scholarly journals PrimaryCare@COVID-19: the implementation of digital monitoring services for patients with chronic diseases during the Covid-19 pandemic (Preprint)

2020 ◽  
Author(s):  
Luis Velez Lapão ◽  
Mariana Santos ◽  
Melanie Maia ◽  
Vasco Pedrosa ◽  
Jorge Seixas ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Primary Healthcare ◽  
Primary Care Physicians ◽  
Design Science ◽  
Digital Health ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Healthcare Provision ◽  
The Impact ◽  
Primary Healthcare Centers

BACKGROUND The COVID-19 pandemic is straining health systems and disrupting the delivery of healthcare services, in particular for the elderly and those with chronic conditions, who are particularly vulnerable to COVID-19 infection. OBJECTIVE The aim of this project is to support primary healthcare provision with a digital health platform that will allow primary care physicians and nurses to remotely manage the care of patients with chronic diseases or COVID-19 infections. METHODS The project followed the 6 steps of the Design Science implementation methodology framework: problem identification and motivation, definition of the objectives aligned with Goal-oriented care, artefact design and development, solution demonstration, evaluation, and communication. RESULTS The digital platform was developed for the specific objectives of the project and successfully piloted in three primary healthcare centers in the Lisbon Health Region. The health professionals were able to safely and thoroughly manage their first patients remotely with high degrees of satisfaction. The first COVID-19 messages were sent to the patients, addressing infodemic issues. CONCLUSIONS Although still in the first steps of implementation, we are seeing promising results with a positive uptake by healthcare providers and patients. Further research is planned to evaluate the impact on patient’s health related outcomes. We are confident that this platform could be scaled-up to all primary healthcare centers in Portugal in the next months, ready to tackle a second wave of COVID-19.

My health, myself: a qualitative study on motivations for effective chronic disease self-management among community dwelling adults

2020 ◽  
Vol 37 (6) ◽  
pp. 839-844
Author(s):  
Muhammad Danial Hadi ◽  
Yongxing Patrick Lin ◽  
Ee-Yuee Chan
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Good Health ◽  
Community Dwelling ◽  
Self Control ◽  
Self Management ◽  
Management Support ◽  
Healthcare Provision

Abstract Background Chronic diseases continue to be a significant cause of morbidity and mortality despite modifiable risk factors. This suggests that current primary healthcare provision needs to delve beyond patient education, to understand the motivators that drive patients to undertake chronic disease self-management. Understanding these motivations within the context of a multi-cultural community can facilitate tailored support for chronic disease self-management. Objectives To explore the motivations behind effective chronic disease self-management in community dwelling adults in Singapore. Methods A qualitative descriptive study was carried out in five clinics in a large medical centre. Twelve participants who were assessed to be optimally managing their chronic diseases were recruited using purposive sampling. Individual in-depth interviews were conducted until data saturation, with data thematically analysed. Results Three salient themes emerged from the data. Firstly, ‘Regaining self-control, avoiding complications’ describes the participants’ journey towards personal mastery in self-management, as well as a fear of debilitating complications resulting in their desire for good health. Secondly, ‘Preserving social identities and roles’ illustrates how participants yearn to maintain their pre-existing roles and functions through maintenance of their health. Finally, ‘Accessing proximal support systems’ highlights resources and supports surrounding the participants that encourage continued chronic disease self-management. Within each theme, specific motivators and challenges encountered by participants in their self-management journey were discussed. Conclusions Findings can prompt primary healthcare providers to leverage on the patients’ life goals and social roles in chronic disease self-management support. This may empower patients to engage in self-management and strengthen primary care provision.

scholarly journals Review: Primary healthcare in six sub-Saharan African countries: an impact assessment using a systematic review

