1205-P: Diabetes Medical Care Quality Index (ICAD): A Nationwide Experience of Continuous Improvement in Primary Health Care Clinics

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1205-P
Author(s):  
HECTOR GALLARDO ◽  
LORENA SUAREZ-IDUETA ◽  
JULIETA LOMELIN-GASCON ◽  
ALEJANDRA MONTOYA ◽  
RICARDO MUJICA-ROSALES ◽  
...  
2013 ◽  
Vol 10 (01) ◽  
pp. 33-37 ◽  
Author(s):  
M. Klinkman ◽  
D. Goldberg

SummaryThis paper describes the necessity of adapting the major classifications of mental disorders exemplified by the ICD-11 and the DSM-5 for the special needs of primary medical care. An earlier version of the classification – the ICD-10-PHC – is described, and the process of adapting it is described in detail. The new 28 item version of the classification is described, and the procedures to be adopted in the Field Trials to be held during 2013 are set out, together with the specific problems these field trials will address.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pinto ◽  
J V Santos ◽  
M Lobo ◽  
J Viana ◽  
J Souza ◽  
...  

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.


2007 ◽  
Vol 12 (1) ◽  
Author(s):  
Norah L Katende-Kyenda ◽  
Martie S Lubbe ◽  
Jan HP Serfontein ◽  
Ilse Truter

The aim of this study was to investigate the prescribing of antimicrobials in private primary health care in South Africa. ABSTRAK Die doel met hierdie studie was om die voorskryfpatrone van antimikrobiese middels in private primêre gesondheidsorginrigtings in Suid-Afrika te ondersoek.


2021 ◽  
Vol 65 (5) ◽  
pp. 411-417
Author(s):  
Sergei S. Budarin ◽  
Andrei V. Starshinin ◽  
Andrei A. Tyazhelnikov ◽  
Elena V. Kostenko ◽  
Yulia V. Elbek

Introduction. The study of public opinion as the basis for strategic planning of the activities of medical institutions is more relevant than ever, as it allows finding ways to solve the problems of ensuring the availability and satisfaction of citizens with medical care. Purpose. Comparative assessment of the availability of primary health care based on the results of a sociological study of public opinion and data from the Unified Medical Information and Analytical System of the City of Moscow (UMIAS). Material and methods. To study public opinion, the practice of population survey was used, which was conducted through direct interviewing with filling out questionnaires of visitors to Moscow polyclinics and the method of questioning doctors based on a questionnaire developed by researchers. To analyze the data, the authors used general scientific methods of cognition, including the dialectical method, a systematic approach, logical correspondence and harmonization, detailing and generalization. As part of the study, the index value of the patient loyalty to the medical institution (MI) was calculated according to Net Promoter Score (NPS) method as the difference between the share of the “Promoters” group and the share of the “Critics” group in the total number of responses. Results and discussion. The established correlations indicate the opinions of doctors and citizens to coincide and the UMIAS data on the issue of assessing the accessibility of admission of level 1 doctors for citizens. Based on the results of a sociological survey, the number of dissatisfied patients is mainly affected by managing medical care and its availability. The study confirmed that the higher the availability of an appointment with a level 1 doctor, the lower the number of visits the doctor on duty. Conclusion. The conducted research has shown the practicality of an integrated approach to evaluating the activities of medical organizations based on the results of public opinion research and UMIAS data.


In this study, they presented the analysis of current views on the important link in medical care provision to the population, namely, primary health care. According to the Alma-Ata Declaration on the organization of primary health care this type of medical assistance has made it possible to carry out reforms within this area in many countries, which has led to effective results (the reduction of infant mortality, the increase of life expectancy and a number of other indicators). In this paper, they performed the analysis of Russian and foreign sources of literature on the topic under study between 1978 and 2018. It has been established that primary health care is regarded as the most effective instrument of health protection than specialized medical care according to the experience of Russian Federation, a number of countries in Europe, Asia and the African continent, Australia and the United States. The performed analysis clearly shows that the experience of some countries demonstrates the correlation between the general coverage of primary health care and the achievement of public health indicative indicators. At the same time, the question is raised about the expediency of certain aspect replacement concerning the provision of specialized medical care by the doctors of general practice, i.e. primary health care. The obtained results can be interpreted as an evidence base for the necessity and an undeniable effectiveness of primary health care as a central link in the health care system.


