scholarly journals Assessing the role of appropriate primary health care on the use of dental services by Brazilian low-income preschool children

2017 ◽  
Vol 33 (11) ◽  
Author(s):  
Márcia Helena Baldani ◽  
Juliana Schaia Rocha ◽  
Cristina Berger Fadel ◽  
Antonio Carlos Nascimento ◽  
José Leopoldo Ferreira Antunes ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Low Income ◽  
World Health ◽  
Dental Services ◽  
Perceived Need ◽  
Primary Health ◽  
The Impact

Abstract: This cross-sectional study aimed to assess the association between the quality of primary health care (PHC) and the use of dental services by preschoolers served by the Family Health Strategy (FHS), controlling for socio-demographic determinants and perceived need. The sample encompassed 438 children aged 3-5 years, enrolled in 19 FHS facilities in Ponta Grossa, Paraná State, Brazil. Individual level variables were collected by interviewing parents or caregivers at home. They answered a questionnaire on socioeconomic conditions, oral hygiene habits and use of dental services. Parental perception of child’s oral health related quality of life, as perceived need, was assessed by the Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS). Normative need was assessed by oral examinations, according to guidelines standardized by the World Health Organization. The contextual level factor was defined as the extent of implementation of PHC in the facilities. Managers responded to PCATool-Brazil, a validated questionnaire which measures the extent of PHC. Dentists answered to a version of PCATool, which was adapted and pretested for dental services. Multilevel analysis, based on Andersen’s behavioral model, fitted the adjustment of “having ever consulted a dentist” to contextual and individual covariates. We observed high prevalence of dental caries. Almost half of the sample had had dental appointments in life. Social gradients were observed for the use of dental services. Although it was not able to eliminate the impact of adverse social conditions, higher levels of PHC attributes in dental services favored the effective use of such services by low-income children.

scholarly journals Access to dental services and oral health-related quality of life in the context of primary health care

2019 ◽  
Vol 33 ◽  
Author(s):  
Lucelen Fontoura BASTOS ◽  
Fernando Neves HUGO ◽  
Juliana Balbinot HILGERT ◽  
Débora Deus CARDOZO ◽  
Alexandre Fávero BULGARELLI ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Health Related Quality ◽  
Dental Services ◽  
Primary Health ◽  
Related Quality ◽  
Health Related

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.

Primary Health Care. Suicide Prevention Proposal. Santiago del Estero. Argentina

2017 ◽  
Vol 41 (S1) ◽  
pp. S570-S570
Author(s):  
T. Sanchez Cantero ◽  
R. Costilla ◽  
M. Chávez
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Young People ◽  
Low Income ◽  
Age Groups ◽  
Care Physician ◽  
World Health ◽  
Primary Health ◽  
Health Organization ◽  
Commit Suicide

Background and aimSuicide is a serious and growing problem worldwide. According to the World Health Organization, for each death there are twenty attempts on record. Every year over 800,000 people commit suicide, that is, one in every forty. 45% of the people who commit suicide visit their Primary Health Care physician in the previous month. Seventy-five percent of suicides take place in countries with medium or low income and Argentine heads the suicide rate in Latin America. In the last twenty years the death by suicides rate in young people (aged 15–35) and has decreased in older age groups (+ 55), which historically presented the highest rates. In the inner zone of the province of Santiago del Estero, suicides have increased among teenagers [1].AimsTo know suicide statistics in young people in the last decade so that a prevention scheme can be produced.MethodsDescriptive observational study.ResultsIn the province of Santiago del Estero suicides occur more frequently among young people, aged 15–35, and the rate has increased significantly in the inner zone of the province.ConclusionsThe analysis carried out reveal that this problem in increasing in our province and it requires analysis and consensus in order to design a model of Primary Health Care Prevention.Disclosure of InterestThe authors have not supplied their declaration of no competing interest.

scholarly journals Prevalence of Older Adult Disability and Primary Health Care Responsiveness in Low-Income Communities

Life ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 133
Author(s):  
Giovana Montoro Pazzini Watfe ◽  
Lais Fajersztajn ◽  
Euler Ribeiro ◽  
Paulo Rossi Menezes ◽  
Marcia Scazufca
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Physician ◽  
Low Income ◽  
Sao Paulo ◽  
Individual Characteristics ◽  
World Health ◽  
São Paulo ◽  
Middle Income ◽  
Primary Health

