scholarly journals Actual issues of staffing of primary health care by district paediatrician on the example of the region of the Russian Federation

2021 ◽  
Vol 65 (6) ◽  
pp. 533-539
Author(s):  
Vladimir V. Shkarin ◽  
Viktoriya V. Ivasheva ◽  
Olga S. Emelyanova ◽  
Tamara S. Dyachenko
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Information ◽  
Medical Personnel ◽  
Central Research ◽  
Primary Health ◽  
Medical Institutions ◽  
Volgograd Region ◽  
Number Of Visits ◽  
The Impact

Introduction. Eliminating the personnel shortage in medical institutions that provide primary health care (PHC) to children is one of the priority tasks of the state policy in healthcare. The purpose of the work was to assess the impact of changes in the system of training medical personnel and measures to provide primary care medical personnel, implemented in the Volgograd region, on the availability of PHC for children in 2016-2018. Material and methods. According to the data of Central Research Institute of Healthcare Organization and Informatization and Volgograd Regional Medical Information and Analytical Centre analyzed the indices of provision, staffing of district paediatricians, coefficients of concurrency and the level of availability of PHC to the children’s population. Results and discussion. The number of district paediatricians in medical institutions of the Volgograd region from the period 2016-2018 increased by only 46 people with the graduation of 356 specialists from Volgograd State Medical University, which led to a slight increase in the provision of district paediatricians. At the same time, the staffing rate for pediatric sites and the average number of visits per child decreased from 7.9 to 7.6 cases. The studied indices vary significantly in urban and rural medical institutions. There is a high proportion of pre-retirement and retirement age specialists in the village. Twenty-eight district paediatricians participated in training under the “Zemsky Doctor” program, but some left for various reasons. Conclusion. The presence of pronounced differences in the indicators of provision of paediatricians by district doctors in the number of visits per 1 child between cities and municipal districts indicates significant differences in the availability of medical care. It requires organizational measures to overcome this kind of inequality. Admission to work through the primary accreditation procedure in the speciality “Pediatrics” and the implementation of the program “Zemsky Doctor” have not significantly eliminated the personnel deficit at the primary level.

Self-assessment by medical workers of the degree of influence of working conditions on the development of occupational diseases

2019 ◽  
pp. 463-467 ◽  
Author(s):  
N. N. Petrukhin ◽  
O. N. Andreenko ◽  
I. V. Boyko ◽  
S. V. Grebenkov
Keyword(s):  
Health Care ◽  
Working Conditions ◽  
Occupational Diseases ◽  
Health Workers ◽  
Medical Personnel ◽  
Long Term Memory ◽  
Self Assessment ◽  
Medical Institutions ◽  
Care Workers ◽  
The Impact

Introduction. The activities of health workers are associated with the impact of many harmful factors that lead to loss of health. Compared with other professional groups, health care workers are ill longer and harder, which may be due to polymorbidity pathology.The aim of the study based on the survey data to study the representation of health workers about working conditions and to identify their impact on the formation of occupational diseases.Materials and methods. In order to get a real idea of the attitude of medical workers to their working conditions in 2018, an anonymous survey was conducted of 1129 doctors and 776 employees of secondary and junior medical personnel working in health care institutions in St. Petersburg, Moscow, Krasnoyarsk, Vologda and Orel.Results. Research of working conditions and health of physicians allowed to establish that work in medical institutions imposes considerable requirements to an organism of working, its physical condition and endurance, volume of operational and long-term memory, ability to resist to mental, moral and ethical overloads.Conclusions: The most important method of combating the development of occupational diseases is their prevention. Organizational and preventive measures should be aimed primarily at monitoring the working conditions and health of medical staff .

The Roots of Global Health Inequity

2017 ◽  
Author(s):  
Joia S. Mukherjee
Keyword(s):  
Health Care ◽  
World War Ii ◽  
Primary Health Care ◽  
Economic Policies ◽  
World War ◽  
The Public ◽  
The World Bank ◽  
Primary Health ◽  
The Cold War ◽  
The Impact

This chapter outlines the historical roots of health inequities. It focuses on the African continent, where life expectancy is the shortest and health systems are weakest. The chapter describes the impoverishment of countries by colonial powers, the development of the global human rights framework in the post-World War II era, the impact of the Cold War on African liberation struggles, and the challenges faced by newly liberated African governments to deliver health care through the public sector. The influence of the World Bank and the International Monetary Fund’s neoliberal economic policies is also discussed. The chapter highlights the shift from the aspiration of “health for all” voiced at the Alma Ata Conference on Primary Health Care in 1978, to the more narrowly defined “selective primary health care.” Finally, the chapter explains the challenges inherent in financing health in impoverished countries and how user fees became standard practice.

scholarly journals Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cohort Study ◽  
Primary Health Care ◽  
Rio Grande ◽  
Cognitive Testing ◽  
Rio Grande Do Sul ◽  
Primary Health ◽  
The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

Impact of community participation in primary health care: what is the evidence?

