scholarly journals Improving Well-Being Among Trainees: A Partnership to Reduce Barriers to Primary Care Services

2020 ◽  
Vol 12 (2) ◽  
pp. 203-207
Author(s):  
Christelle Tan ◽  
Catherine Kuhn ◽  
John Anderson ◽  
Alexander Borun ◽  
David A. Turner ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Services ◽  
Primary Care Physicians ◽  
Health Care Services ◽  
Well Being ◽  
Post Intervention ◽  
Care Services ◽  
Primary Care Services ◽  
Survey Results

ABSTRACT Background Improved well-being is a focus for graduate medical education (GME) programs. Residents and fellows often express difficulty with visiting primary care physicians, and this issue has not been thoroughly investigated. Objective We reported implementation and utilization of a primary care concierge scheduling service and a primary care video visit service for GME trainees. Methods GME leaders collaborated with Duke Primary Care to offer trainees a concierge scheduling service and opportunity for primary care video visits. This quantitative evaluation included (1) analysis of the institutional GME survey results pre- and post-intervention, and (2) review of use of the concierge scheduling line. Results Comparison of the 2018 and 2019 internal GME surveys showed a decrease in perceived barriers accessing primary care (58% to 31%, P < .0001), a decrease in perceived delays to access primary care (27% to 21%, P = .023), and an increase in respondents who reported needing health care services in the past year (37% to 62%, P < .0001). Although increased need for health services was reported, there was no difference in the proportion reporting use of health services (63% and 65%, P = .43). Of the 142 concierge line calls reviewed, 127 (87%) callers requested clinic appointments, and 15 (10%) callers requested video appointments. Of callers requesting clinic appointments, 99 (80%) were scheduled. Conclusions Providing resources to connect trainees to primary care greatly reduces their perception of barriers to health care and may provide a convenient mechanism to schedule flexible primary care appointments.

scholarly journals The Role of Primary Health Care Toward Healthy Aging

2021 ◽  
Vol 4 (1SP) ◽  
pp. 10
Author(s):  
Dhanasari Vidiawati ◽  
Yuda Turana ◽  
Tonny Sundjaya
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Healthy Aging ◽  
The Elderly ◽  
Preventive Health ◽  
Care Services ◽  
Primary Health

Background: According to the World Health Organization, healthy aging is the process of developing and maintaining functional abilities that make the elderly happy. The increase in the elderly population requires more attention. In particular, health services at the primary health care level face problems related to the limited capacity of overall health services, especially in terms of health promotion and preventive health issues. It is necessary to improve the quality of health care services for the elderly to prevent greater health problems among the elderly population.Objectives: Understand the need to provide holistic health services for healthy aging and use their capabilities, and strengthen cooperation among health professionals in achieving healthy aging.Discusion: Primary health care is pointed out that primary health care should provide comprehensive services in a holistic manner to support a healthy aging process. Therefore, a well-structured, integrated, and cross-industry collaborative primary care system is needed. The system should include changes in professional behavior, coordination of care, and participation of patients' families and communities in comprehensive health care. This can be achieved through inter-professional education, continuous training and education of primary health care professionals, as well as primary health care services and cross-level health care technology innovation.Conclusions: Healthy aging is not just the absence of disease. Everyone in health and social care at all levels can play a role to help improve healthy aging. To make the elderly healthy, starting from the prevention of young health problems, it requires collaboration between health workers, primary health care and other health service levels, and health care that cooperates with patients, families, and communities.Keywords: healthy aging, primary care, preventive, health worker

Accessing primary health care services for transition-aged young adults with cerebral palsy; perspectives of young adults, parents, and physicians

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Erin Brandon ◽  
Marilyn Ballantyne ◽  
Melanie Penner ◽  
Andrea Lauzon ◽  
Erin McCarvill
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Young Adults ◽  
Health Care Services ◽  
Adult Health ◽  
Care Needs ◽  
Medical Needs ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Health Care Services

