scholarly journals Healthcare Providers’ Perceptions of Potentially Preventable Rural Hospitalisations: A Qualitative Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12767
Author(s):  
Andrew Ridge ◽  
Gregory M. Peterson ◽  
Bastian M. Seidel ◽  
Vinah Anderson ◽  
Rosie Nash
Keyword(s):  
Primary Care ◽  
Health Literacy ◽  
Rural Communities ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Patient Specific ◽  
Care Services ◽  
Access To Primary Care ◽  
Appointment Availability

Potentially preventable hospitalisations (PPHs) are common in rural communities in Australia and around the world. Healthcare providers have a perspective on PPHs that may not be accessible by analysing routine patient data. This study explores the factors that healthcare providers believe cause PPHs and seeks to identify strategies for preventing them. Physicians, nurses, paramedics, and health administrators with experience in managing rural patients with PPHs were recruited from southern Tasmania, Australia. Semi-structured telephone interviews were conducted, and reflexive thematic analysis was used to analyse the data. Participants linked health literacy, limited access to primary care, and perceptions of primary care services with PPH risk. The belief that patients did not have a good understanding of where, when, and how to manage their health was perceived to be linked to patient-specific health literacy challenges. Access to primary healthcare was impacted by appointment availability, transport, and financial constraints. In contrast, it was felt that the prompt, comprehensive, and free healthcare delivered in hospitals appealed to patients and influenced their decision to bypass rural primary healthcare services. Strategies to reduce PPHs in rural Australian communities may include promoting health literacy, optimising the delivery of existing services, and improving social support structures.

scholarly journals Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

2020 ◽  
Author(s):  
Peter O. Otieno ◽  
Elvis Omondi Achach Wambiya ◽  
Shukri M Mohamed ◽  
Martin Kavao Mutua ◽  
Peter M Kibe ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Healthcare ◽  
Associated Factors ◽  
Healthcare Services ◽  
Urban Slums ◽  
Public Facility ◽  
Health Coverage ◽  
Ordinal Logistic Regression Analysis ◽  
Access To Primary Care ◽  
Female Headed Households

Abstract Background: Access to primary healthcare is crucial for the delivery of Kenya’s universal health coverage policy. However, disparities in healthcare have proved to be the biggest challenge for implementing primary care in poor-urban resource settings. In this study, we assessed the level of access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya. Methods: The data were drawn from the Lown scholars’ study of 300 randomly selected households in Viwandani slums (Nairobi, Kenya), between June and July 2018. Access to primary care was measured using Penchansky and Thomas’ model. Access index was constructed using principal component analysis and recorded into tertiles with categories labeled as poor, moderate, and highest. Generalized ordinal logistic regression analysis was used to determine the factors associated with access to primary care. The adjusted odds ratios (AOR) and 95 percent confidence intervals were used to interpret the strength of associations. Results: The odds of being in the highest access tertile versus the combined categories of lowest and moderate access tertile were 3.5 times higher for males than female-headed households (AOR 3.05 [95% CI 1.47-6.37]; p<.05). Households with an average quarterly out-of-pocket healthcare expenditure of ≥$30 had significantly lower odds of being in the highest versus combined categories of lowest and moderate access tertile compared to those spending ≤ $5.(AOR 0.36 [95% CI 0.18-0.74]; p<.05). Households that sought primary care from private facilities had significantly higher odds of being in the highest versus combined categories of lowest and moderate access tertiles compared to the public facilities (AOR 6.64 [95% CI 3.67-12.01]; p<.001). Conclusion: In Nairobi slums in Kenya, living in a female-headed household, seeking care from a public facility, and paying out of pocket for healthcare are significantly associated with low access to primary care. Therefore, the design of the UHC program in this setting should prioritize quality improvement in public health facilities and focus on policies that encourage economic empowerment of female-headed households to improve access to primary healthcare

scholarly journals Strategies For Strengthening High Risk Pregnancy Care In Primary Healthcare Services

