Apuntes históricos sobre del proceso de formación del médico general integral en Cuba / Historical notes on the training process of the comprehensive general doctor in Cuba

La salud pública cubana se sustenta en la Atención Primaria de Salud y, con ello, la instauración de la especialidad de medicina general integral en 1985, con cambios sustanciales hasta la actualidad, ha dado un importante paso de avance en la accesibilidad y calidad en los servicios médicos; transformación necesaria en el Sistema Nacional de Salud. Teniendo en cuenta lo anterior se realizó el presente estudio con vistas a profundizar en las tendencias históricas por las que ha transitado el proceso de formación del médico general integral en Cuba. Se concluye que dicho proceso ha tenido transformaciones que obedecen a las necesidades nacionales e internacionales, donde todas las versiones del programa consideran la educación en el trabajo como protagonista en los servicios de salud.

The Cuban public health is sustained in the Primary Health Care which improvement has been favored with the establishment of the comprehensive general medicine specialty in 1985, with substantial changes until the present time that have propitiated a step of important advance in the accessibility and quality in the medical services. Taking into account the above-mentioned the present study was carried out aimed at deepening in the historical tendencies that the training process of the comprehensive general doctor in Cuba has gone through. It was concluded that this process has had transformations that obey the national and international necessities, where all the versions of the program consider the education at work as main character in health services.

Exploration on the management path of home-based aging-medical care integration of family doctor teams / 中华医院管理杂志

Under the background that the family doctor teams undertake the evaluation function of long-term care insurance for the elderlies living at home, it is imperative to further improve the efficiency of its integrated aging-medical care by strengthening the management. The Huacao community health service center and Hongqiao community health service center in Minhang District of Shanghai explored the construction of a family doctor′s home-based aging care management path, a practice launched since February 2021. This path was mainly designed with the entry criteria, management requirements for various services and evaluation indicators, with a service path form formulated on such basis. The form covered three stages: that before the on-site service, that on the day of the on-site service and that after the on-site service. Each stage was subdivided into three dimensions: the work content of the main aging-medical care, the key works of family doctors and the key works of assistant nurses. The implementation of this management path can enable such teams to provide further refined, standardized and procedural aging-medical care services, avoid service delays, improve service quality and management efficiency, and improve the utilization efficiency of health resources.

Study on the influence of residents′ psychological contracts on their behavioral intentions from the perspective of incomplete contracts / 中华医院管理杂志

Objective:To analyze the psychological contract satisfaction of contracted residents and its impact on their behavioral intentions under the guidance of incomplete contract theory, for reference in improving the effectiveness of contracted family doctor services.Methods:1 100 contracted residents from nine townships/streets in Shandong province were selected as subjects according to stratified random sampling from September 2019 to June 2020, and a questionnaire survey on the level of satisfaction of contracted residents′ psychological contracts(24 items) and assessment of behavior intentions(9 items) was conducted, and the model of the effect of contracted residents′ psychological contracts on behavior intentions was established and analyzed. The correlation was validated by Pearson test and the structural equation method was used for verifying the model.Results:998 valid questionnaires were recovered. The psychological contract satisfaction score of the contracted residents was 3.45±0.56 and the behavioral intention was 2.81±0.29. Both transactional and relational psychological contracts were correlated with all dimensions of behavioral intention( P<0.01). Concerning the impacts of residents′ psychological contracts on behavioral intentions, the effect coefficients of transactional psychological contracts on loyalty intention, voice intention, exit intention and neglect intention were 0.33, 0.24, -0.25 and -0.49 respectively, with an indirect effect on neglect intention; the effect coefficients of relational psychological contracts on loyalty intention, voice intention, exit intention and neglect intention were 0.26, 0.10, -0.14 and -0.50 respectively, with an indirect effect on advice intention and neglect intention. Conclusions:Residents′ psychological contract has yet not been effectively satisfied. Satisfying and improving the residents′ psychological contract can directly enhance their loyalty intention and reduce their exit intention, indirectly influencing the voice and neglect intentions. In order to enhance the effectiveness of family doctor contracted services and improve the healthcare experience of contracted residents, it is suggested that the relevant departments should actively take the following measures, including carrying out a survey on the psychological contract of contracted residents, building a provincial-city-county-township collaborative linkage platform, and so on.