2020 ◽  
Vol 101 (6) ◽  
pp. 890-896
Author(s):  
A A Kalininskaya ◽  
N A Bayanovа

Aim. To assess the territorial accessibility of primary health care (PHC) to the rural population in the Orenburg region. Methods. Statistical, monographic, organizational experiment research methods were applied. Statistical processing was carried out by using the Statistica 10.0 software. Basic statistics were calculated (arithmetic mean, weighted arithmetic mean). All parameters were checked by using ShapiroWilk, KolmogorovSmirnov and Lilliefors tests for normal distribution. The parametric method of statistics (Student's t-test) was used. Results. The assessment of the territorial accessibility of primary medical health care to the population of the Orenburg region was carried out using the methodology developed by us for calculating the criteria for the accessibility of primary medical health care to the rural population Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population. The use the methodology allows making management decisions regarding the territorial planning of primary health care for the rural population in the selection of problem areas with low accessibility of primary medical care. In the Orenburg region, there are the following problems: different levels of accessibility of primary health care with a variety of distance up to 30 km and different population sizes in settlements create difficulties in organizing the provision of primary health care; remoteness from the regional center up to 300 km forms a personnel deficit. Conclusion. Application of the methodology Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population in the Orenburg region has allowed the development of the following recommendations for making management decisions at the regional level: (1) prioritization of territories for priority measures to ensure the availability help; (2) selection of the form of primary health care organization for the timely medical care provision to the population; (3) the formation of competition among medical organizations in the ranking of the availability of primary health care.


Author(s):  
Egor Aleksandrovich Perevezentsev ◽  
Maya Andreevna Kuzmina ◽  
Dariya Dmitrievna Vasina ◽  
Denis Igorevich Volodin

At present, the quality and availability of medical care are the aspects to which close attention is paid in the system of organizing medical care. One of the ways to achieve a high level of quality and accessibility of medical care is building up human resources, i.e. the presence of highly qualified general practitioners, sub-specialties and middle medical personnel in sufficient numbers in a medical organization. Currently, the oncological service of Russia has been assigned tasks to fulfill the instructions from the State Program for the Development of Health Care. The results of the work should lead to a decrease in mortality and an increase in the quality of life of the population. To address the issue of reducing mortality from malignant neoplasms, in particular from prostate cancer, a three-level system of oncological care has been created on the territory of the Nizhny Novgorod Region, including 1 regional center, 2 interdistrict cancer centers, 88 primary oncology rooms and 96 examination rooms. The tasks set to reduce morbidity and mortality from oncological diseases can be realized only with close interaction of the oncological service with the primary health care sector, in which the prevention should be the priority direction of work.


Author(s):  
Владимир Петрович Косолапов ◽  
Наталья Николаевна Чайкина ◽  
Галина Владимировна Сыч ◽  
Ольга Николаевна Черных

Вопросы улучшения оказания первичной медико-санитарной помощи детскому населению всегда выступали в качестве приоритетных при оптимизации деятельности службы охраны материнства и детства и вызывали особое внимание организаторов здравоохранения. Одним из значимых решений по повышению качества оказания медико-санитарной помощи, в том числе и детям, является проект по реализации «Новой модели медицинской организации, оказывающей первичную медико-санитарную помощь» в детских структурных подразделениях. Одной из основных задач педиатрической службы Воронежской области является реализация мероприятий региональной программы «Развитие детского здравоохранения Воронежской области, включая создание современной инфраструктуры оказания медицинской помощи детям», которой предусмотрено достижение целевых показателей и выполнение определённых задач. В данной статье рассматриваются вопросы организации деятельности педиатрической службы Воронежской области в плане реализации новой модели медицинской организации, оказывающей первичную медико-санитарную помощь в детских структурных подразделениях. Определяются направления развития детского здравоохранения, включая создание современной инфраструктуры оказания медицинской помощи детям. Приводятся данные по достижению в детских поликлиниках и детских поликлинических отделениях Воронежской области организационно-планировочных решений внутренних пространств, создание условий для внедрения принципов бережливого производства и комфортного пребывания детей и их родителей при оказании первичной медико-санитарной помощи, с акцентом на воплощении идей оптимизации первичной медико-санитарной помощи путем использования принципов и методов бережливого производства в части реализации регионального проекта «Развитие системы оказания первичной медико-санитарной помощи» Нацпроекта «Здравоохранение» в рамках создания и тиражирования «Новой модели медицинской организации, оказывающей первичную медико-санитарную помощь» The issues of improving the provision of primary health care to the children's population have always been a priority in optimizing the activities of the maternal and child health care service and have caused special attention of health care organizers. One of the significant decisions to improve the quality of health care, including for children, is the project to implement the "New model of a medical organization providing primary health care" in children's structural units. One of the main tasks of the pediatric service of the Voronezh region is the implementation of the activities of the regional program "Development of children's health care of the Voronezh region, including the creation of a modern infrastructure for the provision of medical care to children", which provides for the achievement of targets and the implementation of certain tasks. The article deals with the organization of the activities of the pediatric service of the Voronezh region in terms of implementing a new model of a medical organization that provides primary health care in children's structural units. The directions of development of children's health care, including the creation of a modern infrastructure for the provision of medical care to children, are determined. The data on the achievement in children's polyclinics and children's polyclinic departments of the Voronezh region of organizational and planning solutions of internal spaces, the creation of conditions for the introduction of the principles of lean production and a comfortable stay of children and their parents in the provision of primary health care, with an emphasis on the implementation of ideas for optimizing primary health care through the use of principles and methods of lean production in terms of implementation regional project "Development of the system of primary health care" of the National Project "Healthcare" in the framework of the creation and replication of the "New model of a medical organization providing primary health care"


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