2019 ◽  
Author(s):  
Nathan Aratani ◽  
Oswaldo Yoshimi Tanaka
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
High Risk Pregnancy ◽  
Pregnancy Care ◽  
Basic Health ◽  
Care Services ◽  
Primary Care Services ◽  
Risk Pregnancy

Abstract Background: In the Brazilian Public healthcare system (The Unified Healthcare System - Sistema Único de Saúde), Primary Healthcare has expanded from implementing healthcare networks, an organization form of services with centrality to primary care services. Due to the extension and heterogeneity of Brazilian municipalities, several organization forms of primary care services existed. In the city of São Paulo they were organized by three modalities of Basic Health Units. Thus, this study aimed to evaluate the care continuity in high-risk pregnancy care in different models of the basic health units. Methods:Data analysis defined performing prenatal care in primary care even after referral to the high-risk pregnancy service as the dependent variable. The independent variables were the sociodemographic and organizational aspects of health services. Logistic regression was used as the statistical technique. Results:Care is provided in a similar way in all basic health unit models, without prioritizing pregnant women with greater vulnerabilities (under 15 years and over 35 years, with education less than 7 years). Regarding women of black or brown color, it was observed that they were more likely (OR 1.997) to have care continuity in family health units. Home visiting and knowing the community health agent proved to be tools for organizing health services which are capable of producing better care. Conclusion: Primary healthcare services in Brazil for high-risk pregnancy care are organized without considering individual vulnerabilities. The home visits and the presence of the community health agent need to be strengthened in organizing the services, as they are able to modify the process of producing healthcare.

scholarly journals Integrative literature review: access to primary healthcare services

2018 ◽  
Vol 71 (3) ◽  
pp. 1178-1188 ◽  
Author(s):  
Maura Cristiane e Silva Figueira ◽  
Wellington Pereira da Silva ◽  
Eliete Maria Silva
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Health Plans ◽  
Access To Health Services ◽  
Primary Health ◽  
Study Selection ◽  
Access To Health ◽  
Access To Primary Care

ABSTRACT Objective: Analyze the scientific production that describes the type of access to primary healthcare services and identify specific populations that have differentiated access to health services. Method: An integrative review. For study selection, the following databases were used: PubMed, Scopus, Bireme, and Cinahl. The sample included 22 national and international articles. Results: The results describe the access of specific populations to health services, the access to primary care through health plans and proposed improvements to the access to primary care. Conclusion: The access to services is a challenge in many countries and some strategies and policies are implemented to solve and improve primary health care.

scholarly journals Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

2020 ◽  
Author(s):  
Peter O. Otieno ◽  
Elvis Omondi Achach Wambiya ◽  
Shukri M Mohamed ◽  
Martin Kavao Mutua ◽  
Peter M Kibe ◽  
...  
Keyword(s):  
Primary Care ◽  
Universal Health Coverage ◽  
Primary Healthcare ◽  
Associated Factors ◽  
Healthcare Services ◽  
Urban Slums ◽  
Health Coverage ◽  
Ordinal Logistic Regression Analysis ◽  
Access To Primary Care ◽  
Universal Health