Curso de capacitación a médicos de familia sobre cuidados biosicosociales a niños con síndrome de Down / Training Course for Family Doctors about Biopsychosocial Cares for Children with Down Syndrome

Introducción: Los niños con síndrome de Down presentan una comorbilidad alta, por lo que se hace necesario mantener un adiestramiento a los médicos de familia para el control y prevención de estas enfermedades. Objetivo: Evaluar un curso de capacitación a médicos de familia sobre los cuidados biopsicosociales a niños con síndrome de Down. Métodos: Se realizó un cuasi experimento a través de un diseño antes-después con un grupo estudio y otro grupo control. En una primera etapa o pretest se aplicó un cuestionario a ambos grupos, después se impartió el curso de capacitación al grupo estudio y en la última etapa o postest se volvió a emplear el mismo cuestionario a los dos grupos y determinar el nivel de conocimiento alcanzado. Resultados: Antes del curso de capacitación, 7 (26,9 por ciento) de médicos de familia del grupo estudio obtuvieron calificación de aceptable; después de recibir el curso aumentó a 22 (84,6 por ciento). La diferencia estándar y la media fue superior en el grupo estudio en relación al grupo control. Conclusiones: Con el curso de capacitación diseñado y aplicado a médicos de familia aumentaron los conocimientos sobre los cuidados biopsicosociales a los niños con síndrome de Down(AU)

Introduction: Children with Down syndrome present high comorbidity, a reason why it is necessary to maintain training for family doctors for the control and prevention of such conditions. Objective: To assess a training course targeted at family doctors about biopsychosocial care for children with Down syndrome. Methods: A quasiexperimental study was carried out using a before-after design with a study group and a control group. In a first stage, or pretest, a questionnaire was applied to both groups. Afterwards, the training course was given to the study group. In the last stage, or post-test, the same questionnaire was used again for the two groups, after which the level of knowledge reached was determined. Results: Before receiving the training course, 7 (26.9 percent) family doctors in the study group obtained an acceptable rating. After receiving the course, it increased to 22 (84.6 percent). The mean and standard difference was higher in the study group compared to the control group. Conclusions: With the training course designed and given to family doctors, the knowledge about biopsychosocial care for children with Down syndrome increased(AU)

Conocimientos sobre COVID-19 en médicos de familia recién egresados de la universidad / Knowledge about COVID-19 in family physicians recently graduated from the university / Conhecimento sobre COVID-19 em médicos de família recém-formados pela universidade

RESUMEN La enfermedad por el nuevo coronavirus continúa azotando a la humanidad. Su conocimiento profundo constituye una necesidad, como único camino para erradicarla. Se realizó una investigación cuasi experimental tipo intervención educativa con el objetivo de fortalecer conocimientos sobre la COVID-19 en médicos generales básicos recién egresados de la universidad e incorporados a ejercer como médicos de familias, pertenecientes al Policlínico Jimmy Hirzel de Bayamo, provincia Granma. La muestra la integraron 42 médicos, y se caracterizó según género e índice académico del egresado. Se evaluó el nivel de conocimiento en adecuado e inadecuado, según respuestas acerca de generalidades de la enfermedad, manifestaciones clínicas, medios diagnósticos y su interpretación, medidas de prevención y conducta a seguir ante casos sospechosos y positivos; se precisó fuente de adquisición de conocimientos. Se emplearon métodos teóricos, empíricos y estadísticos. Como resultados predominaron las mujeres (59,5%), y el índice académico del egresado entre 4 y 4,7 puntos (73,8%). Los conocimientos sobre la conducta a seguir por el médico de familia con los grupos vulnerables sospechosos de COVID -19 fueron inadecuados en el 69,1 % de los médicos, situación que se modificó favorablemente con la intervención educativa, al alcanzar el 85,7 % adecuados conocimientos. En el resto de los temas destacó el nivel adecuado de conocimiento desde la etapa inicial de la investigación. Se concluyó que la intervención permitió revelar las fisuras en el conocimiento de los médicos recién graduados y potenciarlo en todos los temas abordados.

