scholarly journals Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Severina Alice da Costa Uchôa ◽  
Ricardo Alexandre Arcêncio ◽  
Inês Fronteira ◽  
Ardigleusa Alves Coêlho ◽  
Claudia Santos Martiniano ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Secondary Data ◽  
National Program ◽  
Chi Square ◽  
Primary Health ◽  
Chi Square Test ◽  
Access And Quality

Objective: to analyze the influence of contextual indicators on the performance of cities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study using secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the cities stratified in the dimensions on size of the coverage group, supply, coordination and integration. When necessary, the chi-square test with Yates correction or Fisher’s exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n = 15,876; 92.3%). Statistically significant differences were observed between the cities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the cities that make up group 6 tend to perform better in these dimensions, with a better performance in all dimensions analyzed in groups 4, 5 and 6. Conclusion: weakness in smaller cities, confirming inequities in the potential access to Primary Health Care in Brazil as challenges for universal coverage. The preponderant role of nurses for its achievement is highlighted.

scholarly journals Partnership in Practice: a multidisciplinary approach to quality improvement in primary health care

1995 ◽  
Vol 19 (6) ◽  
pp. 371-371
Author(s):  
Michael Phelan
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
General Practitioners ◽  
Multidisciplinary Approach ◽  
Professional Groups ◽  
Primary Health ◽  
Audit Team

This one day seminar was arranged by the King's Fund Organisational Audit team (KFOA), to take a multidisciplinary view of quality improvement in primary care. Despite the title of the day all the speakers were general practitioners and managers, and input from other professional groups was limited to questions and comments from the audience of nearly 200.

scholarly journals Utilization of Breast Cancer Screening in Brazil: An External Assessment of Primary Health Care Access and Quality Improvement Program

2018 ◽  
Vol 4 (1) ◽  
pp. 42-55 ◽  
Author(s):  
Mara Rejane Barroso Barcelos ◽  
Bruno Pereira Nunes ◽  
Suele Manjourany Silva Duro ◽  
Elaine Tomasi ◽  
Rita de Cássia Duarte Lima ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Health Care Access ◽  
Improvement Program ◽  
External Assessment ◽  
Care Access ◽  
Primary Health ◽  
Access And Quality

scholarly journals An implementation history of primary health care transformation: Alberta’s primary care networks and the people, time and culture of change

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Myles Leslie ◽  
Akram Khayatzadeh-Mahani ◽  
Judy Birdsell ◽  
P. G. Forest ◽  
Rita Henderson ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Fee For Service ◽  
Structured Interviews ◽  
Policy Documents ◽  
Incremental Change ◽  
Primary Health ◽  
History Of

Abstract Background Primary care, and its transformation into Primary Health Care (PHC), has become an area of intense policy interest around the world. As part of this trend Alberta, Canada, has implemented Primary Care Networks (PCNs). These are decentralized organizations, mandated with supporting the delivery of PHC, funded through capitation, and operating as partnerships between the province’s healthcare administration system and family physicians. This paper provides an implementation history of the PCNs, giving a detailed account of how people, time, and culture have interacted to implement bottom up, incremental change in a predominantly Fee-For-Service (FFS) environment. Methods Our implementation history is built out of an analysis of policy documents and qualitative interviews. We conducted an interpretive analysis of relevant policy documents (n = 20) published since the first PCN was established. We then grounded 12 semi-structured interviews in that initial policy analysis. These interviews explored 11 key stakeholders’ perceptions of PHC transformation in Alberta generally, and the formation and evolution of the PCNs specifically. The data from the policy review and the interviews were coded inductively, with participants checking our emerging analyses. Results Over time, the PCNs have shifted from an initial Frontier Era that emphasized local solutions to local problems and featured few rules, to a present Era of Accountability that features central demands for standardized measures, governance, and co-planning with other elements of the health system. Across both eras, the PCNs have been first and foremost instruments and supporters of family physician authority and autonomy. A core group of people emerged to create the PCNs and, over time, to develop a long-term Quality Improvement (QI) vision and governance plan for them as organizations. The continuing willingness of both these groups to work at understanding and aligning one another’s cultures to achieve the transformation towards PHC has been central to the PCNs’ survival and success. Conclusions Generalizable lessons from the implementation history of this emerging policy experiment include: The need for flexibility within a broad commitment to improving quality. The importance of time for individuals and organizations to learn about: quality improvement; one another’s cultures; and how best to support the transformation of a system while delivering care locally.