Abstract Background: Access to primary healthcare is crucial for the delivery of Kenya’s universal health coverage (UHC) policy. However, disparities in healthcare have proved to be the biggest challenge for implementing primary care in poor-urban resource settings. In this study, we assessed the level of access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya. Methods: The data were drawn from the Lown scholars’ study of 300 randomly selected households in Viwandani slums (Nairobi, Kenya), between June and July 2018. Access to primary care was measured using Penchansky and Thomas’ model. Access index was constructed using principal component analysis and recoded into tertiles with categories labeled as poor, moderate and highest. Generalized ordinal logistic regression analysis was used to determine the factors associated with access to primary care. The adjusted odds ratios and 95 percent confident intervals were used to interpret the strength of associations. Results : The odds of being in the lowest versus combined moderate and highest access tertile were significantly higher for female than male-headed households (AOR 1.91 [95% CI 1.03-3.54]; p < .05). Households with an average quarterly out-of-pocket healthcare expenditure of ≥$30 had significantly lower odds of being in the lowest versus combined moderate and highest access tertile compared to those spending ≤ $5 quarterly (AOR 0.33 [95% CI 0.50-1.90]; p< .001). Households that sought care from private facilities had significantly higher odds of being in the lowest versus combined moderate and highest access compared to the public facilities (AOR 3.77 [95% CI 2.16-6.56]; p < .05). Conclusion : In Nairobi slums in Kenya, living in a female-headed household and seeking care from private facilities are significantly associated with low access to primary care. Therefore, the design of the UHC program in this setting should prioritize the regulation of private health facilities and focus on policies that encourage economic empowerment of female-headed households to improve access to primary healthcare. Keywords: Access to primary healthcare, Universal health coverage, Urban slums, Penchansky and Thomas’s model.

scholarly journals Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

2020 ◽  
Author(s):  
Peter O. Otieno ◽  
Elvis Omondi Achach Wambiya ◽  
Shukri M Mohamed ◽  
Martin Kavao Mutua ◽  
Peter M Kibe ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Healthcare ◽  
Associated Factors ◽  
Healthcare Services ◽  
Urban Slums ◽  
Public Facility ◽  
Health Coverage ◽  
Ordinal Logistic Regression Analysis ◽  
Access To Primary Care ◽  
Female Headed Households

Abstract Background: Access to primary healthcare is crucial for the delivery of Kenya’s universal health coverage policy. However, disparities in healthcare have proved to be the biggest challenge for implementing primary care in poor-urban resource settings. In this study, we assessed the level of access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya. Methods: The data were drawn from the Lown scholars’ study of 300 randomly selected households in Viwandani slums (Nairobi, Kenya), between June and July 2018. Access to primary care was measured using Penchansky and Thomas’ model. Access index was constructed using principal component analysis and recorded into tertiles with categories labeled as poor, moderate, and highest. Generalized ordinal logistic regression analysis was used to determine the factors associated with access to primary care. The adjusted odds ratios (AOR) and 95 percent confidence intervals were used to interpret the strength of associations. Results: The odds of being in the highest access tertile versus the combined categories of lowest and moderate access tertile were three times higher for males than female-headed households (AOR 3.05 [95% CI 1.47-6.37]; p<.05). Households with an average quarterly out-of-pocket healthcare expenditure of ≥USD 30 had significantly lower odds of being in the highest versus combined categories of lowest and moderate access tertile compared to those spending ≤ USD 5 (AOR 0.36 [95% CI 0.18-0.74]; p<.05). Households that sought primary care from private facilities had significantly higher odds of being in the highest versus combined categories of lowest and moderate access tertiles compared to those who sought care from public facilities (AOR 6.64 [95% CI 3.67-12.01]; p<.001). Conclusion: In Nairobi slums in Kenya, living in a female-headed household, seeking care from a public facility, and paying out-of-pocket for healthcare are significantly associated with low access to primary care. Therefore, the design of the UHC program in this setting should prioritize quality improvement in public health facilities and focus on policies that encourage economic empowerment of female-headed households to improve access to primary healthcare.

scholarly journals Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya

2019 ◽  
Author(s):  
Peter O. Otieno ◽  
Elvis Omondi Achach Wambiya ◽  
Shukri M Mohamed ◽  
Martin Kavao Mutua ◽  
Peter M Kibe ◽  
...  
Keyword(s):  
Primary Care ◽  
Universal Health Coverage ◽  
Primary Healthcare ◽  
Associated Factors ◽  
Healthcare Expenditure ◽  
Healthcare Services ◽  
Urban Slums ◽  
Health Coverage ◽  
Access To Primary Care ◽  
Universal Health

