.Descriptores: Atención Primaria de Salud, Enfermería Práctica, Competencia.

scholarly journals Práticas de enfermagem em cuidados de saúde primários com base num referencial de competências

2019 ◽  
Vol 9 (27) ◽  
pp. 23-32
Author(s):  
Virgínia Maria Sousa Guedes ◽  
Maria Henriqueta Jesus Silva Figueiredo ◽  
João Luís Alves Apóstolo ◽  
Marlene Lebreiro Silva ◽  
Palmira Conceição Martins Oliveira ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Nursing Practice ◽  
Care Plan ◽  
Care Nurse ◽  
Primary Health ◽  
General Care

O objetivo deste estudo é identificar ações desenvolvidas por enfermeiros nos cuidados primários, com base no referencial de competências do enfermeiro de cuidados gerais da Ordem dos Enfermeiros Portuguesa. Estudo exploratório descritivo, em uma amostra de 46 enfermeiros de cuidados gerais, que trabalham em cuidados de saúde primários. As ações mais realizadas pelo enfermeiro de cuidados gerais mais comuns em CSP são: proteger o direito do cliente, atuar de acordo com linhas de orientação, solicitar colaboração de serviços de saúde, documentar processamento de informação, avaliar plano de cuidados em grupo, colaborar com serviços de saúde e estabelecer a confiança. Os princípios éticos profissionais parecem estar claramente presentes na prática do enfermeiro de cuidados gerais em cuidados primários. O conhecimento sobre as ações de enfermagem desenvolvidas em determinado contexto permitirá uma melhor avaliação de competências, dos planos formativos e da qualidade dos cuidados.Descritores: Cuidados de Saúde Primários, Prática de Enfermagem, Competências. Nursing practice in primary health care based on a competency frameworkAbstract: This study aims to identify actions developed by nurses in primary care which translate competencies of the general care nurse based on the Portuguese Order of Nurses competency framework. Descriptive exploratory study in a sample of 46 general care nurses, who exercise their functions in primary care. The most common actions performed by participants are: to protect the client's right, to act according to the guidelines, to request collaboration from health services, to document information processing, to evaluate a group care plan, to collaborate with health services. The professional values and guiding principles seem to be clearly present in the practice of general nurses in primary care. The knowledge about the actions that nurses use in a given context of their practice may allow for a better monitoring of competencies, an improvement in the training plans as well as a consequent continuous improvement of the quality of care services.Descriptors: Primary Health Care, Nursing Practice, Competencies. Práctica de enfermería en atención primaria de salud basada en un marco de competenciasResumen: Este estudio tiene como objetivo identificar las acciones desarrolladas por las enfermeras en atención primaria que traducen las competencias de la enfermera de atención general según el marco de competencias de la Orden de Enfermeras de Portugal. Estudio descriptivo exploratorio en una muestra de 46 enfermeras de cuidados generales, que trabajan en atención primaria. Las acciones más comunes son: proteger el derecho del cliente, actuar de acuerdo con las pautas, solicitar la colaboración de los servicios de salud, documentar el procesamiento de la información, evaluar un plan de atención grupal, colaborar con los servicios de salud. Los valores profesionales y los principios rectores parecen estar claramente presentes en la práctica de las enfermeras generales en atención primaria. El conocimiento sobre las acciones que las enfermeras utilizan en un contexto dado de su práctica puede permitir un mejor monitoreo de las competencias, una mejora en los planes de capacitación y una mejora continua en la calidad de los servicios de atención.Descriptores: Atención Primaria de Salud, Enfermería Práctica, Competencia.

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