RESUMEN
Resumen La diversidad organizativa y financiera que caracteriza la atención primaria europea ha permitido responder extraordinariamente a la pandemia de COVID-19 con soluciones innovadoras: reorganización de la oferta de servicios, digitalización, nuevos roles profesionales e inclusión de nuevas profesiones en atención primaria, y pagos añadidos por la realización de actividades. La telemedicina ha transformado la atención al paciente. Las crisis humanitarias (inmigración y refugiados) requieren todavía nuevas soluciones en Europa. Los cuidados paliativos en atención primaria se han transformado. La novedosa educación médica virtual debe ser evaluada. La disminución de la burocracia es una clara necesidad, al igual que la coordinación con los servicios de medicina preventiva y de salud pública. La práctica en solitario versus los equipos de atención primaria, el acceso a la prescripción de ciertos fármacos, la hiperprescripción, las actividades preventivas, y las migraciones de médicos constituyen los retos del futuro para la atención primaria europea. Summary The organisational and financial diversity that characterizes European primary care has made it possible to respond extraordinarily to the COVID-19 pandemic with innovative solutions: reorganisation of the scope of services, digitization, new professional roles and inclusion of new professions in primary care, and the use of additional fees for service. Telemedicine has transformed patient care. Humanitarian crises (immigration and refugees) still require new solutions in Europe. Palliative care in primary care has been transformed. The new virtual medical education must be evaluated. The reduction of bureaucracy is a clear need, as is coordination with preventive medicine and public health services. Solo practice versus primary care teams, access to the prescription of certain drugs, over-prescription, preventive activities, and migration of physicians constitute future challenges for European primary care.
RESUMEN
La diversidad organizativa y financiera que caracteriza la atención primaria europea ha permitido responder extraordinariamente a la pandemia de COVID-19 con soluciones innovadoras: reorganización de la oferta de servicios, digitalización, nuevos roles profesionales e inclusión de nuevas profesiones en atención primaria, y pagos añadidos por la realización de actividades. La telemedicina ha transformado la atención al paciente. Las crisis humanitarias (inmigración y refugiados) requieren todavía nuevas soluciones en Europa. Los cuidados paliativos en atención primaria se han transformado. La novedosa educación médica virtual debe ser evaluada. La disminución de la burocracia es una clara necesidad, al igual que la coordinación con los servicios de medicina preventiva y de salud pública. La práctica en solitario versus los equipos de atención primaria, el acceso a la prescripción de ciertos fármacos, la hiperprescripción, las actividades preventivas, y las migraciones de médicos constituyen los retos del futuro para la atención primaria europea.
RESUMEN
Primary care is an essential foundation for the global response to COVID-19 pandemic. It plays a significant role in the health care response: identifying and triaging potential COVID-19 cases, making an early diagnosis, helping vulnerable people cope with their anxiety about the virus, strengthening compliance with prevention and protection measures, and reducing the demand for hospital services. Primary care teams have continued to address citizens' health problems during the pandemic, adapting to strict social control measures imposed by governments such as closing of borders, lockdowns and self-isolation of cases and contacts. We describe the COVID-19 response from primary care in Hong Kong and China, based on their recent pandemic experiences. We also present that of a European country, United Kingdom, less experienced in pandemic management, but with universal and highly developed primary care with great social recognition. Finally, we point out some crucial learning for future pandemic management, highlighting the crucial need to improve the relationship between primary care and public health to improve pandemics response.
Asunto(s)
COVID-19 , Pandemias , Control de Enfermedades Transmisibles , Humanos , Pandemias/prevención & control , Atención Primaria de Salud , SARS-CoV-2RESUMEN
The Alma Ata and Astana Declarations reaffirm the importance of high-quality primary healthcare (PHC), yet the capacity to undertake PHC research-a core element of high-quality PHC-in low-income and middle-income countries (LMIC) is limited. Our aim is to explore the current risks or barriers to primary care research capacity building, identify the ongoing tensions that need to be resolved and offer some solutions, focusing on emerging contexts. This paper arose from a workshop held at the 2019 North American Primary Care Research Group Annual Meeting addressing research capacity building in LMICs. Five case studies (three from Africa, one from South-East Asia and one from South America) illustrate tensions and solutions to strengthening PHC research around the world. Research must be conducted in local contexts and be responsive to the needs of patients, populations and practitioners in the community. The case studies exemplify that research capacity can be strengthened at the micro (practice), meso (institutional) and macro (national policy and international collaboration) levels. Clinicians may lack coverage to enable research time; however, practice-based research is precisely the most relevant for PHC. Increasing research capacity requires local skills, training, investment in infrastructure, and support of local academics and PHC service providers to select, host and manage locally needed research, as well as to disseminate findings to impact local practice and policy. Reliance on funding from high-income countries may limit projects of higher priority in LMIC, and 'brain drain' may reduce available research support; however, we provide recommendations on how to deal with these tensions.