scholarly journals Community pharmacy and primary health care in Sweden - at a crossroads

2020 ◽  
Vol 18 (2) ◽  
pp. 1927 ◽  
Author(s):  
Tommy Westerlund ◽  
Bertil Marklund
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Significant Risk ◽  
Small Scale ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Physical Care

The overall goal of Swedish health care is good health and equitable care for the whole population. The responsibility for health is shared by the central government, the regions, and the municipalities. Primary care accounts for approximately 20 percent of all expenditures on health care. About 16% of all physicians work in primary health. The regions have also employed a large number of clinical pharmacists, usually hospital-based, but many perform a variety of different primary care services, the most common of which is patient medication reviews. Swedish primary health care is at a crossroads facing extensive challenges, due to changes in demography and demanding financial conditions. These changes necessitate large transformations in health services and delivery. Current Government inquiries have primarily focused on two ways to meet the challenges; a shift towards more local care requiring a transfer of resources from hospital care, and a further development of structured digi-physical care, that is both digital (“online doctors”) and physical accessibility of care. While primary care at present is undergoing processes of change, community pharmacy has done so during the past decade since the re-regulation of the Swedish pharmacy market. A monopoly was replaced by a competitive system, where five pharmacy chains now share most of the market, a competition that has made community pharmacy very commercialized. A number of different, promising primary care services are being offered, but they are usually delivered on a small scale due to a lack of remuneration and philosophy of providers. Priority is given to sales and fast dispensing of prescriptions, often with a minimum of counseling. Reflecting primary health care, community pharmacy in Sweden is at a crossroads but currently has a golden opportunity to choose a route of collaboration with primary health care in its current transformation into more local and digi-physical care. A major challenge is that primary health care inquires, strategic plans, and national policy documents usually do not include community pharmacy as a partner. Hence, community pharmacy have to be proactive and seize this chance of changes in primary health policy and organization in order to become an important link in the chain of health care delivery, or there is a significant risk that it will predominantly remain a retail business.

scholarly journals Community pharmacy and primary health care in Sweden - at a crossroads

2020 ◽  
Vol 18 (2) ◽  
pp. 1927
Author(s):  
Tommy Westerlund ◽  
Bertil Marklund
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Significant Risk ◽  
Small Scale ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Physical Care

The overall goal of Swedish health care is good health and equitable care for the whole population. The responsibility for health is shared by the central government, the regions, and the municipalities. Primary care accounts for approximately 20 percent of all expenditures on health care. About 16% of all physicians work in primary health. The regions have also employed a large number of clinical pharmacists, usually hospital-based, but many perform a variety of different primary care services, the most common of which is patient medication reviews. Swedish primary health care is at a crossroads facing extensive challenges, due to changes in demography and demanding financial conditions. These changes necessitate large transformations in health services and delivery. Current Government inquiries have primarily focused on two ways to meet the challenges; a shift towards more local care requiring a transfer of resources from hospital care, and a further development of structured digi-physical care, that is both digital (“online doctors”) and physical accessibility of care. While primary care at present is undergoing processes of change, community pharmacy has done so during the past decade since the re-regulation of the Swedish pharmacy market. A monopoly was replaced by a competitive system, where five pharmacy chains now share most of the market, a competition that has made community pharmacy very commercialized. A number of different, promising primary care services are being offered, but they are usually delivered on a small scale due to a lack of remuneration and philosophy of providers. Priority is given to sales and fast dispensing of prescriptions, often with a minimum of counseling. Reflecting primary health care, community pharmacy in Sweden is at a crossroads but currently has a golden opportunity to choose a route of collaboration with primary health care in its current transformation into more local and digi-physical care. A major challenge is that primary health care inquires, strategic plans, and national policy documents usually do not include community pharmacy as a partner. Hence, community pharmacy have to be proactive and seize this chance of changes in primary health policy and organization in order to become an important link in the chain of health care delivery, or there is a significant risk that it will predominantly remain a retail business.

