A novel approach for heart rhythm disorder screening on primary healthcare level using a Personal Digital Mobile Sensor in Slovenia: a pilot study (Preprint)

2020 ◽  
Author(s):  
Stasa Vodicka ◽  
Antonija Poplas Susic ◽  
Erika Zelko
Keyword(s):  
Health Care ◽  
Primary Healthcare ◽  
Heart Rhythm ◽  
Care Level ◽  
Primary Level ◽  
Primary Health ◽  
Healthcare Center ◽  
Heart Rhythm Disorders ◽  
Significant Difference ◽  
History Of

BACKGROUND Heart rhythm disorders affect millions of people annually. The diagnosis usually depends on the electrocardiogram (ECG) record, but a single record does not necessarily reflect the real situation. Continuous methods are rarely accessible at the primary healthcare level. Considering the severity and costs of the diagnostic approach, a cheaper, but reliable, continuous monitoring system for heart rhythm disorders is needed. OBJECTIVE The goal was to analyse the usefulness of telecardiology in the primary health care level. With the help of a patient's history of rhythm disturbance and an ECG scan using an ECG personal sensor (ECG PS), we wanted to evaluate the satisfaction of patients and their physicians with the use of an ECG sensor treatment at the primary level. We also wanted to evaluate the cost-effectiveness of this tool at the primary level and develop a clinical pathway for treating patients with rhythm disorders at the primary health care level. METHODS The Jožef Stefan Institute developed a personal portable ECG sensor that works with a smartphone, which was used in our pilot study. We included patients with a history of suspected rhythm disturbance who visited their family physician at the Healthcare Center Ljubljana and Healthcare Center Murska Sobota from October 2016 to January 2018. RESULTS After the ECG sensor measurement and first checkup at a family physician, the study found that there was no statistical significant difference in the number of present rhythm disorders and actions taken to treat patients with either observation or administration of a new drug. However, there was a statistically significant difference in the number of patients being referred to a cardiologist (p < 0.001). CONCLUSIONS The use of an ECG sensor allows family physicians to confirm an accurate diagnosis and helps them distinguish between patients who need to be referred to a cardiologist as soon as possible and those who can be treated by primary healthcare providers. This method is also readily applicable and useful for both physicians and patients because it shortens the time in starting the treatment and reduces unnecessary cost.

scholarly journals Implementation of a Savvy Mobile ECG Sensor for Heart Rhythm Disorder Screening at the Primary Healthcare Level: An Observational Prospective Study

Micromachines ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 55
Author(s):  
Staša Vodička ◽  
Antonija Poplas Susič ◽  
Erika Zelko
Keyword(s):  
Primary Healthcare ◽  
Test Group ◽  
Heart Rhythm ◽  
Control Group ◽  
Healthcare Center ◽  
Jozef Stefan Institute ◽  
Significant Difference ◽  
Stefan Institute ◽  
History Of ◽  
And Control

Introduction: The Jozef Stefan Institute developed a personal portable electrocardiogram (ECG) sensor Savvy that works with a smartphone, and this was used in our study. This study aimed to analyze the usefulness of telecardiology at the primary healthcare level using an ECG personal sensor. Methods: We included 400 patients with a history of suspected rhythm disturbance who visited their family physician at the Healthcare Center Ljubljana and Healthcare Center Murska Sobota from October 2016 to January 2018. Results: The study found that there was no statistically significant difference between the test and control groups in the number of present rhythm disorders and actions taken to treat patients with either observation or administration of a new drug. However, in the test group, there were significantly fewer patients being referred to a cardiologist than in the control group (p < 0.001). Discussion: The use of an ECG sensor helps family physicians to distinguish between patients who need to be referred to a cardiologist and those who can be treated by them. This method is useful for both physicians and patients because it shortens the time taken to start treatment, can be used during pandemics such as COVID-19, and reduces unnecessary cost.