ABSTRACT The new coronavirus disease continues to plague humanity. Its deep knowledge is a necessity, as the only way to eradicate it. A quasi-experimental research type educational intervention was carried out with the aim of strengthening knowledge about COVID-19 in basic general practitioners recently graduated from the university and incorporated to practice as family doctors, belonging to the Jimmy Hirzel Polyclinic of Bayamo, Granma province. The sample was made up of 42 doctors, and it was characterized according to gender and academic index of the graduate. The level of knowledge was evaluated as adequate and inadequate, according to answers about generalities of the disease, clinical manifestations, diagnostic means and their interpretation, prevention measures and behavior to follow in suspicious and positive cases; source of knowledge acquisition was specified. Theoretical, empirical and statistical methods were used. As results, women (59.5%) predominated, and the graduate's academic index between 4 and 4.7 points (73.8%). Knowledge about the behavior to be followed by the family doctor with the vulnerable groups suspected of COVID-19 was inadequate in 69.1% of the doctors, a situation that was favorably modified with the educational intervention, reaching 85.7% adequate knowledge. In the rest of the topics, the adequate level of knowledge was highlighted from the initial stage of the research. It was concluded that the intervention made it possible to reveal the gaps in the knowledge of recently graduated doctors and to enhance it in all the topics addressed.

RESUMO A nova doença coronavírus continua a atormentar a humanidade. Seu conhecimento profundo é uma necessidade, como única forma de erradicá-lo. Foi realizada uma intervenção educacional do tipo pesquisa quase experimental com o objetivo de fortalecer o conhecimento sobre o COVID-19 em clínicos gerais recém-formados na universidade e incorporados à prática como médicos de família, pertencentes à Policlínica Jimmy Hirzel de Bayamo, província de Granma. A amostra foi composta por 42 doutores e foi caracterizada de acordo com o sexo e índice acadêmico da pós-graduação. O nível de conhecimento foi avaliado como adequado e inadequado, de acordo com as respostas sobre generalidades da doença, manifestações clínicas, meios diagnósticos e sua interpretação, medidas de prevenção e comportamentos a seguir em casos suspeitos e positivos; fonte de aquisição de conhecimento foi especificada. Foram utilizados métodos teóricos, empíricos e estatísticos. Como resultados, houve predomínio do sexo feminino (59,5%) e índice de escolaridade da pós-graduação entre 4 e 4,7 pontos (73,8%). O conhecimento sobre o comportamento a ser seguido pelo médico de família com os grupos vulneráveis ​​suspeitos de COVID-19 foi inadequado em 69,1% dos médicos, situação que se modificou favoravelmente com a intervenção educativa, chegando a 85,7% conhecimento adequado. Nos demais tópicos, destacou-se o nível de conhecimento adequado desde a etapa inicial da pesquisa. Concluiu-se que a intervenção possibilitou revelar lacunas no conhecimento dos médicos recém-formados e aprimorá-lo em todos os temas abordados.

Competencia y desempeño del médico de la familia en la prevención de la conducta suicida a nivel comunitario / Competence and performance of the family doctor in the prevention of suicidal behavior at the community level / Competência e atuação do médico de família na prevenção do comportamento suicida na comunidade

RESUMEN La investigación tiene como objetivo evaluar la competencia profesional y el desempeño del médico de familia en la prevención y control de la conducta suicida. Se realizó un estudio descriptivo, el universo fueron33médicos (residentes y especialistas) distribuidos en las 18 áreas de salud del Policlínico No.2 de Manzanillo. La información se obtuvo de una encuesta que permitió determinar el nivel de competencia específica para la prevención del intento y/o suicidio, una guía para evaluar el desempeño profesional y una entrevista focalizada buscando la triangulación metodológica. La mayoría de los médicos obtienen una competencia inadecuada 81.8%, la razón expresa que por cada 6 médicos evaluados con una competencia inadecuada hay solo 1 con una competencia adecuada, el 75.8%fueron evaluados con un desempeño profesional inadecuado, la razón expresa que por cada 5 médicos evaluados con un desempeño inadecuado hay solo 1 con un desempeño adecuado. Con la aplicación de los instrumentos validados se comprobó insuficientes conocimientos en los médicos de familia para el manejo de este daño a la salud a nivel comunitario lo que limita su actuación en la práctica asistencial y denota la necesidad de la superación postgraduada para resolver las insuficiencias detectadas.