scholarly journals Community-oriented Primary Care Services Model: Can it improve Morbidity Status in India? An Impact Evaluation Study

2017 ◽  
Vol 5 (1) ◽  
pp. 8-14
Author(s):  
Sanjeev Davey ◽  
Pradeep K Kapoor ◽  
Meenu Bala ◽  
Jai V Singh ◽  
Santosh K Raghav ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Evaluation Study ◽  
Medical College ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Care Approach

ABSTRACT Introduction The community-oriented primary care (COPC) services model is an approach prescribed by the Medical Council of India for existing medical colleges in India from their respective urban and rural health training centers (RHTCs). However, the evidence of whether it is better as compared with pure primary health care approach in the Indian context is lacking in the literature. Therefore, it becomes imperative to study this area for its further expansion. Materials and methods The study was done in the catchment area of RHTC and neighboring primary health center (PHC; Makhiyali) attached to the medical college in the district of Western Uttar Pradesh in India. Three surveyed villages out of six villages from July 1, 2016, to December 31, 2016, were taken in this study. Finally, the COPC vs primary health care approach comparison was done on four outcome parameters. Results The utilization of COPC services from RHTC area as compared with primary health care services from PHC area was significantly better for all diseases combined (p < 0.005) and also in the category of management of upper respiratory tract infections (p < 0.0001) and nutritional deficiencies (p < 0.05). On further applying COPC services model, it was also found that RHTC services were significantly better as compared with PHC services in terms of socioeconomic impact on health from services (p < 0.0000), identification of health needs from services (p < 0.0000), and participation in health care services (p < 0.05). Conclusion The COPC services model appears to be successful in the delivery of health care services from RHTC of a medical college as compared with pure primary health care approach delivered from a PHC. However, authors suggest more in-depth multicentric studies on this issue before generalization of COPD model usage across the world. How to cite this article Davey S, Kapoor PK, Bala M, Singh JV, Raghav SK, Singh N. Community-oriented Primary Care Services Model: Can it improve Morbidity Status in India? An Impact Evaluation Study. Int J Res Foundation Hosp Healthc Adm 2017;5(1):8-14.

scholarly journals Levels of engagement in primary health care professionals: a comparative study in two Brazilian municipalities

2019 ◽  
Vol 23 (3) ◽  
Author(s):  
Luciano Garcia Lourenção ◽  
Albertina Gomes da Silva ◽  
Márcio Andrade Borges
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Health ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Significant Difference

Abstract Objective: To evaluate the levels of engagement of Primary Health Care professionals in two municipalities. Methods: A descriptive study was carried out with 238 health professionals who work in the Primary Care services of two municipalities in the state of São Paulo. The engagement dimensions of the professionals were investigated through the Utrecht Work Engagement Scale. Results: Female predominance (82.8%), age under 40 years (52.9%). Median working time in primary care of three (municipality A), four years (municipality B). Significant difference in levels of engagement in both municipalities. Community health agents presented mean scores in all dimensions. Significant difference in levels of engagement according to professional category in all dimensions. Conclusion and implications for practice: Municipal health professionals with 100.0% coverage by the Family Health Strategy tend to have higher levels of engagement. Nurses presented greater engagement; community health workers reached lower levels than other professionals did. Engagement is an indicator that contributes to the evaluation of the workforce in the Primary Health Care services and can be used to direct strategies that improve the levels of dedication, absorption and vigor of the professionals, benefiting the organization of the primary care services.

scholarly journals Inclusion of mental health in primary health care: care strategy in the territory

2019 ◽  
Vol 72 (6) ◽  
pp. 1677-1682
Author(s):  
Ândrea Cardoso de Souza ◽  
Paulo Duarte Amarante ◽  
Ana Lúcia Abrahão
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Psychosocial Care ◽  
Main Tool ◽  
Structured Interviews ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services