In Brazil and in most low- and middle-income countries (LMICs), information about how prepared the health care system is for the rapid aging of the population is scarce. We investigated the prevalence of disability and areas of life affected by disability among elders of the public primary health care in São Paulo and Manaus, Brazil. We investigated whether people with disability visited a primary care professional more frequently, the individual characteristics associated with disability, and differences by city. We randomly selected participants aged ≥60 years (n = 1375). The main outcome was disability, evaluated with the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0). Exposure variables were consultation with a family physician, sociodemographic characteristics, health status, social support, and lifestyle. The prevalence of global disability was higher in Manaus (66.2% vs. 56.4% in São Paulo). In both cities, participation and mobility were the areas of life most affected by disability. The number of consultations with a family physician was not associated with disability. The high prevalence of disability and associated risk factors indicates that public primary health care is not meeting the needs of elders in both cities. It is warning because most elders in LMICs live in more underserved communities compared to Brazil.

scholarly journals Validity and reliability of the Brazilian Primary Care Assessment Tool: Oral Health of Adults

2020 ◽  
Vol 23 ◽  
Author(s):  
Débora Deus Cardozo ◽  
Caroline Stein ◽  
Lisiane Hauser ◽  
Liége Teixeira Fontanive ◽  
Erno Harzheim ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Assessment Tool ◽  
Validity And Reliability ◽  
Dental Services ◽  
Primary Health ◽  
Care Assessment ◽  
Primary Care Assessment Tool

ABSTRACT: Objective: To test the factorial validity and reliability of the Primary Care Assessment Tool adapted to Oral Health, adult patient version, an instrument used to verify the presence and extent of attributes in Primary Health Care services. Methods: Population-based cross-sectional study using conglomerate random sample carried out in Primary Health Care Dental services in Porto Alegre between 2011 and 2013. We interviewed 407 adult patients who used Primary Health Care Dental services. Construct validity was tested through factorial validity and reliability of the Primary Care Assessment Tool, that comprises 81 items distributed throughout Primary Health Care attributes. Equamax orthogonal rotation method was used in the factorial analysis; and, in order to assess reliability of each component, we used the item-total correlation and the ratio of success of the scale. Results: In the factorial analysis, 10 factors were retained, explaining 53.3% of the total variation. This result demonstrates the multidimensional structure of the instrument. The reliability assessment showed Cronbach’s alpha values ranging from 0.39 to 0.89. For the success of the scale most of the results (eight of nine attributes) were greater than 85%. Conclusions: The instrument is valid for the assessment of oral health services in Primary Health Care from the perspective of adult patients, as well as for monitoring and evaluation of oral health services in Primary Health Care attributes and comparative studies.

scholarly journals Impact of patient-perceived quality of primary health care on the patients' bypass behaviour in China

2020 ◽  
Author(s):  
WeiWei Zhang ◽  
Yuankai Huang ◽  
Gaojie Li ◽  
Hongjie Zhou ◽  
Xiaoyu Xi
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Perceived Quality ◽  
Health Care Facilities ◽  
Primary Health ◽  
Care Assessment ◽  
The Impact

Abstract Background Patient bypass often occurs under the loose gatekeeper system. Additionally, patients’ perceived quality of primary health care (PHC) is one of the important factors affecting bypass behaviour. Objective to explore individuals’ bypass behaviour in China and the associations between patients’ perceived quality of PHC and their bypass behaviour. MethodIn 2019, this study investigated Chinese bypass behaviour and the potential influencing factors. The questionnaire that was used assessed the following: the perceived quality of primary care using the Primary Care Assessment Tool; bypass experience; age; health insurance; and other factors. A logit regression model was used to analyse the impact of perceived quality of PHC on bypass behaviour. Results The data of 2070 residents in 706 health care facilities in China were collected. The results show that perceived quality of PHC is significantly associated with bypass behaviour in China. After adjustments were made for patients’ sociodemographic and other characteristics, an increase of one standard deviation (SD; odds ratio (OR) per 1-SD increase) in the PCAT scores led to a 2% decrease in bypass behaviour (OR 0.98, p<0.05). Gender, hukou and cold fee for PHC were negatively associated with bypass behaviour. Conclusion Patients' perceptions of PHC service quality play an active role in reducing their bypass behaviour, which may provide a new perspective for the design of PHC health policies.

scholarly journals Lian gong as a Therapeutic Treatment Option in Primary Care for Patients with Dizziness: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Aline Lamas Lopes ◽  
Stela Maris Aguiar Lemos ◽  
Pedro Henrique Scheidt Figueiredo ◽  
Denise Utsch Gonçalves ◽  
Juliana Nunes Santos
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Fear Of Falling ◽  
Controlled Trial ◽  
Treatment Method ◽  
Control Group ◽  
Primary Health ◽  
The Impact