ABSTRACT The research aims to evaluate the professional competence and performance of the family doctor in the prevention and control of suicidal behavior. A descriptive study was carried out, the universe was 33 doctors (residents and specialists) distributed in the 18 health areas of the Polyclinic No.2 of Manzanillo. The information was obtained from a survey that made it possible to determine the level of specific competence for the prevention of attempt and / or suicide, a guide to evaluate professional performance and a focused interview seeking methodological triangulation. Most of the doctors obtain an inadequate competence 81.8%, the reason expresses that for every 6 doctors evaluated with an inadequate competence there is only 1 with an adequate competence, 75.8% were evaluated with an inadequate professional performance, the reason expresses that for each 5 doctors evaluated with an inadequate performance there is only 1 with an adequate performance. With the application of the validated instruments, insufficient knowledge was found in family physicians for the management of this damage to health at the community level, which limits their performance in healthcare practice and denotes the need for postgraduate improvement to resolve the deficiencies detected.

RESUMO A pesquisa tem como objetivo avaliar a competência profissional e a atuação do médico de família na prevenção e controle do comportamento suicida. Foi realizado um estudo descritivo, o universo foi de 33 médicos (residentes e especialistas) distribuídos nas 18 áreas de saúde da Policlínica nº 2 de Manzanillo. As informações foram obtidas por meio de questionário que possibilitou determinar o nível de competência específica para a prevenção de tentativa e / ou suicídio, guia de avaliação do desempenho profissional e entrevista focada buscando triangulação metodológica. A maioria dos médicos obtém uma competência inadequada 81,8%, o motivo expressa que para cada 6 médicos avaliados com competência inadequada há apenas 1 com competência adequada, 75,8% foram avaliados com desempenho profissional inadequado, o motivo expressa que para cada 5 médicos avaliados com desempenho inadequado restando apenas 1 com desempenho adequado. Com a aplicação dos instrumentos validados, foi constatado conhecimento insuficiente dos médicos de família para o manejo desses agravos à saúde na comunidade, o que limita sua atuação na prática assistencial e denota a necessidade de aprimoramento da pós-graduação para sanar as deficiências detectadas.

Application of intelligent family doctor model in community prevention and control of coronavirus disease 2019 / 中华全科医师杂志

The community is the first line of endemic prevention and control. Facing the challenge of epidemic outbreak, Fangzhuang Community Health Service Center applied the intelligent family doctor model to carry out joint community prevention and control of coronavirus disease 2019 (COVID-19) epidemic. The intelligent family doctor model is a people-centered, information-based approach, which integrates community resources to carry out health education, counseling and public opinion guidance. With this model the community health service center can effectively screen and follow up the key groups to strengthen the joint prevention and control of COVID-19; at the same time it also can manage the chronic disease and the elderly care. This article introduces the intelligent family doctor model, and analyzes its advantages and existing problems, to provide references for community epidemic prevention and control.

Evaluation of individualized medication under the guidance of genetic testing in the management of hypertension patients in rural areas / 中华疾病控制杂志

Objective This study combined genotyping with family doctors' contracting model to assess the application of precision medicine in rural patients with essential hypertension. Methods In this study, 209 hypertensive patients from 3 villages in Lujiang County, Hefei City, Anhui Province were selected as subjects and randomly divided into experimental group(n=105) and control group(n=104). The medication regimen of observation group was guided by genetic testing for gene sensitivity to antihypertensive drugs, and the control group was implemented routine pharmacy. All the patients were managed by family doctors. Adverse drug reaction rate, treatment compliance, blood pressure, body mass index (BMI), fasting blood glucose (FBG), cholesterol (TC), and triglycerides (TG) of the two groups were analyzed, respectively, during the 6-month intervention. Results After 6-month of intervention, the medication compliance of the experimental group were significantly higher than that of the control group, and the blood pressure and adverse drug reaction rate were significantly lower than that of the control group. After 3 months of intervention, there was no significant decrease in BMI, FBG, TC and TG in the two groups. After 6 months of intervention, the FBG, TC and TG of the experimental group were significantly decreased,while only the FBG value of the control group was significantly decreased. There were no significant changes in body mass index (BMI) values in both groups. Conclusions Individualized medication guided by genotyping can improve the treatment compliance, reduce the adverse drug reaction rate, and improve the treatment efficiency of patients with essential hypertension.

