scholarly journals Primary care quality and its effects on leprosy monitoring indicators

2020 ◽  
Vol 73 (4) ◽  
Author(s):  
Nayara Figueiredo Vieira ◽  
José Ramón Martínez-Riera ◽  
Francisco Carlos Félix Lana

ABSTRACT Objectives: to evaluate the quality of primary care in leprosy control actions, to correlate effects on monitoring indicators. Methods: a cross-sectional study, conducted in Belo Horizonte, from July to September 2014. Interviews with 408 professionals were conducted through the application of a tool that assesses attributes of primary care in leprosy control actions, and monitoring indicators were calculated. Spearman correlation was used, significance level p < 0.05. Results: the overall score correlated with the percentage of cases treated in primary care and of family health staff coverage. The derived score correlated with the percentage of cases treated in primary care, and the essential score correlated with the proportion and rate of cases diagnosed, with grade 2 physical disability. Conclusions: the quality of leprosy control actions performed by primary care professionals produces impacts on health indicators, and developing strategies consistent with the reality of the territory is necessary.

2018 ◽  
Vol 23 (2) ◽  
pp. 46-53 ◽  
Author(s):  
Sônia Rodrigues Dutra ◽  
Henrique Pretti ◽  
Milene Torres Martins ◽  
Cristiane Baccin Bendo ◽  
Miriam Pimenta Vale

ABSTRACT Objective: The aim of the present cross-sectional study was to assess the impact of malocclusion on the quality of life of children aged 8 to 10 years attending public elementary schools in Belo Horizonte, State of Minas Gerais, Brazil. Methods: The Brazilian version of the Child Perceptions Questionnaire 8-10 (CPQ8-10) was used to evaluate oral health-related quality of life. The children were examined for the diagnosis of malocclusion using the Dental Aesthetic Index (DAI). The data were analyzed by bivariate and multivariate descriptive statistics using Poisson regression at a 5% significance level. A total of 270 children participated in the study. Results: Children with normal occlusion or mild malocclusion (DAI ≤ 25) were 56% less likely (95%CI: 0.258-0.758; p= 0.003) to have their quality of life affected compared with children diagnosed with extremely severe malocclusion (DAI ≥ 36). Children with a maxillary anterior overjet ≥ 3 mm had higher CPQ8-10 mean scores (19.4; SD = 17.1) than those with an overjet < 3 mm (13.6; SD = 11.7; p= 0.038). Conclusions: Extremely severe malocclusion and pronounced maxillary anterior overjet were associated with a negative impact on quality of life.


2020 ◽  
Vol 7 (6) ◽  
pp. 1678-1684
Author(s):  
Jaya Aysola ◽  
Chang Xu ◽  
Hairong Huo ◽  
Rachel M Werner

We lack knowledge on how patient-reported experience relates to both quality of care services and visit attendance in the primary care setting. Therefore, in a cross-sectional analysis of 8355 primary care patients from 22 primary care practices, we examined the associations between visit-triggered patient-reported experience measures and both (1) quality of care measures and (2) number of missed primary care appointment (no shows). Our independent variables included both overall patient experience and its subdomains. Our outcomes included the following measures: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status (nonsmoker vs smoker), diabetes control Hemoglobin A1c (HbA1c [<8]), blood pressure control, cholesterol control Low Density Lipoprotein (LDL) among patients with diabetes (LDL < 100), and visit no shows 2 and 5 years after the index visit that triggered the completed patient-experience survey. We found that patient experience, while an important stand-alone metric of care quality, may not relate to clinical outcomes or process measures in the outpatient setting. However, patient-reported experiences with their primary care provider appear to influence their future visit attendance.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030624 ◽  
Author(s):  
Veline L’Esperance ◽  
Hugh Gravelle ◽  
Peter Schofield ◽  
Rita Santos ◽  
Mark Ashworth

ObjectiveTo explore the relationship between general practice capitation funding and quality ratings based on general practice inspections.DesignCross-sectional study pooling 3 years of primary care administrative data.SettingUK primary care.Participants7310 practices (95% of all practices) in England which underwent Care Quality Commission (CQC) inspections between November 2014 and December 2017.Main outcome measuresCQC ratings. Ordered logistic regression methods were used to predict the relationship between practice capitation funding and CQC ratings in each of five domains of quality: caring, effective, responsive, safe and well led, together with an overall practice rating.ResultsHigher capitation funding per patient was significantly associated with higher CQC ratings across all five quality domains: caring (OR 1.14, 95% CI 1.04 to 1.23), effective (OR 1.08, 95% CI 1.00 to 1.16), responsive (OR 1.09, 95% CI 1.02 to 1.17), safe (OR 1.11, 95% CI 1.05 to 1.18), well led (OR 1.13, 95% CI 1.06 to 1.20) and overall rating (OR 1.13, 95% CI 1.06 to 1.19).ConclusionHigher capitation funding was consistently associated with higher ratings across all CQC domains and in the overall practice rating. This study suggests that measured dimensions of the quality of care are related to the underlying capitation funding allocated to each general practice, implying that additional capitation funding may be associated with higher levels of primary care quality.


