scholarly journals Desempenho e Importância da Atenção Básica na Prevenção e Controle da Tuberculose: Revisão de Literatura

2019 ◽  
Vol 23 (2) ◽  
pp. 80
Author(s):  
Mikaela Lopes de Caldas ◽  
Francisco Das Chagas Cardoso Filho
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Mycobacterium Tuberculosis ◽  
Primary Health Care ◽  
Communicable Disease ◽  
Control Measures ◽  
Historical Period ◽  
Tuberculosis Control ◽  
Treatment And Prevention ◽  
Primary Health

A tuberculose (TB) é uma doença infecciosa e transmissível, causada pelo Mycobacterium tuberculosis. A detecção de casos figura entre as principais medidas de controle da tuberculose, embora grandes avanços tenham ocorrido no que se relaciona ao diagnóstico, tratamento e prevenção da doença, a mesma ainda requer atenção especial, por parte dos profissionais da saúde (equipe multiprofissional) e da sociedade como um todo. A Atenção Básica se caracteriza como ferramenta primordial na suspeição e na detecção dos casos de tuberculose na comunidade. O objetivo geral do presente trabalho é identificar produções científicas que avaliem o desempenho da Atenção Básica no controle da tuberculose. Os objetivos específicos foram: ressaltar a importância da Atenção Básica na detecção dos casos suspeitos; expor a relevância da Atenção Básica como fator indispensável no controle da tuberculose. Caracteriza-se como uma pesquisa bibliográfica explicativa e explorativa, realizada no recorte histórico de 1998 a 2011, período esse definidor para a implementação de medidas de controle da tuberculose. Encontraram-se 29 referências, das quais 19 obedeciam aos critérios de inclusão. Portanto, a Atenção Básica caracterizada como principal porta de entrada ao acesso à saúde, proporciona a aproximação do cidadão às medidas de controle da tuberculose, assim como promove a educação em saúde, que visa a prevenção dos agravos e proporcionam autonomia e autoconhecimento que são indispensáveis para a manutenção da saúde frente às doenças preveníveis como a tuberculose, porém que se configuram como problemas de saúde pública. Palavras-chave: Tuberculose. Atenção Básica. Controle. AbstractTuberculosis (TB) is an infectious and communicable disease caused by mycobacterium tuberculosis. The case detection is one of the main control  measures of tuberculosis, although major advances have occurred regarding the diagnosis, treatment and prevention of the disease, the same still requires special attention on the part of health professionals (multidisciplinary team) and society as a whole. The primary care is characterized as a primary tool in suspicion and detection of tuberculosis cases in the community. The overall objective of this study is to identify scientific production to assess the performance of primary health care in tuberculosis control. The specific objectives were to highlight the importance of primary care in the detection of suspected cases; expose the relevance of primary health care as an essential factor in tuberculosis control. It is characterized as an explanatory and exploratory literature survey, conducted in historical period from 1998 to 2011, a period defined for the implementation of tb control measures. It was found 29 references, 19 of which obeyed the inclusion criteria. Therefore, the primary care characterized as the main gateway to access to health, provides the citizen’s approach to tuberculosis control measures and promotes health education aimed at prevention of injuries and provides autonomy and self-knowledge that are essential for maintenance health against preventable diseases such as tuberculosis, but which are seen as  the main  public health problems. Keywords: Tuberculosis. Primary Care. Control. 

scholarly journals Primary Care Practitioners’ Response to 2019 Novel Coronavirus Outbreak in China

2020 ◽  
Author(s):  
Zhijie Xu ◽  
Yi Qian ◽  
Lizheng Fang ◽  
Mi Yao
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Communicable Disease ◽  
National Sample ◽  
Primary Health Care System ◽  
Communicable Disease Control ◽  
Primary Health ◽  
Primary Care Practitioners ◽  
Novel Coronavirus

The emerging outbreak of the 2019 novel coronavirus (2019-nCoV) originated from Wuhan poses a great challenge to healthcare system in China.1 Primary care practitioners (PCPs) have an important role in district communicable disease control.2 However, because primary health-care system in China still needs to be substantially strengthened,3,4 whether PCPs are proactive and capable in responding to the outbreak remains unclear. Using an electronic questionnaire, we surveyed a national sample of PCPs to assess their response to novel coronavirus outbreak.

scholarly journals Avaliação dos atributos da atenção primária à saúde nas ações de controle da hanseníase [Assessment of the attributes of primary health care in leprosy control actions] [Evaluación de los atributos de la atención primaria a la salud en las acciones de control de la lepra]

2018 ◽  
Vol 26 ◽  
pp. e31925 ◽  
Author(s):  
Nayara Figueiredo Vieira ◽  
Fernanda Moura Lanza ◽  
Francisco Carlos Félix Lana ◽  
José Ramón Martínez-Riera
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Minas Gerais ◽  
Control Measures ◽  
Assessment Instrument ◽  
Cross Sectional ◽  
Primary Health ◽  
Leprosy Control