2021 ◽  
Vol 14 (1) ◽  
pp. 22-29
Author(s):  
Oladayo Nathaniel Awojobi ◽  
Jane Temidayo Abe ◽  
Oluwatoyin Adenike Adeniji
Keyword(s):  
Primary Healthcare ◽  
Healthcare Services ◽  
Developed Countries ◽  
African Countries ◽  
Working Paper ◽  
Quantitative Studies ◽  
Healthcare Accessibility ◽  
Sub Saharan ◽  
The Impact ◽  
Primary Healthcare Centers

Primary healthcare is provided in most developing and developed countries to enhance healthcare accessibility for the population. This study accesses the impact of primary healthcare in six Sub-Saharan countries. A systematic search for qualitative and quantitative studies published before the end of 2017 was conducted online. Inclusion criteria were met by 6 studies, one each from Ghana, Malawi, Nigeria,  Tanzania, Zambia and Zimbabwe. Five studies are peer-reviewed, and one is a working paper. Three studies reported on the impact of primary healthcare on healthcare accessibility. Four studies reported on the role healthcare resources play in enhancing primary  healthcare services. Two other studies mentioned how cost-sharing mechanism led to an increase in healthcare utilization and how the reduction in user changes in all primary healthcare centers led to the reduction in out-of-pocket spending on healthcare services in a short-term. Primary healthcare offers access and utilization to healthcare services in most countries. It also offers protection against the detrimental effects of user fees. However, concerted efforts are still needed in most African countries in revitalizing the operations of primary healthcare centers for the improvement of healthcare services.

scholarly journals What was the impact of a participatory research project in Australian Indigenous primary healthcare services? Applying a comprehensive framework for assessing translational health research to Lessons for the Best

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040749
Author(s):  
Shanthi Ann Ramanathan ◽  
Sarah Larkins ◽  
Karen Carlisle ◽  
Nalita Turner ◽  
Ross Stewart Bailie ◽  
...  
Keyword(s):  
Learning Community ◽  
Primary Healthcare ◽  
Health Research ◽  
Return On Investment ◽  
Health Centre ◽  
Healthcare Services ◽  
Secondary Outcome ◽  
Cost Consequence ◽  
Comprehensive Framework ◽  
The Impact

ObjectivesTo (1) apply the Framework to Assess the Impact from Translational health research (FAIT) to Lessons from the Best to Better the Rest (LFTB), (2) report on impacts from LFTB and (3) assess the feasibility and outcomes from a retrospective application of FAIT.SettingThree Indigenous primary healthcare (PHC) centres in the Northern Territory, Australia; project coordinating centre distributed between Townsville, Darwin and Cairns and the broader LFTB learning community across Australia.ParticipantsLFTB research team and one representative from each PHC centre.Primary and secondary outcome measuresImpact reported as (1) quantitative metrics within domains of benefit using a modified Payback Framework, (2) a cost-consequence analysis given a return on investment was not appropriate and (3) a narrative incorporating qualitative evidence of impact. Data were gathered through in-depth stakeholder interviews and a review of project documentation, outputs and relevant websites.ResultsLFTB contributed to knowledge advancement in Indigenous PHC service delivery; enhanced existing capacity of health centre staff, researchers and health service users; enhanced supportive networks for quality improvement; and used a strengths-based approach highly valued by health centres. LFTB also leveraged between $A1.4 and $A1.6 million for the subsequent Leveraging Effective Ambulatory Practice (LEAP) Project to apply LFTB learnings to resource development and creation of a learning community to empower striving PHC centres.ConclusionRetrospective application of FAIT to LFTB, although not ideal, was feasible. Prospective application would have allowed Indigenous community perspectives to be included. Greater appreciation of the full benefit of LFTB including a measure of return on investment will be possible when LEAP is complete. Future assessments of impact need to account for the limitations of fully capturing impact when intermediate/final impacts have not yet been realised and captured.

scholarly journals How fast should social restrictions be eased  in England as COVID-19 vaccinations are rolled out?