Author(s):  
Jingyi Liao ◽  
Mengping Zhou ◽  
Chenwen Zhong ◽  
Cuiying Liang ◽  
Nan Hu ◽  
...  

Family practice contract services, an important primary-care reform policy for improving primary healthcare quality in China, incorporate patients with multiple chronic conditions into the priority coverage groups and focus on their management. This study aims to explore the family practice contract services’ effectiveness in improving the quality of primary care experienced by this population. A cross-sectional study using a three-stage sampling was conducted from January to March 2019 in Guangdong, China. A multivariable linear regression, including interaction terms, was applied to examine the associations between the contract services and primary care quality among people with different chronic conditions. The process quality of primary care was measured in six dimensions using the validated assessment survey of primary care (ASPC) scale. People with contract services scored higher in terms of quality of primary care than those without contract services. Contract services moderated the association between chronic condition status and primary care quality. Significantly positive interactions were observed in the patient-centred care dimension and negative interactions were reflected in the accessibility dimension. Our findings suggest that family practice contract services play a crucial role in improving patient-perceived primary care quality and provide emerging evidence that patients with multimorbidity tend to benefit more from the services, especially in patient-centred care.


Author(s):  
José Andrade Louzado ◽  
Matheus Lopes Cortes ◽  
Márcio Galvão Oliveira ◽  
Vanessa Moraes Bezerra ◽  
Sóstenes Mistro ◽  
...  

Background: This study aimed to identify the factors associated with the quality of life of young workers of a Social Work of Industry Unit. Methods: This was a cross-sectional study conducted on 1270 workers. Data were collected using a digital questionnaire built on the KoBoToolbox platform that included the EUROHIS-QOL eight-item index to assess quality of life. Demographic, socioeconomic, behavioral, and clinical variables were considered explanatory. The associations were analyzed using the ordinal logistic regression model at a 5% significance level. Results: Men and women had a mean quality of life of 31.1 and 29.4, respectively. Workers that rated their health as “very good” had an odds ratio of 7.4 (95% confidence interval (CI) = 5.17–10.81), and those who rated it as “good” had an odds ratio of 2.9 (95% CI = 2.31–3.77). Both these groups of workers were more likely to have higher levels of quality of life as compared to workers with “regular”, “poor”, or “very poor” self-rated health. Physically active individuals were 30% more likely to have higher levels of quality of life (odds ratio = 1.3; 95% CI = 1.08–1.65). After adjusting the model by gender, age group, marital status, socioeconomic class, self-rated health, nutritional status, and risky alcohol consumption, the odds ratio of active individuals remained stable (odds ratio = 1.3; 95% CI = 1.05–1.66). Conclusions: In the present study, self-rated health, physical activity, and gender were associated with young workers’ quality of life.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e040781
Author(s):  
Pim P Valentijn ◽  
Marcel Kerkhoven ◽  
Jantien Heideman ◽  
Rosa Arends

ObjectivesThe aim of this study was to evaluate the association between integrated care and health-related quality of life (HRQOL) in a primary care practice population.DesignA cross-sectional survey study.SettingPrimary care practice population.ParticipantsA sample (n=5562) of patients in two general practitioner practices in the Netherlands.Primary outcome measuresThe Rainbow Model of Integrated Care Measurement Tool patient version and EQ-5D was used to assess integrated service delivery and HRQOL. The association between integrated care and HRQOL groups was analysed using multivariate logistic regression.ResultsOverall, 933 respondents with a mean age of 62 participated (20% response rate) in this study. The multivariate analysis revealed that positive organisational coordination experiences were linked to better HRQOL (OR=1.87, 95% CI 1.18 to 2.95), and less anxiety and depression problems (OR=0.36, 95% CI 0.20 to 0.63). Unemployment was associated with a poor HRQOL (OR=0.15, 95% CI 0.08 to 0.28). Ageing was associated with more mobility (OR=1.06, 95% CI 1.04 to 1.09), self-care (OR=1.06, 95% CI 1.02 to 1.11), usual activity (OR=1.03, 95% CI 1.01 to 1.05) and pain problems (OR=1.02, 95% CI 1.01 to 1.04). Being married improved the overall HRQOL (OR=1.60, 95% CI 1.13 to 2.26) and decreased anxiety and depression (OR=0.47, 95% CI 0.31 to 0.72). Finally, females had a poor overall HRQOL (OR=1.67, 95% CI 0.48 to 0.93) and more pain and discomfort problems (OR=1.47, 95% CI 1.11 to 1.95).ConclusionThis study shows for the first time that organisational coordination activities are positively associated with HROQL of adult patients in a primary care context, adding to the evidence of an association between integrated care and HRQOL. Also, unemployment, ageing and being female are accumulating risk factors that should be considered when designing integrated primary care programmes. Further research is needed to explore how various integration types relate to HRQOL for people in local communities.