Objetivo: avaliar a presença e extensão dos atributos da atenção primária nas ações de controle da hanseníase, na visão dos profissionais de saúde. Método: estudo transversal, envolvendo 251 profissionais da atenção primária de Betim. Utilizou-se o Instrumento de avaliação de desempenho da atenção primária nas ações de controle da hanseníase, mediante entrevistas, sendo o escore calculado por meio da média das respostas dadas pelas Escala de Likert. Foi aprovado pelo Comitê de Ética e Pesquisa da Universidade Federal de Minas Gerais. Resultados: forte orientação do serviço (≥6,6) nos atributos porta de entrada, integralidade dos serviços disponíveis e prestados, e orientação familiar; e fragilidades (<6,6) no acesso, orientação comunitária e profissional. Conclusão: ao avaliar a presença e extensão dos referidos atributos, os profissionais constataram deficiências que prejudicam a qualidade das ações de controle da hanseníase. Torna-se necessário integrar as ações da endemia na atenção primária para eliminar esse grave problema de saúde pública.ABSTRACTObjective: to evaluate the presence and extent of the attributes of primary health care in leprosy control measures in the view of health professionals. Method: this cross-sectional study involved 251 primary health care personnel in Betim. The Assessment Instrument primary care performance in leprosy control measures was used through interviews, with scores calculated as means of Likert Scale responses. The study was approved by the research ethics committee of Minas Gerais Federal University. Results: strengths (≥ 6.6) were service orientation to gateway attributes, comprehensiveness of services available and provided, and the family; and weaknesses (<6.6) were access, and orientation towards the community and health professionals. Conclusion: when evaluating the presence and extent of the attributes, the health professionals found deficiencies that impaired the quality of leprosy control measures. Measures to address the endemic must be integrated into primary care in order to eliminate this serious public health problem.RESUMENObjetivo: evaluar la presencia y extensión de los atributos de la atención primaria en las acciones de control de la lepra desde el punto de vista de profesionales de salud. Método: estudio transversal, involucrando a 251 profesionales de la atención primaria de Betim. Se utilizó el Instrumento de evaluación de rendimiento de la atención primaria en las acciones de control de la lepra, a través de entrevistas, siendo la puntuación calculada a través del promedio de las respuestas dadas por la escala de Likert. Estudio aprobado por el Comité de Ética en Investigación de la Universidad Federal de Minas Gerais. Resultados: fuerte orientación del servicio (≥6,6) en los atributos puerta de entrada, integralidad de los servicios disponibles y ofrecidos, orientación familiar y fragilidades (<6,6) en el acceso, orientación comunitaria y profesional. Conclusión: al evaluar la presencia y extensión de los mencionados atributos, los profesionales constataron deficiencias que perjudican la calidad de las acciones de control de la lepra. Se hace necesario integrar las acciones de la endemia en la atención primaria para eliminar este grave problema de salud pública.

Brazilian National Household Health Survey and PCAT: the case of Mato Grosso do Sul, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Pinto ◽  
D Soranz ◽  
L J Santos ◽  
M S Paranhos ◽  
L S Malta ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Health Survey ◽  
Household Surveys ◽  
Mato Grosso ◽  
Primary Health ◽  
The World ◽  
Mato Grosso Do Sul

Abstract Brazil is divided into five administrative regions, 27 federation units and 5,570 municipalities. Mato Grosso do Sul is one of the states located in the Midwest region and has 1.6 million km2 and a resident population of 2.8 million inhabitants, that is, it has an even lower demographic density than its region - only 7.8 inhabitants/km2. Mato Grosso do Sul has part of the Pantanal, a biome considered the largest continuous floodplain in the world, rich in biodiversity. For this reason, displacements for data collection in household surveys combine roads and rivers. In 2019, the Brazilian National Institute of Geography and Statistics (Istituto Nazionale di Statistica del Brasile) in partnership with the Ministry of Health launched the world's largest household sample survey, the National Health Survey (PNS-2019), in which part of its questions included the use of Primary Care Assessment Tool (PCAT, adult version), created by professors Barbara Starfield and Leiyu Shi in the 2000s. IBGE interviewers visited more than 100,000 households across the country. In Mato Grosso do Sul, more than 3,000 households were surveyed. In this work, we present the data collection instrument used by IBGE and its multiple analysis possibilities in the scope of primary health care, crossing the variables from other questionnaire modules in order to compare the results from Brazil with the state of Mato Grosso do Sul and its capital, Campo Grande. Developing a baseline and measuring the attributes of primary health care in each of the Brazilian states is another step towards giving health policy accountability, towards strong primary care. IBGE's experience in household surveys and innovation in data collection in primary care is an example for the world that yes, it is possible to develop statistically representative national sample surveys and make them perennial in their regular household surveys, by the time World Health Organization (WHO) discusses universal health coverage. Key messages Evaluation of primary care using an internationally validated instrument is possible on national bases with random household sample surveys. A questionnaire elaborated academically can be used as an instrument of public policy to evaluate nationwide health services.

