scholarly journals Advanced Access in Primary Health Care: experiences from Brazil and Canada

2021 ◽  
Vol 10 (16) ◽  
pp. e568101624209
Author(s):  
Isabela Oliveira de Almeida ◽  
Débora de Souza Santos ◽  
Dalvani Marques ◽  
Fernanda Mota Rocha ◽  
Nathalia de Souza Monezi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Selection Criteria ◽  
Health Care Experiences ◽  
Canadian Experience ◽  
Primary Health ◽  
Physical Infrastructure ◽  
Use Of Services ◽  
Advanced Access

Access is the timely use of services in order to meet the needs of the user. As an alternative to the traditional model, the Advanced Access (AA) model appears in Canada , with schedules restricted to specific cases. Objectives: The purpose of this article is to analyze the existing scientific production about the Advanced Access model in Primary Health Care. Methods: Integrative literature review using the descriptors (1) “Health Care Accessibility” OR “Primary Health Care” AND and (2) "Advanced Access" in the PubMed, Scopus and BIREME databases. Selection criteria were studies published in the last five years, available in Portuguese, English or Spanish and dealing with the theme. Results: Eight studies were selected, six were grouped into two categories of analysis: “The Canadian experience with AA : a model in consolidation”; and “The Brazilian experience with AA: local experiments” and the other two contributed to enrich the discussion. The AA stands out to balance capacity and demand with physical infrastructure and adequate staff, both in the international arena, as the experiences of municipalities, improving the quality of APS. Conclusion: Studies that detail the AA in its practice, as well as the challenges and needs, can inspire other health units to study it and consider its implementation if it is appropriate for its context, aiming to improve the health and care of its population.

scholarly journals Scheduling models and primary health care quality

2019 ◽  
Vol 53 ◽  
pp. 38
Author(s):  
Tiago Barra Vidal ◽  
Suelen Alves Rocha ◽  
Erno Harzheim ◽  
Lisiane Hauser ◽  
Charles Dalcanale Tesser
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Centers ◽  
Health Team ◽  
Scheduling Model ◽  
Primary Health ◽  
Care Assessment ◽  
One Year ◽  
Advanced Access

OBJECTIVE: To evaluate whether the scheduling model influences the perception of the user about the quality of primary health care centers. METHODS: This is a cross-sectional and population-based study that measured the quality of centers by the Primary Care Assessment Tool (PCATool-Brazil), applied to adult users (n = 409) from 11 health centers in Florianópolis, state of Santa Catarina. Multilevel analysis was used to verify the relationship between the score of general quality of the primary health care and the scheduling model. The independent variables (age, skin color, scheduling model, panel size by primary health team, poverty ratio as income proxy, number of health teams, presence of economically interest areas, number of medical appointments in one year per primary health team, number of people treated in one year per health team), with p < 0.20 were selected for the multilevel model, which was adjusted with aggregates of information from users and health centers. RESULTS: The health center that used advanced access had a general score of 7.04, while those using a weekly carve-out had a score of 6.26; the carve-out every 15 days, score of 5.87; and the traditional carve-out, score of 6.29. CONCLUSIONS: The scheduling model of advanced access had a positive effect on the quality of primary health care, in the perception of users.

Client characteristics and satisfaction with the quality of primary health-care services in Calabar, Nigeria

2020 ◽  
Vol 3 ◽  
pp. 1-8
Author(s):  
H. C. Okeke ◽  
P. Bassey ◽  
O. A. Oduwole ◽  
A. Adindu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Client Satisfaction ◽  
Demographic Characteristics ◽  
Care Providers ◽  
Client Characteristics ◽  
Study Objective ◽  
Primary Health

Different mix of clients visit primary health care (PHC) facilities, and the quality of services is critical even in rural communities. The study objective was to determine the relationship between socio-demographic characteristics and client satisfaction with the quality of PHC services in Calabar Municipality, Cross River State, Nigeria. Specifically to describe aspects of the health facilities that affect client satisfaction; determine the health-care providers’ attitude that influences client satisfaction; and determine the socio-demographic characteristics that influence client satisfaction with PHC services. A cross-sectional survey was adopted. Ten PHCs and 500 clients utilizing services in PHC centers in Calabar Municipality were randomly selected. Clients overall satisfaction with PHC services was high (80.8%). Divorced clients were less (75.0%) satisfied than the singles and the married counterparts (81%), respectively. Clients that were more literate as well as those with higher income were less satisfied, 68.0% and 50.0%, respectively, compared to the less educated and lower-income clients, 92.0% and 85.0% respectively. These differences in satisfaction were statistically significant (P = 0.001). Hence, it was shown that client characteristics such as income and literacy level show a significant negative relationship with the clients satisfaction with the quality of PHC services in Calabar Municipality.