2021 ◽  
Author(s):  
David Miles ◽  
Adrian Heald ◽  
Mike Stedman
Keyword(s):  
Healthcare Services ◽  
Key Factors ◽  
Healthcare Provision ◽  
Factors Affecting ◽  
Education Outcomes ◽  
Trade Offs ◽  
Standards Of Living ◽  
Life Years ◽  
The Uk ◽  
The Impact

Vaccination against the COVID-19 virus began in December 2020 in the UK and is now running at 5% population/week. High Levels of social restrictions were implemented for the third time in January 2021 to control the second wave and resulting increases in hospitalisations and deaths. Easing those restrictions must balance multiple challenging priorities, weighing the risk of more deaths and hospitalisations against damage done to mental health, incomes and standards of living, education outcomes and provision of non-Covid-19 healthcare. Weekly and monthly officially published values in 2020/21 were used to estimate the impact of seasonality and social restrictions on the spread of COVID-19 by age group, on the economy and healthcare services. These factors were combined with the estimated impact of vaccinations and immunity from past infections into a model that retrospectively reflected the actual numbers of reported deaths closely both in 2020 and early 2021. It was applied prospectively to the next 6 months to evaluate the impact of different speeds of easing social restrictions. The results show vaccinations are significantly reducing the number of hospitalisations and deaths. The central estimate is that relative to a rapid easing, the avoided loss of 57,000 life years from a strategy of relatively slow easing over the next 4 months comes at a cost in terms of GDP reduction of around £0.4 million/life-year loss avoided. This is over 10 times higher than the usual limit the NHS uses for spending against Quality Adjusted Life Years (QALYs) saved. Alternative assumptions for key factors affecting give significantly different trade-offs between costs and benefits of different speeds of easing. Disruption of non-Covid-19 Healthcare provision also increases in times of higher levels of social restrictions. In most cases, the results favour a somewhat faster easing of restrictions in England than current policy implies.

scholarly journals A comparison of the levels of satisfaction with the medical services provided by primary healthcare centers in selected communes in Lubelskie Voivodeship

2016 ◽  
Vol 126 (1) ◽  
pp. 8-12
Author(s):  
Daria Przybylska ◽  
Piotr Przybylski ◽  
Bartłomiej Drop ◽  
Krzysztof Czarnocki ◽  
Wojciech Przybylski ◽  
...  
Keyword(s):  
Family Medicine ◽  
Primary Healthcare ◽  
The Elderly ◽  
Healthcare Services ◽  
Medical Services ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
Primary Type ◽  
Primary Healthcare Centers

Abstract Introduction. Family medicine remains the primary type of medical services in Poland and it is supposed to treat both individual patients and the society as a whole. Due to the growing commercialization of the health service, most primary healthcare centers have transformed into non-public healthcare facilities. The public ones (called SPZOZ in Polish) account only for a small fraction of the whole number of primary healthcare facilities. The quality of medical services provided by such facilities, as patients see it, remains one of the key elements determining the development of family medicine centers. Aim. The aim of this paper was to assess patient satisfaction levels regarding the healthcare services they received in two primary healthcare institutions, both of the NZOZ and SPZOZ type, in a small town located close to Lublin. Material and methods. An anonymous survey was filled out by 30 patients of both a public and non-public healthcare center located in Niemce (Niemce Commune, Lublin District). The quality of services was assessed using an original questionnaire in the form of a poll. Results. The results obtained indicate a clear relationship between one’s trust to the physician, diagnosis accuracy and visiting the particular center again, in order to continue the treatment. For older subjects, it was nurses’ kindness and politeness that was the most important. The elderly appreciated the kindness and politeness of the nurses in particular. No significant differences were found between the institutions in respect of the overall perception of satisfaction with services. In terms of infrastructure assessment, the majority of positive feedback was provided for NZOZ. Conclusions. The findings above suggest that it is essential to conduct surveys on a regular basis, in order to check patients’ assessment of the service quality in various institutons.