Abstract Introduction Dizziness is one of the most common reasons for seeking primary health care. Vestibular rehabilitation (VR) is a conventional treatment method for peripheral balance disorders that effectively decreases symptoms. Lian gong [LG] is believed to benefit patients with dizziness and to reduce the impact of the condition on quality of life by stimulating visual fixation, attention, body balance, and neuroplasticity. Objective The present study aimed to evaluate the effects of LG on the impact of dizziness on quality of life and fear of falling in primary health care patients. Methods This was a two-arm, parallel randomized clinical trial that included 36 patients with dizziness not caused by central changes. After specific medical evaluations and indications for treatment, the participants were randomly assigned to 3 groups: the LG group (n = 11), the VR group (n = 11), and the control group (n = 14). The interventions were conducted collectively over a period of 12 weeks. Results Lian gong reduced the influence of dizziness on quality of life in physical (1.8 points, 95% confidence interval [CI]: 0.2–3.4), functional (4.0 points, 95% CI: 2.1–5.9), and emotional domains of quality of life (4.4 points, 95% CI: 1.7–7.2), with no differences compared with VR. There were similar concerns among the groups about the risk of falling. Conclusion Lian gong was shown to be an effective balance rehabilitation strategy to reduce the impact of dizziness on quality of life, with similar results to those of VR.

scholarly journals Quality of Life of Primary Healthcare Centres Physicians in BURAIDAH City 2020, a Study Using WHOQOL-BREF Questionnaire

2021 ◽  
pp. 10-18
Author(s):  
Mohamad Fahad Alreshoudi ◽  
Chandra Sekhar Kalevaru
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
World Health ◽  
Care Providers ◽  
Life Score ◽  
Primary Health ◽  
Psychological Domain

Background: Life of doctors puts them at a high level of challenges and stress which can affect their quality of life. Therefore, the objective of the study was to evaluate the Quality Of Life of Primary health care providers by applying a brief version of the World Health Organization questionnaire for assessing Quality of Life (WHOQOL-BREF). To find the factors which affect the QOL of PHC physicians and know the aspects where it was affecting the health and performance of the Doctors. Methods: A cross-sectional study was conducted among 186 physicians working in primary health care centers in BURAIDAH city under Ministry Of Health. WHOQOL BREF validated questionnaire was used in both English and Arabic versions. Data was entered and cleaned in SPSS 21.0 version and necessary statistical tests were applied. Results: In the present study, about 29.6% were females and 70.4% were males. About 66.6% of the study population were in 30-49 years age group and half (48.4%) of them were general practitioners. Mean QOL score in psychological domain (domain 2) was 63.66. In the other three domains of physical health, social relationships and environmental domain (domain 1, 3 & 4) was scoring more than 65. There was a statistically significant association observed between age and physical ,psychological health domains. This association was also seen between marital status and psychological, social domains. Conclusions: Based on the results, on the whole, the majority of primary health care doctors had a moderate quality of life score to a high quality of life score ranging from 63.66-68.06. Still, there is a scope of improvement in domain 2 (psychological domain). 

Antidepressant and Group Psychosocial Treatment for Depression: A Rater Blind Exploratory RCT from a Low Income Country

2013 ◽  
Vol 42 (6) ◽  
pp. 693-705 ◽  
Author(s):  
Nusrat Husain ◽  
Nasim Chaudhry ◽  
Batool Fatima ◽  
Meher Husain ◽  
Rizwana Amin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Low Income ◽  
Psychosocial Intervention ◽  
Psychological Intervention ◽  
Antidepressant Treatment ◽  
Psychosocial Treatment ◽  
Primary Health

Background: Research in the West shows that group psychological intervention together with an antidepressant treatment leads to more effective treatment of a depressive disorder. There are no treatment trials from low income countries comparing the efficacy of antidepressant treatment with a group psychological intervention. Aim: To conduct a feasibility trial to compare the efficacy of an antidepressant to a group psychosocial intervention, for low income women attending primary health care in Karachi, Pakistan. Method: This was a preliminary RCT in an urban primary health care clinic in Karachi, Pakistan. Consecutive eligible women scoring >12 on the CIS-R and >18 on Hamilton Depression Rating Scale (HDRS) (n = 66) were randomly assigned to antidepressants or a psychosocial treatment in group settings. The primary outcome measure was HDRS score; secondary outcome measures were disability and quality of life. Results: More than half of the patients in both groups improved (50% reduction in HDRS scores); at end of therapy at 3 months 19 (59.4%) vs 18 (56.2%), and at 6-month follow-up 21(67.7%) vs 20(62.5%) for antidepressants and psychosocial intervention respectively. Although HDRS, BDQ and EQ5-D scores all improved considerably in both groups from start to end of treatment, and these improvements were largely maintained after a further 3 months, the differences between the two treatments were not statistically significant. Conclusion: Psychosocial intervention was as effective as antidepressants in reducing depression and in improving quality of life and disability at the end of therapy. However, these findings need further exploration through a larger trial.

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