Quality of life and adherence to mediterranean diet among type 2 diabetes mellitus patients of a primary health care clinic in Hebron city, Palestine

2021 ◽  
pp. 1-10
Author(s):  
Manal Badrasawi ◽  
May Hamdan ◽  
Mohammad Al Tamimi
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Health Care ◽  
Primary Health Care ◽  
Mediterranean Diet ◽  
Well Being ◽  
Care Clinic ◽  
Primary Health Care Clinic ◽  
Primary Health

BACKGROUND: Diabetes mellitus (DM) is a lifelong metabolic disease with a high rate of mortality and morbidity. Uncontrolled and untreated diabetes results in serious complications that subsequently cause patients’ quality of life (QoL) to deteriorate. Adherence to Mediterranean diet (MD) may relieve the complications of diabetes, thereby improving the quality of life for these patients. OBJECTIVE: The aim of this study was to assess the QoL of DM patients who adhered to MD. METHODS: In this cross-sectional study, we examined the QoL and MD data of 106 DM II patients being treated at a primary health care clinic in Hebron. We used the SF-36 questionnaire to measure the patients’ QoL and the MEDAS tool to assess their MD adherence. We also recorded their anthropometric measurements, abdominal obesity, lifestyle habits and blood biochemical results. RESULTS: The sample comprised male and female DM II patients between the ages of 35 and 72, with their mean age being 55.8±10.24. Patients’ QoL scores showed a significant relationship with three BMI categories, i.e., total QoL score, physical function, and pain domains (p <  0.05). In terms of diet, high adherence to MD had a positive impact on all domains and on patients’ total QoL with significant differences in physical functioning, emotional well-being, social functioning and pain domains. CONCLUSION: Patients’ QoL domains were relatively low and highly affected by DM II. Patients with greater MD adherence reported higher scores in all QoL domains. Significantly higher scores were noted for the physical, social and pain domains. Hence, MD is a recommended dietary pattern for DM II patients to achieve a better QoL.

Wybrane parametry jakości ucisku i relaksacji klatki piersiowej wykonywanej przez personel pielęgniarski w ramach pozaszpitalnego nagłego zatrzymania krążenia ? badanie pilotażowe

2018 ◽  
Vol 21 (4) ◽  
Author(s):  
Paweł Więch ◽  
Marek Muster ◽  
Dariusz Bazaliński ◽  
Grzegorz Kucaba ◽  
Izabela Sałacińska ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Statistical Analysis ◽  
Discharge Rate ◽  
Statistical Significance ◽  
Sudden Cardiac Arrest ◽  
Initial Examination ◽  
Relaxation Parameters ◽  
Primary Health

Introduction. Sudden cardiac arrest (SCA) in out-of-hospital conditions is a frequent condition of immediate life-emergency of cardiological background. The survival and discharge rate in SCA patients treated by medical services is still at a low level. Aim. The aim of the study was to analyze selected parameters of the quality of chest compressions and relaxation performed by nursing staff as part of out-of-hospital SCA. Material and methods. The study covered a group of 48 nurses working in primary health care in branches of conservative (PRE/C = 24 people, mean age 33.04 ± 9.20) and surgery profile (PRE/I = 24 people, average age 31.88 ± 9.97), participating in the research project of the Center for Medical and Natural Sciences Research and Innovation, University of Rzeszów in Rzeszów. Two months after the initial examination and intervention, the test was repeated. The assessment of selected compression and relaxation parameters was performed using the True CPR Resuscitation Assistant. The statistical analysis of the collected material was carried out with the SPSS Statistics 20 software. The statistical analysis used the analysis of variables using parametric and non-parametric tests. The statistical significance was assumed at p < 0.05. Results. Initially, a high percentage of the effectiveness of the most important compression and relaxation parameters of the chest was obtained during 2-minute out-of-hospital cardiopulmonary resuscitation with no statistically significant differences between the two groups (PRE/C: 51 mm depth, 83.92% relaxation, frequency 115.46 vs. PRE/I: depth: 47.58 mm, relaxation: 92.54, frequency: 109.96, p < 0.05). After two months, similar parametric values were observed with no statistical significance (p < 0.05). Conclusions. The initial high quality of compressions and relaxation was found in nurses participating in the simulated out-of-hospital SCA, while there were no significant differences between primary health care nurses working at conservative departments and nurses from surgical ones. After a two-month interval from the initial examination and training, high CPR effectiveness was observed based on the guidelines of the European Resuscitation Council from 2015.

scholarly journals Quality of Primary Health Care in Brazil: patients'view

2018 ◽  
Vol 71 (suppl 6) ◽  
pp. 2713-2719
Author(s):  
Daniela Cristina Moreira Marculino de Figueiredo ◽  
Helena Eri Shimizu ◽  
Walter Massa Ramalho ◽  
Alexandre Medeiros de Figueiredo ◽  
Kerle Dayana Tavares de Lucena
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Clinical History ◽  
Coordination Of Care ◽  
Primary Health ◽  
Comprehensive Health ◽  
Access And Quality ◽  
Transversal Study