Abstract Background: Access to primary healthcare is crucial for the delivery of Kenya’s universal health coverage policy. However, disparities in healthcare have proved to be the biggest challenge for implementing primary care in poor-urban resource settings. In this study, we assessed the level of access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya. Methods: The data were drawn from the Lown scholars’ study of 300 randomly selected households in Viwandani slums (Nairobi, Kenya), between June and July 2018. Access to primary care was measured using Penchansky and Thomas’ model. Access index was constructed using principal component analysis and recoded into tertiles with categories labeled as poor, moderate and highest. Generalized ordinal logistic regression analysis was used to determine the factors associated with access to primary care. The adjusted odds ratios and 95 percent confident intervals were used to interpret the strength of associations. Results : The odds of being in the lowest versus combined moderate and highest access tertile were significantly higher for female than male-headed households (AOR 1.91 [95% CI 1.03-3.54]; p < .05). Households with an average quarterly out-of-pocket healthcare expenditure of ≥$30 had significantly lower odds of being in the lowest versus combined moderate and highest access tertile compared to those spending ≤ $5 quarterly (AOR 0.33 [95% CI 0.50-1.90]; p< .001). Households that sought care from private facilities had significantly higher odds of being in the lowest versus combined moderate and highest access compared to the public facilities (AOR 3.77 [95% CI 2.16-6.56]; p < .05). Conclusion : In Nairobi slums in Kenya, the gender of the household head, out of pocket healthcare expenditure, and source of primary care are significantly associated with access to primary care. Therefore, the universal health coverage program in this setting should be designed with an equity lens so that the most vulnerable groups within the community can have access.

scholarly journals Referrals to Urgent Dental Centres During the COVID-19 Pandemic: A Multi-Site Analysis Research Project

2021 ◽  
Vol 10 (1) ◽  
pp. 40-45
Author(s):  
Adam Shathur ◽  
Samuel Reeves ◽  
Faizal Sameja ◽  
Vishal Patel ◽  
Allan Jones
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Easy Access ◽  
Dental Services ◽  
Care Services ◽  
Dental Practitioners ◽  
Consultation And Referral ◽  
Care Systems ◽  
Access To Primary Care ◽  
The Uk

Introduction: The COVID-19 pandemic enforced the cessation of routine dentistry and the creation of local urgent dental care systems in the UK. General dental practices are obligated by NHS guidance to remain open and provide remote consultation and referral where appropriate to patients having pain or problems. Aims: To compare two urgent dental centres with different triage and referral systems with regard to quality and appropriateness of referrals, and patient management outcomes. Methods: 110 consecutive referrals received by a primary care urgent dental centre and a secondary care urgent dental centre were assessed. It was considered whether the patients referred had access to remote primary care dental services, fulfilled the criteria required to be deemed a dental emergency as mandated by NHS guidance, and what the outcomes of referrals were. Results: At the primary care centre, 100% of patients were referred by general dental practitioners and had access to remote primary care dental services. 95.5% of referrals were deemed appropriate and were seen for treatment. At the secondary care site, 94.5% of referrals were direct from the patient by contacting NHS 111. 40% had received triaging to include ‘advice, analgesia and antimicrobial’ from a general dental practitioner, and 25.5% were deemed appropriate and resulted in treatment. Conclusion: Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.

scholarly journals A focus group study of older Chinese people with CVD patients in the North West of the UK

2021 ◽  
Vol 22 ◽  
Author(s):  
Shaun Speed ◽  
Zeyuan Sun ◽  
Zhenmi Liu
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Focus Group ◽  
Cultural Values ◽  
Help Seeking ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Chinese Patients ◽  
Focus Group Study ◽  
North West