scholarly journals The impact of the COVID-19 lockdown on orthopaedic emergency presentations in a remote and rural population

2020 ◽  
Vol 1 (10) ◽  
pp. 621-627
Author(s):  
Ahmed S. Elhalawany ◽  
James Beastall ◽  
Gerard Cousins
Keyword(s):  
Healthcare Providers ◽  
Local Area ◽  
Time Frame ◽  
Healthcare Provision ◽  
Proportional Increase ◽  
Minor Injuries ◽  
The Uk ◽  
A Minor ◽  
The Impact ◽  
Second Wave

Aims COVID-19 remains the major focus of healthcare provision. Managing orthopaedic emergencies effectively, while at the same time protecting patients and staff, remains a challenge. We explore how the UK lockdown affected the rate, distribution, and type of orthopaedic emergency department (ED) presentations, using the same period in 2019 as reference. This article discusses considerations for the ED and trauma wards to help to maintain the safety of patients and healthcare providers with an emphasis on more remote geography. Methods The study was conducted from 23 March 2020 to 5 May 2020 during the full lockdown period (2020 group) and compared to the same time frame in 2019 (2019 group). Included are all patients who attended the ED at Raigmore Hospital during this period from both the local area and tertiary referral from throughout the UK Highlands. Data was collected and analyzed through the ED Information System (EDIS) as well as ward and theatre records. Results A total of 1,978 patients presented to the ED during the lockdown period, compared to 4,777 patients in the same timeframe in 2019; a reduction of 58.6%. Orthopaedic presentations in 2020 and 2019 were 736 (37.2%) and 1,729 (36.2%) respectively, representing a 57.4% reduction. During the lockdown, 43.6% of operations were major procedures (n = 48) and 56.4% were minor procedures (n = 62), representing a significant proportional shift. Conclusion During the COVID- 19 lockdown period there was a significant reduction in ED attendances and orthopaedic presentations compared to 2019. We also observed that there was a proportional increase in fractures in elderly patients and in minor injuries requiring surgery. These represented the majority of the orthopaedic workload during the lockdown period of 2020. Given this shift towards smaller surgical procedures, we suggest that access to a minor operating theatre in or close to ED would be desirable in the event of a second wave or future crisis.

scholarly journals The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane

2016 ◽  
Vol 21 ◽  
pp. 67-76
Author(s):  
M. L.S. Mataboge ◽  
S. Beukes ◽  
A. G.W. Nolte
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Primary Healthcare ◽  
Informal Settlement ◽  
Healthcare Providers ◽  
Hiv And Aids ◽  
Reproductive Health Services ◽  
Healthcare Provision ◽  
Reproductive Healthcare ◽  
Prevention Of Hiv

Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV) and to acquired immunodeficiency syndrome (AIDS) than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.

scholarly journals Implementation of Primary Healthcare Services in Community Health Stations in Highly Urbanized City

2021 ◽  
Vol 4 (3) ◽  
pp. 123-132
Author(s):  
Hanna B. Gella ◽  
Merlita V. Caelian
Keyword(s):  
Community Health ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Well Being ◽  
Healthcare Services ◽  
Health Improvement ◽  
Patient Centeredness ◽  
Sustainable Development Goal ◽  
The Sustainable Development ◽  
Child Healthcare

Primary healthcare is integral to the Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being.  A descriptive study assessed the implementation of primary healthcare services in community health stations through a researcher-made questionnaire among healthcare providers and beneficiaries of 30 community health stations.  The results revealed that, as a whole, the implementation of primary healthcare services in community health stations is great, with maternal and child healthcare implemented to a very great extent while the treatment of non-communicable diseases to a great extent only.  The major challenges encountered are the lack of medical drugs, supplies and equipment, and medical professionals.  Primary healthcare has made contributions to the community's health improvement; however, challenges imply that the quality and efficiency of the services need improvement. The study contributed to new knowledge on implementing healthcare at the lowest level of government, emphasizing patient-centeredness.

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