scholarly journals Prospects and Challenges of Telemedicine at the Primary Health Care Level: A Basis for Certification of Providers in Ghana

2021 ◽  
pp. 46-65
Author(s):  
James Antwi ◽  
Daniel Opoku-Mensah
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Healthcare Professionals ◽  
Easy Access ◽  
Mobile Telephony ◽  
Care Providers ◽  
Care Level ◽  
Primary Health ◽  
Primary Health Care Level

Background: Telemedicine has proven to be one of the modern medical discoveries in recent times, serving as a technological tool to deliver healthcare at a distance and providing medical solutions to remote communities with limited access to quality healthcare. However, the challenges associated with the use of telemedicine in Ghana make it difficult to scale up its application at the Primary Healthcare (PHC) level. Aim: The aim of the study was to assess the current trends and applications of telemedicine in health care delivery at the primary health care level in Ghana. The study also sought to identify the prospects and challenges of telemedicine implementation in Ghana.  Study Design: The study employed both qualitative and quantitative design involving 200 respondents made up of 80 healthcare professionals and 120 patients from four primary healthcare facilities in the Ahafo-Ano North District of the Ashanti region of Ghana Methods: Survey questionnaire, semi-structured interview guide, and field observations were used to find out the knowledge of providers, capacity, availability of network infrastructure, and challenges of implementing telemedicine at the PHC level from the viewpoint of healthcare 'professionals' and to verify factors that can persuade patients to participate in the implementation of telemedicine. Logistic regression analysis was conducted to estimate the factors influencing 'patients' decision to participate in telemedicine, while the qualitative data were analyzed using thematic content analysis. Results: The results show that knowledge and education about telemedicine, easy access to specialist care at home, widespread use of mobile telephony, and reduction in travel cost due to telemedicine significantly influence both providers' and patients' participation in telemedicine at the primary healthcare level. The minimum educational level for patients to participate in telemedicine implementation is a primary education (OR = 0.233, p<0.025). On the other hand, inadequate infrastructure, legal issues such as non-certification of providers, reimbursement and confidentiality challenges are some of the factors that impede telemedicine implementation. Conclusion: The authors suggest that developing countries need to take advantage of the massive use of mobile telephony and embrace telemedicine application to increase access to healthcare in rural areas. Again, certification of care providers is critical for effective application and integration of telemedicine and this should be adaptive to local needs, high internet connectivity and the demands of both healthcare professionals and patients especially in rural communities.

scholarly journals Peran kepala puskesmas SKM dan non SKM dalam meningkatkan kemampuan manajerial puskesmas di kabupaten Oku Timur

2018 ◽  
Vol 32 (9) ◽  
pp. 339
Author(s):  
Aulawi Aulawi ◽  
Riris Andono Ahmad ◽  
Mubasysyir Hasanbasri
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Case Series ◽  
Leadership Role ◽  
Primary Health ◽  
Significant Difference ◽  
Managerial Capabilities

Role of the head of public health centers from public health graduates and others on improving managerial skills in East OkuPurposeThis study aimed to understand how public health and non-public health backgrounds affect management skill of primary health care heads, based on ten managerial roles. MethodsThis study was a descriptive study with case-series method, using qualitative methods supported by quantitative data. Eight people were recruited as respondents. They consisted of 4 people that were primary healthcare heads with public health background and 4 people that were primary healthcare heads with non-public health background. Respondents were recruited by purposive sampling. Data collection was performed using in-depth interviews and questionnaire. ResultsPrimary healthcare head with public health background owned more work experience than those with non-public health background. Period of employment in primary health care had an influence on managerial capabilities. There were no significant differences of period of employment in primary health care head positions among the longest with the least to the managerial capabilities. Primary health care heads who had been trained with PIM IV training and other structural positions were known to have better management capabilities, especially compared to the leadership role of those who had not been trained.ConclusionThere was no significant difference in managerial capacity between primary health care heads with public health and those with non-public health background.

scholarly journals Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pinto ◽  
J V Santos ◽  
M Lobo ◽  
J Viana ◽  
J Souza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Pay For Performance ◽  
Care Quality ◽  
Organizational Model ◽  
Avoidable Hospitalizations ◽  
Primary Health ◽  
Age And Sex

Abstract Background In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality. Methods We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model. Results Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865). Conclusions Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed. This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”. Key messages Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.