Study of family doctor's contracted service in the Healthy Zhenjiang campaign / 中华医院管理杂志

The paper introduced the practice of family doctor′s contracted service in Zhenjiang,Jiangsu province over the past six years.By exploring the tiered family doctor′s contracted services,namely 3+X teamwork responsible for household health,health insurance contracting with chronic disease patients,and personalized contracts,the city highlights the cornerstone role of primary care in the Healthy Zhenjiang 2015 Campaign.The campaign aims at providing fair,accessible,systematic and uninterrupted health services.Outcomes of the campaign have proved that the 3+X teamwork model helps building acquaintances relationship with residents by means of contracting,hence motivating both the sector and individuals in the health promotion and building a healthy Zhenjiang.

Framework of family doctors′contract-based service system and its practice in Zhejiang province / 中华医院管理杂志

The control handles( including financing, provider payment, organization, regulation and behavior) proposed by World Bank in health policy research as the basic framework,and the nature and positioning of family doctors′ contract-based service as the precondition, we recommended the system framework of such a mechanism, comprising one contract, three regulations, five control handles and seven supporting policies. Such a framework can serve as the cornerstone for family doctors′ contract-based service experiment in Zhejiang province for the sake of hierarchical medical system.

Effect of responsibility system of family doctors for patients with diabetic retinopathy / 中国基层医药

Objective To explore the effect of responsibility system of family doctors( RSFD) for community management of the patients with diabetic retinopathy ( DR ) .Methods Fifty -two cases with non -proliferative diabetic retinopathy( NPDR) found in annual health examination in community health care centers were selected and randomly divided into intervention group(30 cases) and control group(22 cases).The intervention group received RSFD service mode and the control group received conventional management mode for 1 year.Patients'visual acuity, fundus,fasting blood-glucose(FBG),glycosylated haemoglobin(HbA1c) were observed and compared before and after intervention.Results In this study,the efficacy in improving patients'visual acuity and retinopathy was 73.3%in the intervention group and 45.5%in the control group,there was statistically significant difference between the two groups(χ2 =4.168,P=0.041).Before intervention,the control rates of patients'FBG were 36.4% and 30.0%respectively,and HbA1c was 27.3%and 33.3%.There were no statistically significant differences between the two groups(P>0.05).After intervention,the control rates of patients'FBG and HbA1c were 86.6% and 80.0% in intervention group,and 59.1%and 54.5%in the control group,there were statistically significant differences between the two groups (χ2 =5.147,P=0.023;χ2 =3.861,P=0.049).Conclusion RSFD service mode was conductive to control patients'blood sugar and improve visual acuity and retinopathy,we could disseminate and apply it to manage-ment of DR in community.

Gestión de calidad en el primer nivel de atención de salud de los adultos mayores. Instituto Nacional de Servicios Sociales para jubilados y pensionados (INSSJP-PAMI). Córdoba, 2013

El efectivo desarrollo de la Estrategia de Atención Primaria en el Primer Nivel de Atención del Instituto Nacional de Servicios Sociales para Jubilados y Pensionados (INSSJP-PAMI), exige correspondencia entre la formulación de políticas sanitarias para el adulto mayor y la implementación de determinados modelos de gestión. Con este propósito se describió el primer nivel de atención sanitaria en el marco del Modelo Médicos de Cabecera vigente según Resolución 284/05, se evaluó Gestión de Calidad así como el grado de desarrollo de la Estrategia de APS y se busco conocer la calidad de las prestaciones que reciben los adultos mayores en el primer nivel de atención desde la perspectiva de los propios usuarios como Sujetos Activos de Derecho. Por ultimo se formularon recomendaciones destinadas a fortalecer la capacidad de gestión de los Médicos de Cabecera del INSSJP-PAMI. Material y Método: Estudio descriptivo, transversal. Análisis de fuentes secundarias. Encuesta semi-estructurada. Muestra probabilística. Se utilizaron para el procesamiento estadístico Info Stat y SPSS...