scholarly journals Diabetic Neuropathy among Type 2 Diabetes Mellitus Patients at Amplas Primary Health Care in Medan City

2019 ◽  
Vol 7 (20) ◽  
pp. 3400-3403 ◽  
Author(s):  
Rina Amelia ◽  
Arlinda Sari Wahyuni ◽  
Yuki Yunanda
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Diabetic Neuropathy ◽  
Chi Square ◽  
Clinical Neurological Examination ◽  
Type 2 Dm ◽  
Primary Health ◽  
Chi Square Test

BACKGROUND: Diabetic neuropathy is one of the most complicated complications of diabetes patients with Type 2 diabetes. AIM: The purpose of this study was to determine the diagnosis of diabetic neuropathy based on Clinical Neurological Examination (CNE) and the factors that influence the occurrence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care (PHC) in Medan City. METHODS: The research design was descriptive-analytic with the cross-sectional approach. The study population was all Type 2 DM patients who came to Amplas PHC with a total sample of 53 people using the consecutive sampling. The research data source is primary data, namely the assessment of diabetic neuropathy using the Clinical Neurological Examination (CNE) criteria. Data were processed using SPSS and analysis using the chi-square test. RESULTS: The results showed the majority of Type 2 DM patients had mild neuropathy as many as 24 people (45.3%). The Chi-square test results showed there was a relationship between age and duration of diabetes with the incidence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care. CONCLUSION: Education and early detection with proper management can prevent more severe complications so that the quality of life of patients can be maintained better.

scholarly journals HUBUNGAN UMUR DAN JENIS KELAMIN TERHADAP KEBERHASILAN PITC (PROVIDER INITIATED TESTING AND COUNSELLING) PADA PASIEN TB DI KOTA MEDAN TAHUN 2017

2019 ◽  
Vol 13 (2) ◽  
Author(s):  
Sity Kunarisasi ◽  
Imran Pambudi ◽  
Asri Mutiara Putri ◽  
Nurhanifah Hamdah
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Public Health Issue ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Primary Health ◽  
Hiv Test ◽  
Chi Square Test ◽  
And Gender

Tuberculosis is a public health issue. Prevalence of tuberculosis in 2017 is estimated 824.000 cases in which making Indonesia the third country in the world with biggest burden TB and the seventh country with biggest burden in HIV-TB. PITC in primary health care is a Health Ministry program. PITC is the only test and counseling to motivated TB patient to get HIV test. The aim of this study is to analyze relationship between age and gender with the success of PITC in TB patients to know the HIV status at Medan in 2017. Method This research is a descriptive-analytic study with cross-sectional approach. the population in this study is TB patients with age 15-49 years old wo had TB diagnosed either with bacteriologic or clinical in primary health care at Medan in 2017. Medan is chosen because Medan is one of eight cities with the highest burden of TB and HIV in Indonesia, also it has complete recording of TB patients. The sample of this study is all TB patients in primary health care at Medan in 2017 who had PITC in total 2.228 from all TB patients in total 5.039 patients. Data analysis using SPSS to search for p value and Odds Ratio (OR). Result 250 of 2.228 (11,22%) patients is positive in HIV test. Statistics analysis using chi-square test shows p value 0.000 (p<0.05) and OR = 1.905 for relationship between gender and HIV test positive. Also, p value of 0,006 (p<0,05) and OR = 1.459 for relationship between age and HIV test positive. In this study with the implementation of PITC in TB patients in primary health care at Medan there is a relationship between sex and age with HIV infection.

scholarly journals Detection of tuberculosis: respiratory symptoms flow and results achieved