2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Outcomes ◽  
Community Participation ◽  
Service Providers ◽  
Developmental Process ◽  
Service Access ◽  
Primary Health ◽  
Intermediate Outcomes ◽  
The Impact

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.

The Use of and Attitude Towards Telehealth in Rural Communities

2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Routine Practice ◽  
Care Providers ◽  
Urban Hospital ◽  
Primary Health ◽  
The Impact ◽  
Rural Patients

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.

A Human Resource Development Strategy for Primary Health Care: an Exploratory Study of Mixed Methods

2021 ◽  
Author(s):  
Huanhuan Jia ◽  
Hairui Jiang ◽  
Jianxing Yu ◽  
Jingru Zhang ◽  
Zhou Zheng ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Human Resource Development ◽  
Structural Equation ◽  
External Environment ◽  
Medical Personnel ◽  
Public Hospitals ◽  
Individual Development ◽  
Primary Health ◽  
The Government

Abstract Background: The serious shortage of primary health care (PHC) providers is a common issue in the health reforms worldwide, including in China. The government of China have proposed that encouraging and guiding qualified medical personnel to work in primary medical and health care institutions (PMHCIs) is an effective way to improve the overall quality and efficiency of PHC, but it has not produced good results. The problem of insufficient human resources of PHC has not been substantially ameliorated.Methods: Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PMHCIs from the perspective of guided objects. Through a three-phase investigation of 1,160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors.Results: A total of 5 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PMHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG, whereas CCPL had no significant direct effect. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of the institution and the willing of medical personnel to seek employment at PMHCIs. The values of fit index indicated an acceptable-fitting model.Conclusion: Family, remuneration, individual development, and job responsibility are closely related with the willingness of medical personnel to seek employment at PMHCIs, and the internal and external environment of PMHCIs is also an important factor. Based on this, targeted measures can be proposed to promote the development of PHC providers.

scholarly journals Promoting cross-jurisdictional primary health care research: developing a set of common indicators across 12 community-based primary health care teams in Canada

2018 ◽  
Vol 20 ◽  
Author(s):  
Sabrina T. Wong ◽  
Julia M. Langton ◽  
Alan Katz ◽  
Martin Fortin ◽  
Marshall Godwin ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Working Group ◽  
Scale Up ◽  
Data Sources ◽  
Knowledge Generation ◽  
Community Based ◽  
Primary Health ◽  
The Impact

AbstractAimTo describe the process by which the 12 community-based primary health care (CBPHC) research teams worked together and fostered cross-jurisdictional collaboration, including collection of common indicators with the goal of using the same measures and data sources.BackgroundA pan-Canadian mechanism for common measurement of the impact of primary care innovations across Canada is lacking. The Canadian Institutes for Health Research and its partners funded 12 teams to conduct research and collaborate on development of a set of commonly collected indicators.MethodsA working group representing the 12 teams was established. They undertook an iterative process to consider existing primary care indicators identified from the literature and by stakeholders. Indicators were agreed upon with the intention of addressing three objectives across the 12 teams: (1) describing the impact of improving access to CBPHC; (2) examining the impact of alternative models of chronic disease prevention and management in CBPHC; and (3) describing the structures and context that influence the implementation, delivery, cost, and potential for scale-up of CBPHC innovations.FindingsNineteen common indicators within the core dimensions of primary care were identified: access, comprehensiveness, coordination, effectiveness, and equity. We also agreed to collect data on health care costs and utilization within each team. Data sources include surveys, health administrative data, interviews, focus groups, and case studies. Collaboration across these teams sets the foundation for a unique opportunity for new knowledge generation, over and above any knowledge developed by any one team. Keys to success are each team’s willingness to engage and commitment to working across teams, funding to support this collaboration, and distributed leadership across the working group. Reaching consensus on collection of common indicators is challenging but achievable.