ABSTRACT Objective: To analyze the strategies, challenges and possibilities of the articulation between mental health and primary health care from the perspective of health managers. Method: Exploratory, qualitative research carried out with 28 managers of mental health and primary care. The data were collected through semi-structured interviews between July and November 2013 and submitted to thematic content analysis. Results: The inclusion of mental health actions in primary care made it possible, in the view of managers, to increase users’ access to the care they need. This care strategy allows the extension of care practices in the territory, with matrix support as the main tool for the implementation of this care strategy. Final considerations: The articulation between primary care and mental health is a powerful device for psychosocial care, but it demands a new conformation of the Psychosocial Care Centers (Caps) and primary care services.

scholarly journals Phytotherapy in primary health care

2014 ◽  
Vol 48 (3) ◽  
pp. 541-553 ◽  
Author(s):  
Gisele Damian Antonio ◽  
Charles Dalcanale Tesser ◽  
Rodrigo Otavio Moretti-Pires
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Treatment Options ◽  
Journal Articles ◽  
Care Services ◽  
Plant Medicine ◽  
Unified Health System ◽  
Primary Health ◽  
Primary Care Services

OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population.

scholarly journals Cross-cultural adaptation of the primary health care satisfaction questionnaire

2014 ◽  
Vol 27 (5) ◽  
pp. 419-426 ◽  
Author(s):  
Elisabete Pimenta Araujo Paz ◽  
Pedro Miguel Santos Dinis Parreira ◽  
Alexandrina de Jesus Serra Lobo ◽  
Rosilene Rocha Palasson ◽  
Sheila Nascimento Pereira de Farias
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Cultural Adaptation ◽  
Care Service ◽  
Cross Cultural ◽  
Care Services ◽  
Primary Health

Objective To develop the cross-cultural validation and assessment of the psychometric properties of the Questionnaire about the quality and satisfaction dimensions of patients with primary health care. Methods Methodological cultural adaptation and assessment study of the psychometric properties, involving 398 users from a primary care service. The construct validity was verified through principal components factor analysis and internal consistency assessment as determined by Cronbach’s alpha, using SPSS. Results A factorial structure was identified that is equivalent to the original instrument, showing six factors that explain 70.81% of the total variance. All internal consistency coefficients were higher than 0.84, indicating appropriate psychometric properties. Conclusion The results show that the Brazilian Portuguese version of the instrument is culturally and linguistically appropriate to assess the satisfaction of users attended in primary care services.

Community Health and General Practice: The Impact of Different Cultures on the Integration of Primary Care

2001 ◽  
Vol 7 (1) ◽  
pp. 65 ◽  
Author(s):  
Hal Swerissen ◽  
Jenny Macmillan ◽  
Catuscia Biuso ◽  
Linda Tilgner
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Centres ◽  
Care Services ◽  
Primary Health ◽  
Health Centres ◽  
The Relationship

This study examined the existing relationship between community health centres and General Practice Divisions in the State of Victoria, including the nature of joint working arrangements and the identification of barriers to greater collaboration. Improved integration of primary health care services has been advocated to improve consumer and population health outcomes and to reduce inappropriate use of acute and extended care services. General practitioners (GPs) and community health centres are two key providers of primary health care with potential for greater integration. The current study conducted telephone interviews with 20 community health centre CEOs and 18 Executive Officers of divisions, which were matched according to catchment boundaries. Results suggest, while some joint planning is occurring, especially on committees, working parties and projects, there is an overall low level of satisfaction with the relationship between community health centres and GPs and GP divisions. Major barriers to greater integration are the financial or business interests of GPs and misunderstanding and differences in perceived roles and ideology between GPs and community health centres. Improved communication, greater contact and referral and follow-up procedures are identified as a means of improving the relationship between GPs, GP divisions and community health centres. Community health centres and general practitioners (GPs) are key providers of primary care (Australian Community Health Association, 1990).

scholarly journals Primary health care policy and vision for community pharmacy and pharmacists in Australia