Supportive supervision: An effective intervention in achieving high quality malaria case management at primary health care level in Jos, Nigeria

2013 ◽  
Vol 12 (4) ◽  
pp. 243 ◽  
Author(s):  
DanjumaAyotunde Bello ◽  
ZuwairaIbrahim Hassan ◽  
TolulopeOlumide Afolaranmi ◽  
YetundeOlubusayo Tagurum ◽  
OluwabunmiOluwayemisi Chirdan ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Case Management ◽  
Malaria Case ◽  
Effective Intervention ◽  
Supportive Supervision ◽  
Malaria Case Management ◽  
High Quality ◽  
Care Level ◽  
Primary Health

The Preparedness of Primary Health Care Network in terms of Emergency Risk Communication: A Study in Iran

2021 ◽  
pp. 1-10
Author(s):  
Zeinab Bagheri ◽  
Tahereh Dehdari ◽  
Masoud Lotfizadeh
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Risk Communication ◽  
Health Care Facilities ◽  
Effective Response ◽  
Care Network ◽  
Primary Health ◽  
Significant Difference ◽  
Health Care Network ◽  
Control And Prevention

Abstract Objective: Emergency Risk Communication (ERC) is known as 1 of the important components of an effective response to public health emergencies. In this study, we aimed to investigate the preparedness of the Primary Health Care Network (PHCN) of Iran in terms of the ERC. Methods: This study was conducted in 136 Primary Health Care Facilities (PHCFs) affilated to Shahrekord University of Medical Sciences, Chaharmahal and Bakhtiari Province, Iran. Data in terms of ERC were collected using a checklist developed by the Center of Disease Control and Prevention (CDC). Results: The findings of the study revealed that 65.9% of the PHCFs had low preparedness in terms of the ERC, 33.3% had a moderate level and 0.8% had high preparedness in this regard. There was a significant difference between the level of ERC and the history of crisis in the past year, PHCF type, and the education level of the responsible employees in the crisis unit in the PHCF. Conclusions: The results showed that the PHCFs studied need to increase their capacity and capability in the field of ERC. Further efforts to provide ERC components may increase the preparedness of PHCN in Iran in terms of the ERC.

scholarly journals Prevalence of postnatal depression and associated risk factors among South Asian mothers living in a newly developing country

2016 ◽  
Vol 9 (6) ◽  
pp. 57
Author(s):  
Hashim Mohamed
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
South Asian ◽  
Postnatal Depression ◽  
Marital Problems ◽  
Primary Health ◽  
History Of ◽  
Associated Risk Factors ◽  
Asian Mothers