2018 ◽  
Vol 71 (5) ◽  
pp. 2543-2551 ◽  
Author(s):  
Lílian Moura de Lima Spagnolo ◽  
Jéssica Oliveira Tomberg ◽  
Dagoberta Alves Vieira ◽  
Roxana Isabel Cardozo Gonzales
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Respiratory Symptoms ◽  
Secondary Data ◽  
Health Care Teams ◽  
Structured Interviews ◽  
Primary Health ◽  
Municipal Management ◽  
Descriptive Statistical Analysis

ABSTRACT Objective: to analyze the flow of care to the person with symptoms of tuberculosis and the results achieved in the detection of cases in Primary Health Care units of two municipalities of Rio Grande do Sul. Method: descriptive of mixed methods, developed between 2013 and 2016. We used secondary data of 69 units and semi-structured interviews with 10 professionals. Descriptive statistical analysis and content analysis were used. Results: it was observed that the fragmented flow of attention to the respiratory symptoms in Pelotas resulted in low detection of cases by Primary Care, 8.8% of the diagnoses of the municipality. The Sapucaia do Sul flow presents continuity of care, and Primary Care performed 50% of the diagnoses of the municipality. Conclusion: the organization of flows by municipal management was instrumental in promoting or limiting the commitment of Primary Health Care teams in coordinating care and consequently in achieving the goals of disease control.

scholarly journals Factors associated with user satisfaction regarding treatment offered in Brazilian primary health care

2017 ◽  
Vol 33 (2) ◽  
Author(s):  
Ane Polline Lacerda Protasio ◽  
Luciano Bezerra Gomes ◽  
Liliane dos Santos Machado ◽  
Ana Maria Gondim Valença
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
User Satisfaction ◽  
Health Care Services ◽  
Secondary Data ◽  
Care Access ◽  
Care Services ◽  
Primary Health ◽  
Two Factors ◽  
Access And Quality

Abstract: The Program for Access and Quality Improvement in Primary Care (PMAQ-AB) aimed to improve healthcare public service quality. The purpose of this study was to identify the main factors that influence user satisfaction in Brazilian primary health care services. This research was carried out using secondary data from the first cycle of the PMAQ-AB. A cluster analysis was carried out to find the dependent variable of user satisfaction; and logistic regression was applied in order to obtain the decision model. From the resulting regression model, two factors can be highlighted as regards influencing user satisfaction in Brazil: the user's perception that the team did not attempt to address their needs/problems within the health unit; and the user not feeling respected by the professionals in relation to cultural habits, customs, and religion or only sometimes feeling so. This study revealed the importance of continued commitment of teams and managers to improving care access, meeting user needs, and improving organizational aspects and the health professional-user relationship.

scholarly journals An Implementation History of Primary Health Care Transformation: Alberta’s Primary Care Networks and the People, Time and Culture of change

2020 ◽  
Author(s):  
Myles Leslie ◽  
Akram Khayatzadeh-Mahani ◽  
Judy Birdsell ◽  
PG Forest ◽  
Rita Henderson ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Fee For Service ◽  
Structured Interviews ◽  
Policy Documents ◽  
Incremental Change ◽  
Primary Health ◽  
History Of