2020 ◽  
Vol 18 (2) ◽  
pp. 1967 ◽  
Author(s):  
Sarah Dineen-Griffin ◽  
Shalom I. Benrimoj ◽  
Victoria Garcia-Cardenas
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Community Pharmacists ◽  
Residential Aged Care ◽  
Multidisciplinary Teams ◽  
Care Providers ◽  
Australian Government ◽  
Primary Health

There is evidence that the Australian Government is embracing a more integrated approach to health, with implementation of initiatives like primary health networks (PHNs) and the Government’s Health Care Homes program. However, integration of community pharmacy into primary health care faces challenges, including the lack of realistic integration in PHNs, and in service and remuneration models from government. Ideally, coordinated multidisciplinary teams working collaboratively in the community setting are needed, where expanding skills are embraced rather than resisted. It appears that community pharmacy is not sufficiently represented at a local level. Current service remuneration models encourage a volume approach. While more complex services and clinical roles, with associated remuneration structures (such as, accredited pharmacists, pharmacists embedded in general practice and residential aged care facilities) promote follow up, collaboration and integration into primary health care, they potentially marginalize community pharmacies. Community pharmacists’ roles have evolved and are being recognized as the medication management experts of the health care team at a less complex level with the delivery of MedChecks, clinical interventions and medication adherence services. More recently, vaccination services have greatly expanded through community pharmacy. Policy documents from professional bodies highlight the need to extend pharmacy services and enhance integration within primary care. The Pharmaceutical Society of Australia’s Pharmacists in 2023 report envisages pharmacists practising to full scope, driving greater efficiencies in the health system. The Pharmacy Guild of Australia’s future vision identifies community pharmacy as health hubs facilitating the provision of cost-effective and integrated health care services to patients. In 2019, the Australian Government announced the development of a Primary Health Care 10-Year Plan which will guide resource allocation for primary health care in Australia. At the same time, the Government has committed to conclude negotiations on the 7th Community Pharmacy Agreement (7CPA) with a focus on allowing pharmacists to practice to full scope and pledges to strengthen the role of primary care by better supporting pharmacists as primary health care providers. The 7CPA and the Government’s 10-year plan will largely shape the practice and viability of community pharmacy. It is essential that both provide a philosophical direction and prioritize integration, remuneration and resources which recognize the professional contribution and competencies of community pharmacy and community pharmacists, the financial implications of service roles and the retention of medicines-supply roles.

scholarly journals The Role of Primary Health Care Toward Healthy Aging

2021 ◽  
Vol 4 (1SP) ◽  
pp. 10
Author(s):  
Dhanasari Vidiawati ◽  
Yuda Turana ◽  
Tonny Sundjaya
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Healthy Aging ◽  
The Elderly ◽  
Preventive Health ◽  
Care Services ◽  
Primary Health

Background: According to the World Health Organization, healthy aging is the process of developing and maintaining functional abilities that make the elderly happy. The increase in the elderly population requires more attention. In particular, health services at the primary health care level face problems related to the limited capacity of overall health services, especially in terms of health promotion and preventive health issues. It is necessary to improve the quality of health care services for the elderly to prevent greater health problems among the elderly population.Objectives: Understand the need to provide holistic health services for healthy aging and use their capabilities, and strengthen cooperation among health professionals in achieving healthy aging.Discusion: Primary health care is pointed out that primary health care should provide comprehensive services in a holistic manner to support a healthy aging process. Therefore, a well-structured, integrated, and cross-industry collaborative primary care system is needed. The system should include changes in professional behavior, coordination of care, and participation of patients' families and communities in comprehensive health care. This can be achieved through inter-professional education, continuous training and education of primary health care professionals, as well as primary health care services and cross-level health care technology innovation.Conclusions: Healthy aging is not just the absence of disease. Everyone in health and social care at all levels can play a role to help improve healthy aging. To make the elderly healthy, starting from the prevention of young health problems, it requires collaboration between health workers, primary health care and other health service levels, and health care that cooperates with patients, families, and communities.Keywords: healthy aging, primary care, preventive, health worker

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