AbstractIntroductionPostnatal Depression (PND) is a major health problem affecting mother, her child and family.  Its prevalence and associated risk factors among South Asian mothers (SAM) living  in Qatar remain unknown. The objectives of this study were to estimate the prevalence of PND among (SEAM) in Qatar and to correlate risk factors contributing to the development of PND.Materials and methodsA total of (285 ) (SAM)females who were six months  postpartum were interviewed as  part of a prospective study conducted in primary health care centers in Qatar.  PND symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 10 or higher. Descriptive statistics were used for summarizing the study and outcome variables. The χ2 test and ORs with 95% confidence intervals (CIs) were used for observation and quantifying the association between different variables. Multivariate binary logistic regression was used to identify the independent associated factors of PPD. P≤0.05 was considered significant. Variables included were age , occupation, education level ,previous psychiatric history ,comorbidities , ,history of depression during current  pregnancy, history of anxiety during current pregnancy, number of previous pregnancies, strong social support, husband support, marital problem before pregnancy and ongoing marital problems during current pregnancy.Results The prevalence of postnatal depression among 285 respondents was 33.2% .several psychosocial risk factors were significantly associated with postnatal depression and, after multiple regression analysis, a history of depressive illness ,anxiety ,marital problems before delivery ,a history of diabetes and asthma ,history of congenital malformations ,and lack of mother support.Other variables, including age, parity, education, occupation, and delivery type, were not significantly correlated (P=0.15–0.95), but marginally indicative of the risk of depressive symptoms.ConclusionThis study showed a high rate of depressive symptoms among(SAM) six months Postpartum . Future screening protocols  must be employed at primary care level and hospital based clinics in Qatar to detect and treat post natal depression.Keywords: postnatal  depression,  South Asians, primary health care ,Doha, EPDS  

scholarly journals Access to medicines by patients of the primary health care in the Brazilian Unified Health System

2017 ◽  
Vol 51 ◽  
pp. 20s ◽  
Author(s):  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Vânia Eloisa de Araújo ◽  
Alessandra Maciel Almeida ◽  
Carolina Zampirolli Dias ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Developed Countries ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Unified Health System ◽  
Primary Health ◽  
Significant Difference ◽  
Good For

OBJECTIVE: To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients’ perspective. METHODS: This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Services, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. RESULTS: For the “availability” dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For “accessibility,” 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For “accommodation,” UBS was evaluated as very good/good for the items “comfort” (74.2%) and “cleanliness” (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For “acceptability,” 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units’ service was very good/good. For “affordability,” 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. CONCLUSIONS: Results show 70%–90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally, and decisively to the population

scholarly journals Physiotherapy services required at primary health care level in gauteng and limpopo provinces (service provider’s perspective -physiotherapists/assistants)

2008 ◽  
Vol 64 (1) ◽  
Author(s):  
Douglas Maleka ◽  
D. Franzsen ◽  
A. Stewart
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Descriptive Study ◽  
The Other ◽  
Gauteng Province ◽  
Care Level ◽  
Primary Health ◽  
Rehabilitative Services ◽  
Self Administered Questionnaire ◽  
Preventative Services

This study was conducted to determine the opinion of physiotherapists and physiotherapy assistants with regards to physiotherapyservices required at a Primary Health Care (PHC) level in two provinces ofSouth Africa, one being urban (Gauteng) and the other one more rural(Limpopo). Using a descriptive study design, a sample consisting of 728 physio-therapists and assistants was selected from the HPCSA register list. Datacollection was by a self-administered questionnaire. Sixty six percent of physiotherapists in Gauteng Province and 68% inLimpopo Province agreed that promotive services are required whereas thepercentage for physiotherapy assistants in Gauteng province and Limpopoprovince were 78% and 89% respectively. Preventative services were suggested by 82% and 85% by physiotherapistsand 95% and 96% by physiotherapy assistants in Gauteng and Limpopo. Eighty nine percent and 88% of physio-therapists, 80% and 85% of physiotherapy assistants in Gauteng and Limpopo respectively agreed that curative services are required.  Rehabilitative services were suggested to be required by 83% and 90% of physiotherapists, 85% and 95% by physiotherapy assistants in Gauteng and Limpopo respectively.

scholarly journals Effect of implementation intention on walking in people with diabetes

2020 ◽  
Vol 54 ◽  
pp. 103
Author(s):  
Marco Antonio Vieira da Silva ◽  
Thaís Moreira São-João ◽  
Marilia Estevam Cornelio ◽  
Fábio Luiz Mialhe
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Leisure Time Physical Activity ◽  
Intervention Strategy ◽  
Intervention Group ◽  
Implementation Intention ◽  
Control Group ◽  
Primary Health ◽  
Significant Difference

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

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