ABSTRACT
Objective: To compare and analyze the patient perceived quality of care in primary health institutions within medical groups from the experience of Zhenjiang city in Jiangsu Province. Methods : Random selection was used picking the districts and community health centers. In this paper, one district was randomly selected from each medical group,and then one community health center (CHC) was randomly selected in the sample district. The Primary Care Assessment Tool survey (PCAT) was conducted in the sample primary health institutions. Thereafter, data analysis was conducted using the ddescriptive statistics and multi-linear regression methods. Results : Research results showed that the PCAT total score of CHC in Rehabilitation Medical Group (25. 21 ) was significantly higher than that in Jiangbin Medical Group (23.06) with the variation coefficient of β =2. 191. Except for the "extent of affiliation with a place" and " coordination (information systems),,,PCAT scores in all the other core domains were significantly higher in Rehabilitation Medical Group than those in Jiangbin Medical Group. Conclusion : Given the PCAT results, patients perception on quality of care in primary health institutions figuring in Rehabilitation Medical Group was better than those in Jiangbin Medical Group. The close relationship in management and technical skills, and the formation of interest allocation mechanism probably probably contributed into the way towards the results.
ABSTRACT
Objective To evaluate the quality of primary healthcare institutions entrusted to private hospitals as seen by the consumers. Methods The vertical integrated model between Renhe Hospital and Lixian township health center was selected as the case study. Consumer survey data of both November 2016 and September 2017 were collected by using Primary Care Assessment Tool(PCAT) (n=376). Stata 14.0 and Excel 2013 were used for descriptive statistics and multiple linear regression. Results Scoring in such key domains as continuity, comprehensiveness and coordination, and the derivative domains was higher in 2017 than those of 2016. And the differences were significant except for the domain of continuity and coordination (referral). PACT total score in 2017 was 21.28,higher than 19.83 in 2016 and the difference was significant(P<0.01). Conclusions Under the vertical integrated model between Renhe and Lixian, the quality of primary healthcare institutions was improving from 2016 to 2017 from the perspective of consumers. First contact (accessibility), comprehensiveness (services availability) and community orientation of primary healthcare institutions need to be strengthened in the future.
ABSTRACT
Resumo O objetivo deste trabalho foi analisar os estudos que avaliaram o desempenho dos serviços de Atenção Primária à Saúde (APS) mediante uso do instrumento Primary Care Assessment Tool (PCATool) na perspectiva do usuário, em âmbito mundial. Estudo de revisão sistemática, seguindo o modelo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a partir das seguintes bases: Lilacs, MedLine, SciElo, PubMed e Portal de Periódicos da Capes. Os descritores utilizados foram: Primary Care Assessment Tool e PCATool. Seguindo os critérios de inclusão e exclusão, analisaram-se 22 artigos, publicados entre os anos de 2007 a 2015 na literatura nacional e internacional. Os atributos mais bem avaliados foram competência cultural, acesso de primeiro contato subitem utilização e longitudinalidade. Enquanto os piores desempenhos encontrados foram acesso de primeiro contato, acesso de primeiro contato subitem acessibilidade, orientação familiar, orientação comunitária e integralidade. Grande parte dos serviços avaliados eram brasileiros, aplicados nas Unidades Básicas de Saúde e nas Estratégia de Saúde da Família; os serviços avaliados apresentaram necessidade de fortalecimento dos componentes da estrutura e processo para melhor desempenho da APS.
Abstract This study aims to analyze studies that evaluated the performance of Primary Health Care (PHC) services by using the Primary Care Assessment Tool (PCATool) under a worldwide user perspective. This is a systematic review that implemented the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model, from the following databases: Lilacs, Medline, SciELO, PubMed and the Coordination for the Improvement of Higher Education Personnel (CAPES) Journals Website, using descriptors Primary Care Assessment Tool and PCATool. Considering inclusion and exclusion criteria, we analyzed 22 research papers published from 2007 to 2015. The best-evaluated attributes were cultural competence, first contact use and longitudinality. On the other hand, the worst evaluated were first contact accessibility, family orientation, community orientation and comprehensiveness. Most of the health services evaluated were from Brazil, applied to “traditional” primary care clinic (UBS) and the Health Family Strategy (FHS). Services evaluated should strengthen structure and process components to achieve a better performance in PHC.
