scholarly journals Primary Care in Cuba

2016 ◽  
Vol 23 (1) ◽  
pp. 37
Author(s):  
Stephanie Hauge
Keyword(s):  
Primary Care ◽  
Health System ◽  
International Health ◽  
Health Indicators ◽  
Special Focus ◽  
Political Situation ◽  
Health Community ◽  
Health Initiatives ◽  
Primary Care Practitioners

The Cuban health system surprises the international health community with strong health indicators despite economic hardship and international political tensions. This paper provides an analysis of the Cuban health system with a special focus on the role of primary care and primary care practitioners in Cuban culture. The paper also includes a discussion of Cuban health indicators, current epidemiological issues, national health initiatives, and the effects of Cuba’s political situation on its health care system.

scholarly journals Identifying important health system factors that influence primary care practitioners’ referrals for cancer suspicion: a European cross-sectional survey

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022904 ◽  
Author(s):  
Michael Harris ◽  
Peter Vedsted ◽  
Magdalena Esteva ◽  
Peter Murchie ◽  
Isabelle Aubin-Auger ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Factor Analysis ◽  
Health System ◽  
Health Systems ◽  
European Countries ◽  
Cancer Symptoms ◽  
Referral Decision ◽  
System Factors ◽  
Primary Care Practitioners

ObjectivesCancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitioners’ (PCPs’) referral decisions is lacking.This study analyses health system factors potentially influencing PCPs’ referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.DesignBased on a content-validity consensus, a list of 45 items relating to a PCP’s decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPs’ referral decision-making.SettingA primary care study; 25 participating centres in 20 European countries.Participants1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.Outcome measuresThe factors derived from items related to PCPs’ referral decision-making. Mean factor scores were produced for each country, allowing comparisons.ResultsFactor analysis identified five underlying factors: PCPs’ ability to refer; degree of direct patient access to secondary care; PCPs’ perceptions of being under pressure; expectations of PCPs’ role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.ConclusionsFive healthcare system factors influencing PCPs’ referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.

scholarly journals The Primary Care Spend Model: a systems approach to measuring investment in primary care

2019 ◽  
Vol 4 (4) ◽  
pp. e001601 ◽  
Author(s):  
Robert Baillieu ◽  
Michael Kidd ◽  
Robert Phillips ◽  
Martin Roland ◽  
Michael Mueller ◽  
...  
Keyword(s):  
Primary Care ◽  
Health System ◽  
Systems Approach ◽  
Dynamic Assessment ◽  
International Health ◽  
Coordinated Care ◽  
Healthcare Budget ◽  
Care Services ◽  
Primary Care Services ◽  
Data Limitations

Increased investment in primary care is associated with lower healthcare costs and improved population health. The allocation of scarce resources should be driven by robust models that adequately describe primary care activities and spending within a health system, and allow comparisons within and across health systems. However, disparate definitions result in wide variations in estimates of spending on primary care. We propose a new model that allows for a dynamic assessment of primary care spending (PC Spend) within the context of a system’s total healthcare budget. The model articulates varied definitions of primary care through a tiered structure which includes overall spending on primary care services, spending on services delivered by primary care professionals and spending delivered by providers that can be characterised by the ‘4Cs’ (first contact, continuous, comprehensive and coordinated care). This unifying framework allows a more refined description of services to be included in any estimate of primary care spend and also supports measurement of primary care spending across nations of varying economic development, accommodating data limitations and international health system differences. It provides a goal for best accounting while also offering guidance, comparability and assessments of how primary care expenditures are associated with outcomes. Such a framework facilitates comparison through the creation of standard definitions and terms, and it also has the potential to foster new areas of research that facilitate robust policy analysis at the national and international levels.

scholarly journals Oral Health in Primary Care through the Family Health Strategy

2019 ◽  
Vol 21 (2) ◽  
pp. 139
Author(s):  
Aline Claudia Ribeiro Medeiros Silva ◽  
Mário Molari
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Oral Health ◽  
Health System ◽  
Family Health ◽  
Health Indicators ◽  
Family Health Program ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy

AbstractThe purpose of this article is to carry out a literature review on oral health team in primary care with their inclusion in the Family Health Strategy (FHS). The publications were consulted in national papers, official documents and other publications of Health Ministry (MS). In the literature it is observed that with the creation of the Unified Health System (SUS) a process of health restructuring services in Brazil began. The Primary Care National Policy (PNAB) is the result of several historical facts involved with the development and consolidation of SUS. The Family Health Program (PSF), now called the Family Health Strategy (ESF) was created in 1994 aimed at reorienting health care with new bases, centering family focus and attempting to achieve improvement in quality of life of Brazilians. In 2000, oral health teams were included in the PSF to extend access  of the Brazilian population to health promotion actions, prevention and recovery of oral health, improve health indicators and encourage the reorganization of dentistry in primary care. ESF is a unique strategy in the reorganization of the Brazilian health system and the inclusion of the ESB an important complement in primary care, aiming an integral dental practice. Keywords: Primary Health Care. Family Health Strategy. Oral Health. ResumoO presente artigo tem o objetivo de realizar uma revisão de literatura sobre a equipe de saúde bucal na atenção básica, através da sua inserção na Estratégia Saúde da Família (ESF). As publicações consultadas foram artigos científicos nacionais, documentos oficiais (leis e portarias) e outras publicações do Ministério da Saúde (MS).  Na literatura observa-se que com a criação do Sistema Único de Saúde (SUS) iniciou no Brasil um processo de reestruturação dos serviços de saúde. A Política Nacional de Atenção Básica (PNAB) é resultado da experiência acumulada de vários atores envolvidos historicamente com o desenvolvimento e a consolidação do SUS. O Programa Saúde da Família (PSF), atualmente denominado Estratégia Saúde da Família (ESF), foi implantado em 1994 visando a reorientação da prática da atenção à saúde sob novas bases, centrando o foco na família, na tentativa de alcançar uma melhoria na qualidade de vida dos brasileiros. Em 2000, as equipes de saúde bucal foram inseridas no PSF com o objetivo de ampliar o acesso da população brasileira às ações de promoção, prevenção e recuperação da saúde bucal, melhorar os indicadores de saúde, além de incentivar a reorganização da odontologia na atenção básica. A ESF consiste em uma estratégia ímpar na reorganização do sistema de saúde brasileiro e a inclusão da ESB um importante complemento na atenção básica, visando uma prática odontológica integral. Palavras-chave: Atenção Primária à Saúde. Estratégia Saúde da Família. Saúde Bucal.

Shaping the Next Generation of Providers

2019 ◽  
pp. 457-464
Author(s):  
Gerri Mattson ◽  
Karen Remley
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Clinical Medicine ◽  
Collaborative Work ◽  
Well Being ◽  
Primary Care Providers ◽  
Care Providers ◽  
Health Community ◽  
Changing Role

This chapter is about the changing role of the primary carer in the health setting with a particular focus on the training of primary carers. Primary care providers are already increasingly called on to expand their practice beyond their traditional knowledge and skills in clinical medicine. The chapter looks at the population health competency of primary health carers. Primary care providers, once trained, in the community can serve as mentors for trainees, which can provide additional perspective and experience outside of the academic setting. The chapter goes on to argue that the health and well-being of the entire community are dependent on the collaborative work of health care providers, public health, community organizations, faith-based organizations, and the community itself. Understanding the myriad connections, competencies, and impacts of these partnerships allows clinicians to engage with the community early in their careers; to deepen their engagement, understanding, and ability over time; and to be effective advocates with and on behalf of the communities they serve.

General practice nurses and physicians and end of life: a systematic review of models of care

2020 ◽  
pp. bmjspcare-2019-002114 ◽  
Author(s):  
Geoffrey Mitchell ◽  
Michèle Aubin ◽  
Hugh Senior ◽  
Claire Johnson ◽  
Julia Fallon-Ferguson ◽  
...  
Keyword(s):  
General Practice ◽  
Health System ◽  
End Of Life ◽  
Models Of Care ◽  
Case Conference ◽  
Practice Nurses ◽  
Patients With Cancer ◽  
Primary Care Practitioners ◽  
The Impact