ABSTRACT Objective: To describe the evaluation of patients that participated in the National Program for Improving the Access and Quality in Primary Health Care (Programa Nacional de Melhoria do Acesso e da Qualidade na Atenção Básica) for the comprehensive healthcare, the bond and the coordination of care in the country's macro-regions. Method: A descriptive, transversal study, from interviews with 65,391 patients of Primary Health Care, in 3,944 municipalities regarding the use of health services. Results: The professionals seek to solve the patients' problems in their unit (73.1%) but focused mainly on the scope of the appointment (65.6%) and offering care away from the population's reality (69.4%). Difficulties in the rescue of clinical history were referred (50.3%) and in the care performed in other health services (29.2%). Conclusion: The comprehensive health care, the bond and the coordination of care remain challenges to the Primary Health Care in the country, requiring reflections on the implementation of national policies, especially considering the regional diversities in Brazil.

scholarly journals Quality of Health Assistants in primary Health centres in Rural Maharashtra, India

2013 ◽  
Vol 6 ◽  
pp. HSI.S11226
Author(s):  
Enakshi Ganguly ◽  
Bishan S. Garg
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Primary Health Care System ◽  
Job Descriptions ◽  
Continuous Training ◽  
Primary Health ◽  
Primary Health Centres ◽  
Quality Assurance Mechanism ◽  
Health Centres

Introduction Health assistants are important functionaries of the primary health care system in India. Their role is supervision of field-based services among other things. A quality assurance mechanism for these health assistants is lacking. The present study was undertaken with the objectives of developing a tool to assess the quality of health assistants in primary health centres (PHCs) and to assess their quality using this tool. Methodology Health assistants from three PHCs in the Wardha district of India were observed for a year using a tool developed from primary health care management Aavancement program modules. Data was collected by direct observation, interview, and review of records for quality of activities. Results Staff strength of health assistants was 87.5%. None of the health assistants were clear about their job descriptions. A supervisory schedule for providing supportive supervision to auxiliary nurse midwives (ANMs) was absent; most field activities pertaining to maternal and child health received poor focus. Monthly meetings lacked a clear agenda, and comments on quality improvement of services provided by the ANMs were missing. Conclusion Continuous training with sensitization on quality issues is required to improve the unsatisfactory quality.

scholarly journals Comorbid mental disorders and quality of life of people with epilepsy attending primary health care clinics in rural Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0238137
Author(s):  
Ruth Tsigebrhan ◽  
Abebaw Fekadu ◽  
Girmay Medhin ◽  
Charles R. Newton ◽  
Martin J. Prince ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Seizure Frequency ◽  
Functional Disability ◽  
Social Outcomes ◽  
Primary Health ◽  
Comorbid Mental Disorders

Background Evidence from high-income countries demonstrates that co-morbid mental disorders in people with epilepsy adversely affect clinical and social outcomes. However, evidence from low-income countries is lacking. The objective of this study was to measure the association between co-morbid mental disorders and quality of life and functioning in people with epilepsy. Methods A facility-based, community ascertained cross-sectional survey was carried out in selected districts of the Gurage Zone, Southern Ethiopia. Participants were identified in the community and referred to primary health care (PHC) clinics. Those diagnosed by PHC workers were recruited. Co-morbid mental disorders were measured using a standardised, semi-structured clinical interview administered by mental health professionals. The main outcome, quality of life, was measured using the Quality of Life in Epilepsy questionnaire (QOLIE-10p). The secondary outcome, functional disability, was assessed using the 12-item World Health Organization Disability Assessment Schedule (WHODAS-2). Results The prevalence of comorbid mental disorders was 13.9%. Comorbid mental disorders were associated with poorer quality of life (Adjusted (Adj.) β -13.27; 95% CI -23.28 to-3.26) and greater disability (multiplier of WHODAS-2 score 1.62; 95% CI 1.05, 2.50) after adjusting for hypothesised confounding factors. Low or very low relative wealth (Adj. β = -12.57, 95% CI -19.94 to-5.20), higher seizure frequency (Adj.β coef. = -1.92, 95% CI -2.83 to -1.02), and poor to intermediate social support (Adj. β coef. = -9.66, 95% CI -16.51 to -2.81) were associated independently with decreased quality of life. Higher seizure frequency (multiplier of WHODAS-2 score 1.11; 95% CI 1.04, 1.19) was associated independently with functional disability. Conclusion Co-morbid mental disorders were associated with poorer quality of life and impairment, independent of level of seizure control. Integrated and comprehensive psychosocial care is required for better health and social outcomes of people with epilepsy.

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