scholarly journals Six Basic Clinical Principles of Primary Care Practice

2019 ◽  
Author(s):  
John Yang Lee ◽  
Yingying Liu
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Key Words ◽  
Primary Care Practice ◽  
Care Practice ◽  
Patient Centered ◽  
Primary Health ◽  
Clinical Thinking

Abstract BACKGROUND: The features of primary care are well described on the dimension of public health. Primary care clinicians consist of a large portion of health-care workforce. To guide clinical thinking in primary care practice, its basic clinical principles should be synthesized. METHODS: We searched literature in PubMed, MEDLINE, China National Knowledge Infrastructure, and Wanfang Med Online, using the key words of “primary care practice”, “primary care”, “primary health care”, “general practice” in combination with “principle”, “ideal”, “description”, “characteristic” and “feature” to synthesize basic clinical principles of primary care practice. RESULTS: Six basic clinical principles of primary care practice are synthesized. 1. Holistic: includes holism, whole person care, bio-psycho-social model, lateral clinical thinking, and overcoming fragmented specialization. 2. Integrative: consists of combination of orthodox and complementary medicine, coordinated care, and practicing holistic integrated medicine(HIM). 3. Continuous: deals with continuous clinician-patient relationship, seamless services, life-cycle medical services, and full medical care at any time and place. 4. Preventive: contains undifferentiated disease care, health habit counseling, screening for asymptomatic diseases, and immunization. 5. Patient-centered: comprises responsive to individual patient needs and values, people-oriented care, and practicing Patient Centered Medical Home (PCMH). 6. Standardized: involves use of evidence-based medicine (EBM), following the clinical guideline, and applying clinical pathway. CONCLUSION: The six basic clinical principles of primary care practice are holistic, integrative, continuous, preventive, patient-centered and standardized care. They might be the backbone of primary care practice and be recommended to be used to construct the disciplinary knowledge of clinical primary care practice. KEY WORDS: Primary care practice, primary care, primary health care, general practice.

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 Editorial: Recording Excellence in Primary Care Practice

2003 ◽  
Vol 9 (1) ◽  
pp. 7
Author(s):  
Rae Walker ◽  
Hal Swerissen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Development Strategy ◽  
Health Care Research ◽  
System Level ◽  
Care Practice ◽  
Community Activities ◽  
Primary Health ◽  
And Control

In this issue of the Australian Journal of Primary Health we publish papers that reflect the diverse approaches to knowledge characteristic of primary health care. There are articles on policy and management at the system level (for example, Primary health care research and evaluation development strategy in the Northern Territory), critical reviews of programs and community activities (for example, Motor racing in Australia: Health damaging or health promoting), and the community experiences of health and health services (for example, Communication and control in the co-construction of depression ...). The range of research valued in primary care is reflected in these articles.

scholarly journals Determinants of Overall Satisfaction with Public Clinics in Rural China: Interpersonal Care Quality and Treatment Outcome

2019 ◽  
Vol 16 (5) ◽  
pp. 697 ◽  
Author(s):  
Wenhua Wang ◽  
Elizabeth Maitland ◽  
Stephen Nicholas ◽  
Jeannie Haggerty
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Treatment Outcome ◽  
Primary Health Care ◽  
Care Quality ◽  
Patient Centered ◽  
Primary Health ◽  
Quality Aspects ◽  
Interpersonal Care ◽  
Public Clinics

The primary health care quality factors determining patient satisfaction will shape patient-centered health reform in China. While rural public clinics performed better than hospitals and private clinics in terms of patient perceived quality of primary care in China, there is little information about which quality care aspects drove patients’ satisfaction. Using a World Health Organization database on 1014 rural public clinic users from eight provinces in China, our multiple linear regression model estimated the association between patient perceived quality aspects, one treatment outcome, and overall primary health care satisfaction. Our results show that treatment outcome was the strongest predictor of overall satisfaction (β = 0.338 (95% CI: 0.284 to 0.392); p < 0.001), followed by two interpersonal care quality aspects, Dignity (being treated respectfully) (β = 0.219 (95% CI: 0.117 to 0.320); p < 0.001) and Communication (clear explanation by the physician) (β = 0.103 (95% CI: 0.003 to 0.203); p = 0.043). Prompt attention (waiting time before seeing the doctor) and Confidentiality (talking privately to the provider) were not correlated with overall satisfaction. The treatment outcome focus, and weak interpersonal primary care aspects, in overall patient satisfaction, pose barriers towards a patient-centered transformation of China’s primary care rural clinics, but support the focus of improving the clinical competency of rural primary care workers.

scholarly journals The organisation and delivery of health improvement in general practice and primary care: a scoping study

2015 ◽  
Vol 3 (29) ◽  
pp. 1-180 ◽  
Author(s):  
Stephen Peckham ◽  
Jane Falconer ◽  
Steve Gillam ◽  
Alison Hann ◽  
Sally Kendall ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Health Care Team ◽  
Care Team ◽  
Health Improvement ◽  
Primary Health Care Team ◽  
Primary Health ◽  
Improvement Interventions

BackgroundThis project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities.AimsThe aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice.MethodsWe undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff.FindingsMany of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely.Future ResearchFuture research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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