Abstract Background: Primary care, and its transformation into Primary Health Care (PHC), has become an area of intense policy interest around the world. As part of this trend Alberta, Canada, has implemented Primary Care Networks (PCNs). These are decentralized organizations, mandated with supporting the delivery of PHC, funded through capitation, and operating as partnerships between the province’s healthcare administration system and family physicians. This paper provides an implementationhistory of the PCNs, giving a detailed account of how people, time, and culture have interacted to implement bottom up, incremental change in a predominantly Fee-For-Service (FFS) environment.Methods: Our implementation history is built out of an analysis of policy documents and qualitative interviews. We conducted an interpretive analysis of relevant policy documents (n=20) published since the first PCN was established. We then grounded 12 semi-structured interviews in that initial policy analysis. These interviews explored 11 key stakeholders’ perceptions of PHC transformation in Alberta generally, and the formation and evolution of the PCNs specifically. The data from the policy review and the interviews were coded inductively, with participants checking our emerging analyses.Results: Over time, the PCNs have shifted from an initial Frontier Era that emphasized local solutions to local problems and featured few rules, to a present Era of Accountability that features central demands for standardized measures, governance, and co-planning with other elements of the health system. Across both eras, the PCNs have been first and foremost instruments and supporters of family physician authority and autonomy. A core group of people emerged to create the PCNs and, over time, to develop a long-term Quality Improvement (QI) vision and governance plan for them as organizations. The continuing willingness of both these groups to work at understanding and aligning one another’s cultures to achieve the transformation towards PHC has been central to the PCNs’ survival and success.Conclusions: Generalizable lessons from the implementation history of this emerging policy experiment include: The need for flexibility within a broad commitment to improving quality. The importance of time for individuals and organizations to learn about: quality improvement; one another’s cultures; and how best to support the transformation of a system while delivering care locally.

scholarly journals An implementation history of primary health care transformation: Alberta’s primary care networks and the people, time and culture of change

2020 ◽  
Author(s):  
Myles Leslie ◽  
Akram Khayatzadeh-Mahani ◽  
Judy Birdsell ◽  
PG Forest ◽  
Rita Henderson ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Fee For Service ◽  
Structured Interviews ◽  
Policy Documents ◽  
Incremental Change ◽  
Primary Health ◽  
History Of

Abstract Background: Primary care, and its transformation into Primary Health Care (PHC), has become an area of intense policy interest around the world. As part of this trend Alberta, Canada, has implemented Primary Care Networks (PCNs). These are decentralized organizations, mandated with supporting the delivery of PHC, funded through capitation, and operating as partnerships between the province’s healthcare administration system and family physicians. This paper provides an implementationhistory of the PCNs, giving a detailed account of how people, time, and culture have interacted to implement bottom up, incremental change in a predominantly Fee-For-Service (FFS) environment.Methods: Our implementation history is built out of an analysis of policy documents and qualitative interviews. We conducted an interpretive analysis of relevant policy documents (n=20) published since the first PCN was established. We then grounded 12 semi-structured interviews in that initial policy analysis. These interviews explored 11 key stakeholders’ perceptions of PHC transformation in Alberta generally, and the formation and evolution of the PCNs specifically. The data from the policy review and the interviews were coded inductively, with participants checking our emerging analyses.Results: Over time, the PCNs have shifted from an initial Frontier Era that emphasized local solutions to local problems and featured few rules, to a present Era of Accountability that features central demands for standardized measures, governance, and co-planning with other elements of the health system. Across both eras, the PCNs have been first and foremost instruments and supporters of family physician authority and autonomy. A core group of people emerged to create the PCNs and, over time, to develop a long-term Quality Improvement (QI) vision and governance plan for them as organizations. The continuing willingness of both these groups to work at understanding and aligning one another’s cultures to achieve the transformation towards PHC has been central to the PCNs’ survival and success.Conclusions: Generalizable lessons from the implementation history of this emerging policy experiment include: The need for flexibility within a broad commitment to improving quality. The importance of time for individuals and organizations to learn about: quality improvement; one another’s cultures; and how best to support the transformation of a system while delivering care locally.

scholarly journals Exploration of funding models to support hybridisation of Australian primary health care organisations

2017 ◽  
Vol 9 (3) ◽  
pp. 208 ◽  
Author(s):  
Sandeep Reddy
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Continuous Quality Improvement ◽  
Continuous Quality ◽  
Funding Model ◽  
Primary Health ◽  
Set Up

ABSTRACT Primary Health Care (PHC) funding in Australia is complex and fragmented. The focus of PHC funding in Australia has been on volume rather than comprehensive primary care and continuous quality improvement. As PHC in Australia is increasingly delivered by hybrid style organisations, an appropriate funding model that matches this set-up while addressing current issues with PHC funding is required. This article discusses and proposes an appropriate funding model for hybrid PHC organisations.

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