Abstract Background: Cardiovascular disease (CVD) is the leading cause of death for Chinese migrants around the world. Chinese CVD patients rely heavily on their native Chinese language, cultural values and beliefs, which adds challenges for the healthcare providers to offer primary healthcare services with standard protocol. The inappropriate treatment could lead to life loss, mistrust in doctor-patient relationship and heavy burden for healthcare funding. Methods: 28 participants were included for focus group study with the grounded theory methodology. Results: There is considerable misunderstanding among the Chinese community about the role of primary care doctors in the treatment of cardiovascular disease resulting in the variable use of primary care services. Conclusion: Chinese CVD patients or identified risk factors for CVD arguably need closer management, culturally sensitive advice, support and robust follow-up compared to the general population. Doctors and nurses should enhance their practice and give them confidence in their interaction with Chinese patients on the basis of how they think and behave in relation to help seeking.

scholarly journals O direito à saúde na atenção básica no MERCOSUL: a fraternidade como possibilidade de garantia de direitos sociais / The Right to Primary Healthcare in MERCOSUL: the Fraternity as a Possibility of Social Rights Guarantee

2019 ◽  
Vol 6 (2) ◽  
pp. 33-43
Author(s):  
Sandra Regina Martini ◽  
Maria Isabel Barros Bellini
Keyword(s):  
Primary Care ◽  
Primary Healthcare ◽  
International Organization ◽  
Social Rights ◽  
Economic Policies ◽  
Time Limits ◽  
Access To Primary Care ◽  
The Right ◽  
Dividing Line

ABSTRACTThis article discusses health as a fundamental and universal right therefore not limited to border demarcation, races and / or any other indicator . The analysis Locus is MERCOSUL- international organization between Brazil, Argentina , Paraguay and Uruguay established in 1991 to facilitate the integration of economic policies between these countries, it is associated with Chile and Bolivia. Discusses the importance of resizing the limits of law in today's society , for which the "frontier" is at the same time limits and possibilities between these to promote access to primary care as a bridge to the execution of other social rights thus breaking with traditional dimensions of the border or transfrontier idea where the right ended at the dividing line between one country and another.RESUMENEste artigo aborda a saúde como direito fundamental e universal portanto não limitado a demarcação de fronteiras, raças e/ou qualquer outro indicador. O Lócus de análise é o MERCOSUL -organização internacional entre Brasil, Argentina, Paraguai e Uruguai criada em 1991 para facilitar a integração de políticas econômicas entre estes países, tem como associados o Chile e Bolívia. Discute a importância de redimensionar os limites do direito na sociedade atual, para a qual a “fronteira” representa, ao mesmo tempo limites e possibilidades entre estas o de promover o acesso à atenção básica como uma ponte para a efetivação de outros direitos sociais rompendo assim com as dimensões tradicionais da ideia de fronteira ou transfronteira onde o direito terminava na linha divisória entre um país e outro. Tem como pressupostos teóricos o Direito Vivo e a Metateoria do Direito Fraterno e  aposta no pressuposto da fraternidade como uma possibilidade de agregação e superação das divisões postas pelas fronteiras.

Quality Management in Primary Dental Care

2021 ◽  
pp. 192-212
Author(s):  
A. I. Syngelakis ◽  
Maria Kamariotou ◽  
Fotis C. Kitsios ◽  
Chrystala Charalambous ◽  
Argy Polychronopoulou
Keyword(s):  
Decision Making ◽  
Quality Management ◽  
Dental Care ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Assessment Methods ◽  
Dental Services ◽  
Care Services ◽  
Number Of Publications ◽  
The Cost

In dental care services, quality is an important factor that affects decision making, the planning of health strategies and policies, the cost of health services, and the evaluation of them. The evaluation of quality in dental services using the assessment methods that are used in other services of primary healthcare is difficult due to the special characteristics of dentistry. However, the improvement and the evaluation of primary oral healthcare services is a complicated issue because it involves many factors that affect it. Therefore, the purpose of this chapter is to provide a complete overview of the literature using Webster and Watson's methodology. Fifty peer-reviewed papers were analyzed and the results of this review revealed that the number of publications in this domain has increased in the last decade, and there is a need to foster research (especially empirical) in this field.

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