AbstractBackgroundYoung adults with childhood-onset disabilities experience challenges with accessing age appropriate primary health care services as they transition from pediatric to adult health care services. They often experience a negative impact on their health with associated long-term health and social concerns, disease complications and increased use of emergency services once transitioned to adult services. This is particularly challenging for youth with cerebral palsy (CP) due the complexity of their medical needs. The aim of this study was to explore experiences with accessing or providing primary care services for transitioned-aged young adults with CP from young adult, parent, pediatrician and primary care physician perspectives.MethodsA qualitative descriptive design was conducted to identify the challenges and facilitators for transitioned aged young adults with accessing primary, adult care services. Semi-structured interviews were conducted with 16 participants within the circle of care (4 adults with CP, 4 parents, 4 pediatricians and 4 primary healthcare physicians) for individuals with CP in Toronto, Canada. Interviews were audio-recorded and transcribed verbatim. Qualitative analysis guided both the data collection and the data analysis processes.ResultsData analysis revealed that all participant groups reported transition challenges with respect to accessibility, the suitability of some primary care environments for caring for individuals with complex care needs, gaps in seamless care, and limited time and funding when receiving or providing primary care services to young adults with CP.DiscussionThere is a greater demand for adult healthcare providers now to deliver services for adults with childhood onset disabilities. Transition-aged young adults with CP and complex medical needs have increased challenges with accessing primary care services. Considering the following would improve primary care services transition for this population with complex medical needs: ongoing partnering between pediatric and adult health care streams to promote seamless care; connection to team-based primary care services where family physicians, subspecialties and interprofessional practitioners work together to provide joint care planning; salary compensation for increased service needs due to medical complexity; accessible sites; and development of guidelines for transitioning youth/young adults with complex care needs.

scholarly journals Community-oriented Primary Care Services Model: Can it improve Morbidity Status in India? An Impact Evaluation Study

2017 ◽  
Vol 5 (1) ◽  
pp. 8-14
Author(s):  
Sanjeev Davey ◽  
Pradeep K Kapoor ◽  
Meenu Bala ◽  
Jai V Singh ◽  
Santosh K Raghav ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Evaluation Study ◽  
Medical College ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Care Approach

ABSTRACT Introduction The community-oriented primary care (COPC) services model is an approach prescribed by the Medical Council of India for existing medical colleges in India from their respective urban and rural health training centers (RHTCs). However, the evidence of whether it is better as compared with pure primary health care approach in the Indian context is lacking in the literature. Therefore, it becomes imperative to study this area for its further expansion. Materials and methods The study was done in the catchment area of RHTC and neighboring primary health center (PHC; Makhiyali) attached to the medical college in the district of Western Uttar Pradesh in India. Three surveyed villages out of six villages from July 1, 2016, to December 31, 2016, were taken in this study. Finally, the COPC vs primary health care approach comparison was done on four outcome parameters. Results The utilization of COPC services from RHTC area as compared with primary health care services from PHC area was significantly better for all diseases combined (p < 0.005) and also in the category of management of upper respiratory tract infections (p < 0.0001) and nutritional deficiencies (p < 0.05). On further applying COPC services model, it was also found that RHTC services were significantly better as compared with PHC services in terms of socioeconomic impact on health from services (p < 0.0000), identification of health needs from services (p < 0.0000), and participation in health care services (p < 0.05). Conclusion The COPC services model appears to be successful in the delivery of health care services from RHTC of a medical college as compared with pure primary health care approach delivered from a PHC. However, authors suggest more in-depth multicentric studies on this issue before generalization of COPD model usage across the world. How to cite this article Davey S, Kapoor PK, Bala M, Singh JV, Raghav SK, Singh N. Community-oriented Primary Care Services Model: Can it improve Morbidity Status in India? An Impact Evaluation Study. Int J Res Foundation Hosp Healthc Adm 2017;5(1):8-14.

Service dominant logic and primary care services

2019 ◽  
Vol 11 (1) ◽  
pp. 127-140 ◽  
Author(s):  
May-Kristin Vespestad ◽  
Anne Clancy
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Theoretical Framework ◽  
Content Type ◽  
Care Services ◽  
Primary Care Services ◽  
Health And Social Care ◽  
Micro Level

Purpose The purpose of this study is to explore perceptions of successful collaboration by a group of professionals in primary health care, using service-dominant logic (SDL) as a theoretical framework. Design/methodology/approach This study carries out secondary analysis of the results from a Norwegian national survey on collaboration amongst professionals in primary health care services. Findings Findings illustrate that SDL can provide a theoretical framework for understanding health and social care services. The study provides evidence for the relevance of the theory at micro level. Viewing primary care through the lens of SDL enables an understanding of the applicability of market principles to health and social care. The study illustrates the relevance of the following principles: services are the fundamental basis of exchange; indirect exchange can mask the fundamental basis of exchange. Operant resources are the fundamental source of strategic benefit; actors cannot deliver value but can participate in the creation and offering of value propositions. Social implications Awareness of the use of SDL in health care services can be positive for service provision and it could be incorporated as a supplementary perspective in educational programs for health care professionals. Originality/value Applying principles from SDL as a theoretical framework for primary care services challenges the conventional understanding of marketing in health services. This paper responds to the need for a more in-depth understanding of how SDL can help health care professionals recognize their role as participants in providing seamless health care at micro level.

