scholarly journals Primary Health Care: care coordinator in regionalized networks?

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Patty Fidelis de Almeida ◽  
Adriano Maia dos Santos

RESUMO OBJECTIVE To analyze the breadth of care coordination by Primary Health Care in three health regions. METHODS This is a quantitative and qualitative case study. Thirty-one semi-structured interviews with municipal, regional and state managers were carried out, besides a cross-sectional survey with the administration of questionnaires to physicians (74), nurses (127), and a representative sample of users (1,590) of Estratégia Saúde da Família (Family Health Strategy) in three municipal centers of health regions in the state of Bahia. RESULTS Primary Health Care as first contact of preference faced strong competition from hospital outpatient and emergency services outside the network. Issues related to access to and provision of specialized care were aggravated by dependence on the private sector in the regions, despite progress observed in institutionalizing flows starting out from Primary Health Care. The counter-referral system was deficient and interprofessional communication was scarce, especially concerning services provided by the contracted network. CONCLUSIONS Coordination capacity is affected both by the fragmentation of the regional network and intrinsic problems in Primary Health Care, which poorly supported in its essential attributes. Although the health regions have common problems, Primary Health Care remains a subject confined to municipal boundaries.

2015 ◽  
Vol 8 (8) ◽  
pp. 192 ◽  
Author(s):  
Majed A. Aloufi ◽  
Marwan A. Bakarman

<p><strong>OBJECTIVES:</strong> To estimate the prevalence of emergency cases reporting to Primary Health Care centers (PHC), Jeddah, Saudi Arabia and to explore the barriers facing PHC physicians when dealing with such emergency cases.<strong></strong></p><p><strong>METHODS:</strong> A cross-sectional analytic study, where all physicians working in the PHC of the Ministry of Health (MOH) in Jeddah; were invited to participate (n=247). The study period was from July 2013 till December 2013. Data were collected through two sources. 1- A self-administered questionnaire used to determine the physicians’ perceived competence when dealing with emergency cases. 2- A structured observation sheet used to evaluate availability of equipment, drugs, ambulances and other supporting facilities required to deal with emergency cases.</p><p><strong>RESULTS:</strong> The response rate was 83.4%. The physicians’ age ranged between 25 and 60 years with a mean ±SD of 34.4±7.5 years. Majority of them (83.5%) did not attend ATLS courses at all whereas 60.7% never attended ACLS courses. The majority (97.1%) had however attended BLS courses. Physicians in the age group 36-45 years, non-Saudi, those who had SBFM, those who reported experience in working in emergency departments and physicians who reported more working years in PHCCs (&gt;5 years) had a significant higher score of perceived level of competence in performing emergency skill scale than others (P&lt;0.05). The prevalence of emergency cases attending PHC in Jeddah (2013) was 5.2%.</p><p><strong>CONCLUSION:</strong> Emergency services at PHC in Jeddah are functioning reasonably well, but require fine tuning of services and an upgrade in their quality.</p>


10.2196/11147 ◽  
2018 ◽  
Vol 6 (12) ◽  
pp. e11147 ◽  
Author(s):  
Francesc X Marin-Gomez ◽  
Francesc Garcia Cuyas ◽  
Ramon Reig-Bolano ◽  
Jacobo Mendioroz ◽  
Pere Roura-Poch ◽  
...  

Author(s):  
Katariina Mäkelä ◽  
Mira Rajala ◽  
Kirsi Kivelä ◽  
Maria Kääriäinen ◽  
Pirjo Kaakinen

2020 ◽  
Vol 37 (5) ◽  
pp. 648-654
Author(s):  
Patricia S Chueiri ◽  
Marcelo Rodrigues Gonçalves ◽  
Lisiane Hauser ◽  
Lucas Wollmann ◽  
Sotero Serrate Mengue ◽  
...  

Abstract Background Primary health care (PHC) delivery in Brazil has improved in the last decades. However, it remains unknown whether the Family Health Strategy teams are meeting the health needs of the population. Objectives To describe the reasons for encounter (RFEs) in PHC in Brazil and to examine variations in RFEs according to sex, age and geographic region. Methods This descriptive study is part of a national cross-sectional study conducted in 2016. The sample was stratified by the number of PHC physicians per geographic region. Physicians who had been working for at least 1 year in the same PHC unit were included. For every participating physician, 12 patients aged ≥18 years who had attended at least two encounters were included. Patients were asked about their RFEs, which were classified according to the International Classification of Primary Care. Results In 6160 encounters, a total of 8046 RFEs were coded. Seven reasons accounted for 50% of all RFEs. There was a high frequency of codes related to test results, medication renewal and preventive medicine. RFEs did not vary significantly by sex or geographic region, but they did by age group (P &lt; 0.001). The rates of prescriptions, requests for investigations and referrals to specialized care were 71.1%, 42.8%, and 21.3%, respectively. Conclusion This novel study opened the ‘black box’ of RFEs in PHC in Brazil. These findings can contribute to redefining the scope of PHC services and reorienting work practices in order to improve the quality of PHC in Brazil.


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