The actual development of the Strategy of Medical care in the Primary health Care in the primary health care of attention of National Institute of Social Services for the Retired and Pensioned (INSSJP-PAMI), requires correspondence between the formulation of health policies for the elderly and the implementation of specific role models. To this end we escribed the current primary level of medical care in the frame of the family doctors model under the 284/05 resolution, we analyzed the quality of the management as well as the degree of development of the APS Strategy and we searched information about the quality of the assistance provided to the elderly during the primary health care from the user´s point of view as Active Lawful Subjects. Finally, we offer ecommendations meant to the strengthen the capacity of the treatment of the INSSJP-PAMI family doctors. Material and Methods: Descriptive cross-section analysis. Analysis of secondary sources. Semi structured survey. Proof samples. InfoStat and SPSS were used for the processing of statistics...

Influences of responsibility administration system by family doctors and nurses on hypertensive patients in communities / 现代临床护理

Objective To discuss the influences of responsibility administration system by family doctors and nurses on knowledge management and treatment compliance of hypertension patients. Methods Two hunderd hypertension patients (≥40 years old) registered in a community of Shenzhen were selected and randomized into two groups with 100 cases in each group based on the digit random number table. According to the management requirement of Work Manual of Community Comprehensive Prevention and Treatment Project on Hypertension and Diabetes in Shenzhen, patients in the control group were classified for follow-up and management, while the patients in the experiment group signed protocol of family doctor service and were managed by family doctors and nurses in addition to the management by the control group. After 1 year intervention, the two groups were compared in changes of awareness rate of hypertension related knowledge, treatment compliance, blood pressure and BMI. Results The awareness rate of hypertension related knowledge, treatment compliance, blood pressure and BMI in the experiment group after intervention were statistically better than those before intervention (P<0.01). After intervention, those indexes of the experiment group were significantly better than those of the control group (P<0.01). Conclusion Responsibility administration system by family doctors and nurses can effectively improve the awareness rate of hypertension related knowledge and treatment compliance of hypertension patients , thus effectively control the blood pressure.

Study on health policy instrument options for sinking high-quality medical resources from cities to primary care / 中华医院管理杂志

Objective To study and identify factors and evaluation criteria for optional health policy instruments for policy making reference.Methods A field survey was made to the10,000 primary care doctors to rural households campaign in Jining city,covering 453 doctors sent to villages,294 village doctors,and 572 rural residents,with the data obtained subject to descriptive analysis.Results In terms of equity of the campaign,97.8％ of the rural residents have entered into agreements,and 1.715 million of free visits have been provided by family doctors; in terms of economics,most of the superior doctors,rural doctors and rural residents believed that the policy could encourage high quality resources to sink to rural areas,and enhance the competence of public health services by rural doctors.In terms of the adaptability,60.4 ％ of the superior doctors and 92.7％ of the rural doctors hold that they are competent for health care role,but 51.8％ of the superior doctors were found not used to the current working mode.In terms of the enforceability,main complaints of superior doctors and rural doctors were excessive workload,overlong working hours,insufficient medical equipments,and reduced institutional revenue In terms of acceptability,90.4％ of the rural residents are supportive Conclusion The promotion of such a policy calls for a combination of compulsory,voluntary and mixed policy instruments in sinking the resources,with appropriate selection and optimization of such instruments,to ensure outcomes of the policy.