scholarly journals Mapping Services at Two Nairobi County Primary Health Facilities: Identifying Challenges and Opportunities in Integrated Mental Health Care as a Universal Health Coverage (UHC) Priority

2021 ◽  
Author(s):  
Manasi Kumar ◽  
Vincent Nyongesa ◽  
Martha Kagoya ◽  
Byamah Brian Mutamba ◽  
Beatrice Amugune ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Services ◽  
Health Coverage ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Facilities

Abstract Introduction: We describe a facility mapping exercise conducted in two low-income/primary health facilities in Kenya to identify available service resources, cadres, and developmental partners as well as existing barriers and facilitators in the delivery of mental health services in general and specifically for peripartum adolescents in primary health care. We have tried to embrace the principles of integrating mental health services in primary care and keeping WHO mhGAP in mind. Additionally, primary care facilities’ capacity is a major limiting factor for expanding universal health coverage in low- and middle-income countries. Method and Measures: This study utilized a qualitative evidence synthesis through semi-structured facility services mapping and stakeholder interviews. Services-related data was collected from two facility in-charges using the Nairobi City County Human Resource Health Strategy record forms. Additionally, we conducted 12 key informant interviews (KIIs) with and clinical officers (Clinicians at diploma level), Nurses, Community Health Assistants (CHAs), Prevention of Mother-to-child Transmission of HIV Mentor Mothers (PMTCTMs), around both general and adolescent mental health as well as psychosocial services they offered. Using the World Health Organization Assessments Instrument for Mental Health Systems (WHO-AIMS) as a guideline for the interview, all KII questions were structured to identify the extent of mental health integration in primary health care services. Interview transcripts were then systematically analyzed for common themes and discussed by the first three authors to eliminate discrepancies. Results: Our findings show that health care services centered around physical health were offered daily while the mental health services were offered weekly through specialist services by the Ministry of Health directly or non-governmental partner. Despite Health care workers being aware of the urgent need to integrate mental health services into routine care, they expressed limited knowledge about mental health disorders, lack of trained mental health personnel, the need for more significant funding and resources to provide mental health services, and promotion of CMHS to treat mental health conditions in the primary care setting. Our stakeholders underscored the urgency of integrating mental health treatment, prevention, and well-being promotive activities targeting adolescents especially peripartum adolescent girls.Conclusion: There is a need for further refining of the integrated care model in mental health services and targeted capacity building for health care providers to deliver quality services.

Hypnotherapy as an Adjunct to Medical Treatment: Highlighting Effectiveness and Identifying Barriers to Further Integrative Treatment

2021 ◽  
pp. 097206342110115
Author(s):  
Feryad A. Hussain
Keyword(s):  
Health Care ◽  
Medical Treatment ◽  
Health Care Services ◽  
Well Being ◽  
Medical Treatments ◽  
Care Services ◽  
Secondary Health Care ◽  
History Of ◽  
Clinical Hypnosis ◽  
The Mind

Integrative models of health care have garnered increasing attention over the years and are currently being employed within acute and secondary health care services to support medical treatments in a range of specialities. Clinical hypnosis has a history of working in partnership with medical treatments quite apart from its psychiatric associations. It aims to mobilise the mind–body connection in order to identify and overcome obstacles to managing symptoms of ill health, resulting in overall improved emotional and physical well-being. This article aims to encourage the use of hypnotherapy in physical health care by highlighting the effectiveness of hypnosis as an adjunct to medical treatment and identifying barriers preventing further integrative treatments.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

Virtual Primary Care Implementation during COVID-19 in High-Income Countries: A Scoping Review (Preprint)

2021 ◽  
Author(s):  
Kristina De Vera ◽  
Priyanka Challa ◽  
Rebecca H Liu ◽  
Kaitlin Fuller ◽  
Anam Shahil Feroz ◽  
...  
Keyword(s):  
Primary Care ◽  
Scoping Review ◽  
Primary Care Physicians ◽  
Underserved Populations ◽  
High Income ◽  
Lessons Learned ◽  
Regulatory Policies ◽  
Care Services ◽  
Virtual Care ◽  
Primary Care Services