BackgroundGeneral practitioners (GPs) and general practice nurses (GPNs) face increasing demands to provide palliative care (PC) or end-of-life care (EoLC) as the population ages. In order to maximise the impact of GPs and GPNs, the impact of different models of care that have been developed to support their practice of EoLC needs to be understood.ObjectiveTo examine published models of EoLC that incorporate or support GP and GPN practice, and their impact on patients, families and the health system.MethodSystematic literature review. Data included papers (2000 to 2017) sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases.ResultsFrom 6209 journal articles, 13 papers reported models of care supporting the GP and GPN’s role in EoLC or PC practice. Services and guidelines for clinical issues have mixed impact on improving symptoms, but improved adherence to clinical guidelines. National Frameworks facilitated patients being able to die in their preferred place. A single specialist PC-GP case conference reduced hospitalisations, better maintained functional capacity and improved quality of life parameters in both patients with cancer and without cancer. No studies examined models of care aimed at supporting GPNs.ConclusionsPrimary care practitioners have a natural role to play in EoLC, and most patient and health system outcomes are substantially improved with their involvement. Successful integrative models need to be tested, particularly in non-malignant diseases. Such models need to be explored further. More work is required on the role of GPNs and how to support them in this role.

Cancer, familial cancer and genomics: A primary care perspective

2020 ◽  
pp. 175573802097183
Author(s):  
Judith Hayward ◽  
Anju Kulkarni ◽  
Imran Rafi
Keyword(s):  
Primary Care ◽  
Cancer Risk ◽  
Familial Cancer ◽  
Diagnosis And Treatment ◽  
Inherited Cancer ◽  
Screening And Surveillance ◽  
History Of ◽  
Risk Reduction Measures ◽  
Primary Care Practitioners

Advances in genomics have vastly increased our understanding of inherited cancer risk and underlying cancer predisposition syndromes, thereby underpinning a revolution in the diagnosis and treatment of cancer itself. Concern regarding family history of cancer is a common presentation within primary care. This article provides an overview of the role of primary care practitioners in the clinical identification and management of inherited cancer risk within primary care including risk assessment, screening and surveillance. The article will consider management issues, including access to genomic testing and advice on risk-reduction measures. The role of genomics in cancer diagnosis and treatment and future applications will be outlined.

The Evolving Role of Primary Care Practitioners in Dermatology

2015 ◽  
Vol 7 (6) ◽  
pp. 325-329 ◽  
Author(s):  
Kourosh Beroukhim ◽  
Catherine Nguyen ◽  
Melissa J. Danesh ◽  
Jashin J. Wu ◽  
John Koo
Keyword(s):  
Primary Care ◽  
Primary Care Practitioners

Assessment of primary care practitioners’ attitudes and interest in pharmacogenomic testing

2020 ◽  
Vol 21 (15) ◽  
pp. 1085-1094
Author(s):  
D Max Smith ◽  
Tarlan Namvar ◽  
Ryan P Brown ◽  
T Blaise Springfield ◽  
Beth N Peshkin ◽  
...  
Keyword(s):  
Primary Care ◽  
Health System ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Primary Care Providers ◽  
Test Results ◽  
Care Providers ◽  
Primary Care Practitioners

Aims: Identify the attitudes and interests of primary care providers (PCPs) in applying clinical pharmacogenomics (PGx) test results. Materials & methods: A questionnaire was designed and then disseminated to PCPs across the MedStar Health System. Results: Ninety of 312 (29%) PCPs responded and were included in analyses. Seventy-six (84%) had heard of PGx and 12 (13%) previously ordered PGx testing. Most, 68 (76%), believed PGx can improve care; however, a minority, 23 (26%), reported confidence in using PGx in prescribing decisions. Sixty-four (70%) wanted a pharmacist consultation. PCPs desired PGx for antidepressants (75%), proton pump inhibitors (72%) and other medications. Conclusion: Most PCPs felt unprepared to interpret PGx results and desired pharmacist consultations. These data can inform future PGx implementations with PCPs.

scholarly journals The role of primary care in the dynamics of a health system

2018 ◽  
Vol 27 (2) ◽  
pp. 71-72 ◽  
Author(s):  
David Bruce Matchar ◽  
Josip Car ◽  
Gerald Choon Huat Koh
Keyword(s):  
Primary Care ◽  
Health System
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