scholarly journals Melhores práticas de enfermagem na saúde da pessoa idosa

2020 ◽  
Vol 14 ◽  
Author(s):  
Maria Alice De Freitas ◽  
Angela Maria Alvarez
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Best Practices ◽  
Methodological Approach ◽  
Family Health ◽  
The Elderly ◽  
Structured Interview ◽  
Primary Health ◽  
La Red ◽  
The Impact

Objetivo: compreender, dentro das melhores práticas, as experiências de busca por conhecimento e utilização da experiência profissional dos enfermeiros no cuidado da pessoa idosa na Atenção Primária à Saúde. Método: trata-se de um estudo qualitativo, descritivo e exploratório, com 30 enfermeiros atuantes nas Estratégias Saúde da Família. Utilizou-se um instrumento de entrevista semiestruturado. Analisaram-se os dados pela técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: revelaram-se a busca por conhecimento com outros profissionais e o acesso à rede de internet como fontes de conhecimento. Evidenciou-se a necessidade do estabelecimento de uma rotina de estudos sistematizada e agenda de educação permanente sob a temática do envelhecimento. Conclusão: conclui-se que o estudo confirma que os enfermeiros realizam ações que carecem de notoriedade e que estão preocupados com o impacto de suas ações para o usuário idoso, mas, para que as melhores práticas sejam completamente estabelecidas,  se faz necessária a imersão científica e metodológica dos profissionais e da gestão, além da busca por conhecimento e valorização da experiência, que já coexistem. Descritores: Idoso; Enfermagem; Conhecimento, Atenção Primária à Saúde; Saúde da Pessoa Idosa; Dinâmica Populacional.AbstractObjective: to understand, within the best practices, the experiences of searching for knowledge and using nurses' professional experience in the care of the elderly in Primary Health Care. Method: this is a qualitative, descriptive and exploratory study, with 30 nurses working in the Family Health Strategies. A semi-structured interview instrument was used. Data was analyzed using the Content Analysis technique in the Thematic Analysis modality. Results: the search for knowledge with other professionals and access to the internet network as sources of knowledge were revealed. The need to establish a systematic study routine and a permanent education agenda under the theme of aging became evident. Conclusion: it is concluded that the study confirms that nurses perform actions that lack notoriety and that they are concerned with the impact of their actions for the elderly user, but, for the best practices to be completely established, scientific immersion is necessary and methodological approach of professionals and management, in addition to the search for knowledge and appreciation of experience, which already coexist. Descriptors: Elderly; Nursing; Knowledge; Primary Health Care; Elderly health; Population Dynamics.ResumenObjetivo: comprender, dentro de las mejores prácticas, las experiencias de búsqueda de conocimiento y el uso de la experiencia profesional de los enfermeros en el cuidado de ancianos en Atención Primaria de Salud. Método: estudio cualitativo, descriptivo y exploratorio con 30 enfermeros activos en las Estrategias de Salud Familiar. Se utilizó un instrumento de entrevista semiestructurada. Los datos se analizaron utilizando la técnica de Análisis de Contenido en la modalidad de Análisis Temático. Resultados: se reveló la búsqueda de conocimiento con otros profesionales y el acceso a la red de Internet como fuentes de conocimiento. La necesidad de establecer una rutina de estudio sistemática y una agenda de educación permanente bajo el tema del envejecimiento se hizo evidente. Conclusión: se concluye que el estudio confirma que los enfermeros realizan acciones que carecen de notoriedad y que están preocupados por el impacto de sus acciones para el usuario mayor, pero, para que las mejores prácticas se establezcan por completo, es necesaria la inmersión científica y enfoque metodológico de profesionales y directivos, además de la búsqueda de conocimiento y valoración de la experiencia, que ya coexisten. Descriptores: Anciano; Enfermería; Conocimiento; Atencíon Primária de la Salud; Saúde do Idoso; Dinámica Poblacional.

scholarly journals The value of an integrated approach to assessing the availability of primary health care, taking into account public opinion and EMIAS data

2021 ◽  
Vol 65 (5) ◽  
pp. 411-417
Author(s):  
Sergei S. Budarin ◽  
Andrei V. Starshinin ◽  
Andrei A. Tyazhelnikov ◽  
Elena V. Kostenko ◽  
Yulia V. Elbek
Keyword(s):  
Health Care ◽  
Public Opinion ◽  
Primary Health Care ◽  
Medical Care ◽  
Medical Information ◽  
Integrated Approach ◽  
Sociological Study ◽  
Primary Health ◽  
Level 1 ◽  
Index Value

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.

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