Construction of 24-hour cooperation with family doctors in palliative care unit

<b>Purpose:</b> The prefered location for recuperation of cancer patients is constantly changing. In order to meet the request of the patients and their family that they want to stay at home, our answer is to provide a “back-up bed” on the role for our palliative care unit. We developed a 24-hr hot line (Bethel Hospice Hotline; HL), and carried out HL from April 2010. For the purpose of future enhancement of cooperation, we examined the case of HL history over 3 years. <b>Methods:</b> Palliative care physicians interviewed patients and their families, explained the mechanism of cooperation to their family doctors. With their consent patients were registered to the HL. <b>Results:</b> 75 cases of HL registration from April 2010 to April 2013, 63 cases were supported by home care supporting clinics, 7 by other clinics, 3 by other hospitals and 2 others. The demands of family doctors upon HL: 69 cases were back bed and 14 cases required consultation for symptom relief. Our results show 42 (21 were emergency) patients admitted to our hospital, 18 received care at home supported family doctors, 4 were admitted to other hospitals, and 11 are ongoing. <b>Conclusion:</b> Since half of the admissions (21/42 cases, 6 were off hours) to our hospital were emergency, it is necessary to promote efficient cooperation to reduce the burden of the family doctors and the palliative care unit. Thus, it is expected to relieve the symptoms from early stages of the illness and to facilitate timely hospitalization.

Estado y avances de la salud familiar en Latinoamérica y el Caribe desde la mirada de la Confederación Ibero Americana de Medicina Familiar (CIMF) / Status and progress of family health in Latin America and the Caribbean: the Ibero-American Confederation of Family Medicine (ICPM) perspective

En pleno siglo XXI, gran parte de la humanidad no goza de una atención a la salud integral, equitativa o ni siquiera básica. Si estudios evidencian que los países que tienen sistemas de salud organizados en base a un modelo calificado e inclusivo de Atención Primaria a la Salud (APS) y con médicos familiares en sus equipos, están logrando resultados incuestionables ¿por qué en una buena parte de los países con los índices más bajos de desarrollo socio-económico, aún no se han comprometido de la manera necesaria para implantar una reforma eficiente de sus sistemas de salud para que la APS y la Medicina Familiar (MF) se constituyan en la base de los mismos? Estos temas constituyen los principales focos de acción de la Confederación Iberoamericana de Medicina Familiar, organización internacional sin fines de lucro, conformada por asociaciones nacionales de MF de países comprendidos en Latinoamérica, España y Portugal. Su principal misión es actuar de manera propositiva para que sea implementada una APS calificada en todos los países de su región y que la medicina familiar sea considerada una especialidad fundamental para los sistemas de salud, transformándola en una política pública.

In the XXI century, much of humanity does not have access to comprehensive health care, or even basic equitable health care. If studies show that countries with organized health systems based on a qualified and inclusive model of Primary Health Care (PHC) and family physicians as permanent staff are achieving unquestionable results, why a large part of the countries with lower socio-economic development have not committed strongly to implement an efficient reform of their health systems based on PHC and family medicine (FM)? These issues are at the core of the Latin American Confederation of Family Medicine’s concerns, an international non-profit organization composed of national associations of countries of FM from Latin America, Spain and Portugal. Its primary mission is to drive the implementation of a proper PHC system in all countries of the region and to ensure that family medicine, as a specialty, is considered critical to health systems, thereby transforming it into a public policy.

Metodología para la realización de la teleconferencia / Methodology for the performance of a telelecture

Se elaboró una metodología para impartir las tele conferencias con el objetivo de unificar criterios partiendo de la revisión de la bibliografía y de la experiencia práctica de los profesores del Policlínico Universitario "Turcios Lima". Se plantea un orden metodológico que sirve de guía para impartir esta actividad, definiendo tres etapas que son la fase preparatoria, el desarrollo y las conclusiones o reflexiones, destacando a su vez que la etapa de desarrollo se subdivide en introducción, desarrollo propiamente dicho y conclusiones. Se hace mención a las principales ventajas de esta actividad.

A methodology to teach a telelecture was prepared, aimed at reaching into agreements from the literature revision and practical experience of professors at "Turcios Lima" University Outpatient Clinic. The methodological order that is to be used as a guide to teach this activity is described in three stages: preparatory, development, conclusions or reflections, highlighting at the same time the stage of development that is subdivided in introduction, development and conclusions. The main advantages of this activity are mentioned.