scholarly journals Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pinto ◽  
J V Santos ◽  
M Lobo ◽  
J Viana ◽  
J Souza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Pay For Performance ◽  
Care Quality ◽  
Organizational Model ◽  
Avoidable Hospitalizations ◽  
Primary Health ◽  
Age And Sex

Abstract Background In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality. Methods We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model. Results Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865). Conclusions Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed. This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”. Key messages Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.

scholarly journals Cross-cultural adaptation of the primary health care satisfaction questionnaire

2014 ◽  
Vol 27 (5) ◽  
pp. 419-426 ◽  
Author(s):  
Elisabete Pimenta Araujo Paz ◽  
Pedro Miguel Santos Dinis Parreira ◽  
Alexandrina de Jesus Serra Lobo ◽  
Rosilene Rocha Palasson ◽  
Sheila Nascimento Pereira de Farias
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Cultural Adaptation ◽  
Care Service ◽  
Cross Cultural ◽  
Care Services ◽  
Primary Health

Objective To develop the cross-cultural validation and assessment of the psychometric properties of the Questionnaire about the quality and satisfaction dimensions of patients with primary health care. Methods Methodological cultural adaptation and assessment study of the psychometric properties, involving 398 users from a primary care service. The construct validity was verified through principal components factor analysis and internal consistency assessment as determined by Cronbach’s alpha, using SPSS. Results A factorial structure was identified that is equivalent to the original instrument, showing six factors that explain 70.81% of the total variance. All internal consistency coefficients were higher than 0.84, indicating appropriate psychometric properties. Conclusion The results show that the Brazilian Portuguese version of the instrument is culturally and linguistically appropriate to assess the satisfaction of users attended in primary care services.

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 Partnership in Practice: a multidisciplinary approach to quality improvement in primary health care

1995 ◽  
Vol 19 (6) ◽  
pp. 371-371
Author(s):  
Michael Phelan
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
General Practitioners ◽  
Multidisciplinary Approach ◽  
Professional Groups ◽  
Primary Health ◽  
Audit Team

This one day seminar was arranged by the King's Fund Organisational Audit team (KFOA), to take a multidisciplinary view of quality improvement in primary care. Despite the title of the day all the speakers were general practitioners and managers, and input from other professional groups was limited to questions and comments from the audience of nearly 200.

scholarly journals Impact of mental health and addiction NIMHANS ECHO on primary care physicians: study from a rural state of India

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Providers ◽  
Primary Health ◽  
Secondary Outcomes

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.

scholarly journals The Future of Health Care: Protocol for Measuring the Potential of Task Automation Grounded in the National Health Service Primary Care System (Preprint)

2018 ◽  
Author(s):  
Matthew Willis ◽  
Paul Duckworth ◽  
Angela Coulter ◽  
Eric T Meyer ◽  
Michael Osborne
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Care Staff ◽  
Primary Health ◽  
The Future

BACKGROUND Recent advances in technology have reopened an old debate on which sectors will be most affected by automation. This debate is ill served by the current lack of detailed data on the exact capabilities of new machines and how they are influencing work. Although recent debates about the future of jobs have focused on whether they are at risk of automation, our research focuses on a more fine-grained and transparent method to model task automation and specifically focus on the domain of primary health care. OBJECTIVE This protocol describes a new wave of intelligent automation, focusing on the specific pressures faced by primary care within the National Health Service (NHS) in England. These pressures include staff shortages, increased service demand, and reduced budgets. A critical part of the problem we propose to address is a formal framework for measuring automation, which is lacking in the literature. The health care domain offers a further challenge in measuring automation because of a general lack of detailed, health care–specific occupation and task observational data to provide good insights on this misunderstood topic. METHODS This project utilizes a multimethod research design comprising two phases: a qualitative observational phase and a quantitative data analysis phase; each phase addresses one of the two project aims. Our first aim is to address the lack of task data by collecting high-quality, detailed task-specific data from UK primary health care practices. This phase employs ethnography, observation, interviews, document collection, and focus groups. The second aim is to propose a formal machine learning approach for probabilistic inference of task- and occupation-level automation to gain valuable insights. Sensitivity analysis is then used to present the occupational attributes that increase/decrease automatability most, which is vital for establishing effective training and staffing policy. RESULTS Our detailed fieldwork includes observing and documenting 16 unique occupations and performing over 130 tasks across six primary care centers. Preliminary results on the current state of automation and the potential for further automation in primary care are discussed. Our initial findings are that tasks are often shared amongst staff and can include convoluted workflows that often vary between practices. The single most used technology in primary health care is the desktop computer. In addition, we have conducted a large-scale survey of over 156 machine learning and robotics experts to assess what tasks are susceptible to automation, given the state-of-the-art technology available today. Further results and detailed analysis will be published toward the end of the project in early 2019. CONCLUSIONS We believe our analysis will identify many tasks currently performed manually within primary care that can be automated using currently available technology. Given the proper implementation of such automating technologies, we expect considerable staff resources to be saved, alleviating some pressures on the NHS primary care staff. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11232

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