Author(s):  
Krista Schultz ◽  
Sharan Sandhu ◽  
David Kealy

Objective The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Method Cross-sectional population-based study in Greater Vancouver, Canada. One-hundred ninety-seven participants were recruited from three Mental Health Clinics who reported having a primary care physician. Participants completed a survey containing questions regarding items assessing quality of Patient-Doctor Relationship, general psychiatric distress (K10), borderline personality disorder, and suicidality (Suicidal Behaviours Questionnaire-Revised-SBQ-R). Zero-order correlations were computed to evaluate relationships between study variables. Hierarchical regression analysis was used to control for confounding variables. Results The quality of the patient doctor relationship was significantly negatively associated with suicidality. The association between the quality of the patient-doctor relationship and suicidality remained significant even after controlling for the effects of psychiatric symptom distress and borderline personality disorder features. Conclusions The degree to which patients’ perceive their primary care physician as understanding, reliable, and dedicated, is associated with a reduction in suicidal behaviors. Further research is needed to better explicate the mechanisms of this relationship over time.


Author(s):  
Rafael Turano Mota ◽  
Helder Márcio Ferreira Júnior ◽  
Fabiane Silva Pereira ◽  
Maria Aparecida Vieira ◽  
Simone de Melo Costa

Abstract Objective: To characterize scientific publications on the quality of life of people with lung cancer in order to explore current knowledge of the subject, with emphasis on assessment instruments and methodological aspects. Method: A scoping type literature review was performed. Articles were sought in the databases of the Virtual Health Library, in an integrative manner, with the descriptors: Quality of life and Lung Neoplasms, with no date of publication or language restrictions (n=138). The selection of articles was based on inclusion and exclusion criteria defined in the study proposal. Results: We included 18 publications published between 2006 and 2017, the majority (n = 10) of which had a cross-sectional design. Eight different instruments were used to evaluate the quality of life of patients with lung cancer, four of which were specific for people with cancer. There was a prevalence of the use of the European Organization for Research and Treatment of Cancer Care Quality of Life Questionnaire - EORTC QLQ-C30 (n=8). Prospective studies (n=8) assessed quality of life before and after chemotherapy, physical therapy or pulmonary resection. The studies adopted different methodologies and provided conflicting results of quality of life. Cross-sectional studies with comparatively healthy subjects found an inferior quality of life for people with lung cancer. Conclusion: The scoping review contributed to the identification of the multiple evaluated instruments, both generic and specific. It found a lack of homogeneity in the methodological approaches of the studies. Further prospective studies with a specific instrument and methodological standardization to evaluate the quality of life of people with lung cancer are recommended.


BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021317 ◽  
Author(s):  
Lina Li ◽  
Chenwen Zhong ◽  
Jie Mei ◽  
Yuan Liang ◽  
Li Li ◽  
...  

ObjectiveCurrent healthcare reform in China has an overall goal of strengthening primary care and establishing a family practice system based on contract services. The objective of this study was to determine whether contracting a general practitioner (GP) could improve quality of primary care.DesignA cross-sectional study using two-stage sampling conducted from June to September 2014. Propensity score matching (PSM) was employed to control for confounding between patients with and without contracted GP.SettingThree community health centres in Guangzhou, China.Participants698 patients aged 18–89 years.Main outcome measuresThe quality of primary care was measured using a validated Chinese version of primary care assessment tool (PCAT). Eight domains are included (first contact utilisation, accessibility, continuity, comprehensiveness, coordination, family-centredness, community orientation and cultural competence from patient’s perceptions).ResultsA total of 692 effective samples were included for data analysis. After PSM, 94 pairs of patients were matched between the patients with and without contracted GPs. The total PCAT score, continuity (3.12 vs 2.68, p<0.01), comprehensiveness (2.31 vs 2.04, p<0.01) and family-centredness (2.11 vs 1.79, p<0.01) were higher in patients who contracted GPs than those did not. However, the domains of first contact utilisation (2.74 vs 2.87, p=0.14) and coordination (1.76 vs 1.93, p<0.05) were lower among patients contracted with GPs than in those who did not.ConclusionOur findings demonstrated that patients who had a contracted GP tend to experience higher quality of primary care. Our study provided evidence for health policies aiming to promote the implementation of family practice contract services. Our results also highlight further emphases on the features of primary care, first contact services and coordination services in particular.


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