BACKGROUND Primary care physicians across the world are grappling with adopting virtual services to provide appropriate patient care during the COVID-19 pandemic. As the crisis continues, it is imperative to recognize the wide-scale barriers and seek strategies to mitigate the challenges of rapid adoption to virtual care felt by patients and physicians alike. OBJECTIVE The purpose of this scoping review was to map the challenges, strategies, and lessons learned from high-income countries that can be mobilized to inform decision-makers on how to best implement virtual primary care services during and after the COVID-19 pandemic. Moreover, the findings of our scoping review identified the barriers and strategies within the Quadruple Aim components, which may prove to be an effective implementation strategy for virtual care adoption in primary care settings. METHODS The two concepts of virtual care and COVID-19 were searched in MEDLINE, EMBASE, and CINAHL on Aug 10, 2020, and Scopus was searched on Aug 15, 2020. The database searches returned 10,549 citations and an additional 766 citations were retrieved from searching the citations from the reference lists of articles that met all inclusion criteria. After deduplication, 6,580 unique citations remained. Following title and abstract screening, 1,260 full-text articles were reviewed, of which 49 articles were included for data extraction, and 38 articles met the eligibility criteria for inclusion in the review. RESULTS Seven factors were identified as major barriers to the implementation of virtual primary care. Of the 38 articles included in this scoping review, 20 (53%) articles focused on challenges to equitable access to care, specifically regarding the lack of access to internet, smartphones, and Internet bandwidth for rural, seniors, and underserved populations. The second most common factor discussed in the articles was the lack of funding for virtual care (n= 14; 37%), such as inadequate reimbursement policies for virtual care. Other factors included negative patient and clinician perceptions of virtual care (n=11; 29%), lack of appropriate regulatory policies (n= 10, 26%), inappropriate clinical workflows (n= 9, 24%), lack of virtual care infrastructure (n= 8; 21%), and lastly, a need for appropriate virtual care training and education for clinicians (n=5;13%). CONCLUSIONS This review identified several barriers and strategies to mitigate those barriers that address the challenges of virtual primary care implementation related to equity, regulatory policies, technology and infrastructure, education, clinician and patient experience, clinical workflows, and funding for virtual care. These strategies included providing equitable alternatives to access care for patients with limited technical literacy and English proficiency and altering clinical workflows to integrate virtual care services. As many countries enter potential subsequent waves of the COVID-19 pandemic, applying early lessons learned to mitigate implementation barriers can help with the transition to equitable and appropriate virtual primary care services.

The Role of the Primary Care Physician in the Care of Children with Serious Heart Disease

PEDIATRICS ◽  
1994 ◽  
Vol 94 (3) ◽  
pp. 284-290
Author(s):  
Paul C. Young ◽  
Yu Shyr ◽  
M. Anthony Schork
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Chronic Illness ◽  
Medical Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Care Needs ◽  
Care Services ◽  
Primary Care Services

Objective. To determine the roles of primary care physicians and specialists in the medical care of children with serious heart disease. Setting. Pediatric Cardiology Division; Tertiary Care Children's Hospital. Subjects. Convenience sample of parents, primary care physicians, and pediatric cardiologists of 92 children with serious heart disease. Design. Questionnaire study; questionnaires based on 16 medical care needs, encompassing basic primary care services, care specific to the child's heart disease and general issues related to chronic illness. Results. All children had a primary care physician (PCP), and both they and the parents (P) reported high utilization of PCP for basic primary care services. However, there was little involvement of PCP in providing care for virtually any aspect of the child's heart disease. Parents expressed a low level of confidence in the ability of PCP in general or their child's own PCP to meet many of their child's medical care needs. Both PCP and pediatric cardiologists (PC) were significantly more likely than parents to see a role for PCP in providing for care specific to the heart disease as well as more general issues related to chronic illness. PC and PCP generally agreed about the role PCP should play, although PC saw a bigger role for PCP in providing advice about the child's activity than PCP themselves did. PC were less likely to see the PCP as able to follow the child for long term complications than PCP did. PC were more likely than PCP to believe that PCP were too busy or were inadequately reimbursed to care for children with serious heart disease. Only about one-third of parents reported discussing psychosocial, family, economic, or genetic issues with any provider, and PCP were rarely involved in these aspects of chronic illness. Conclusions. Primary care physicians do not take an active role in managing either the condition-specific or the more general aspects of this serious chronic childhood illness. With appropriate information and support from their specialist colleagues primary care physicians could provide much of the care for this group of children. Generalists and specialists are both responsible for educating and influencing parents about the role primary care physicians can play in caring for children with serious chronic illness.

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