Subject(s)
Humans , Primary Health Care/organization & administration , Quality of Health Care , Delivery of Health Care/organization & administration , Primary Health Care/standards , Brazil , Comprehensive Health Care/statistics & numerical data , Delivery of Health Care/standards , Cultural CompetencyABSTRACT
Resumo O objetivo deste artigo é avaliar a extensão dos atributos da APS, desde a experiência dos usuários, tanto adultos quanto cuidadores de crianças, comparando a área atendida pelas unidades de saúde do bairro da Rocinha com as demais áreas do distrito sanitário 2.1, no município do Rio de Janeiro. O instrumento de medida utilizado para avaliar a qualidade dos serviços prestados foi o Primary Care Assement Tool. Foi realizado estudo transversal, com amostras aleatórias independentes, com 802 entrevistados. Os resultados apontam melhor desempenho para o cuidado das crianças, quando comparado aos adultos. Os atributos "acesso" e "integralidade - serviços disponíveis" foram aqueles que tiveram os piores desempenhos, provavelmente devido a grande migração externa e interna existente dentro da própria Rocinha. Para melhoria desses atributos, recomendamos a adoção de uma lista única de moradores por ESF, com um número máximo de pessoas, contemplando além da delimitação territorial, a mobilidade interna das pessoas. Destacamos também a importância do fortalecimento do Programa de Residência em Medicina de Família e Comunidade, que desde 2012 forma especialistas, com apoio de preceptores, e viabiliza a ampliação da oferta da carteira de serviços de APS.
Abstract This paper aims to evaluate the extent of PHC attributes, from the experience of users, both adults and children caregivers, comparing the area served by the health facilities of the district of Rocinha with other areas of health district 2.1 in the municipality of Rio de Janeiro. The measuring tool used to evaluate the quality of services provided was the Primary Care Assessment Tools. A cross-sectional study was conducted, with independent random samples and 802 interviewees. Results indicate a better performance for children care when compared to adult care. Attributes "access" and "comprehensiveness - available services" were the worst performers, probably due to the great external and internal migration existing within Rocinha itself. To improve these attributes, we recommend the adoption of a single list of residents by Family Health Team (ESF), with a maximum number of people, including territorial delimitation and people internal mobility. We also highlight the importance of strengthening the Family and Community Medicine Residency Program, which, since 2012, has been training specialists with the support of preceptors and enables increased portfolio of PHC services.
Subject(s)
Humans , Male , Female , Child, Preschool , Adult , Primary Health Care/standards , Quality of Health Care , Patient Satisfaction/statistics & numerical data , Caregivers/statistics & numerical data , Patient Care Team/organization & administration , Brazil , Family Health , Cross-Sectional Studies , Interviews as Topic , Age Factors , Health Services Accessibility , Middle AgedABSTRACT
BACKGROUND: Management of hypertension has been performed mainly in primary care institutions, but hypertension control in population is still unsatisfactory. This study was aimed at finding a strategy to improve health promotion activities in patients with hypertension by exploring the association between health behaviors and quality of primary care. METHODS: April to June in 2007, a questionnaire survey of the patients who has a family physician as a usual source of care was conducted for the development of the Korean Primary Care Assessment Tool (KPCAT). In this study, a usual source of care was defined as a physician of the persons who had visited their primary care clinic on six or more occasions over a period of more than 6 months. Of the data collected from 9 private clinics (3 in Seoul and 6 at small cities), cases of the patients who marked on having hypertension were selected. The associations between levels of quality of primary care and socio-demographic characteristics or health behaviors were analysed by Student t-test and chi-square test. Controlling socio-demographic variables, the association between quality of primary care and health behaviors was examined by multiple logistic regression analysis. RESULTS: Among the patients (n = 602) of 9 private clinics who has a family physician as a usual source of care, those who marked on having hypertension were 134. Among 5 domains of the KPCAT, the highest domain in score was personalized care (71.7/100), and the lowest domain in score was coordination function (49.7/100). In patients who gave total average (69.2/100) or more in total primary care score, after adjustment with age, sex, income, education, and duration, odds ratio to have a normal BMI (<25 kg/m2) was 2.53 (P = 0.02), and odds ratio to have a habit drinking an adequate amount of alcohol was 4.32 (P = 0.02). CONCLUSION: The fact that high-quality primary care was associated with good health behaviors in this study suggests that improving quality of primary care by health care reform can make health behaviors more desirable in patients with essential hypertension.