On the Quality Variation of Primary Health Care Services: A Test of the ‘Inverse Care Law’ for General Practice

10.1068/a3616 ◽  
2004 ◽  
Vol 36 (4) ◽  
pp. 701-714 ◽  
Author(s):  
Huw Williams ◽  
Sean White ◽  
Martyn Senior ◽  
Stephanie Williams ◽  
Brynley Davies
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Health Care Services ◽  
Care Services ◽  
Primary Health ◽  
Inverse Care Law ◽  
Primary Health Care Services ◽  
Quality Variation

What can the Experiences of Primary Care Organisations in England, Scotland and New Zealand Suggest About the Potential Role of Divisions of General Practice and Primary Care Networks/Partnerships in Addressing Australian Challenges?

2007 ◽  
Vol 13 (2) ◽  
pp. 46 ◽  
Author(s):  
Julie McDonald ◽  
Gawaine Powell Davies ◽  
Jacqueline Cumming ◽  
Mark Fort Harris
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Health Care Services ◽  
Potential Role ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services

This paper focuses on what can be learnt from the experiences of Primary Care Organisations (PCOs) in England, Scotland and New Zealand about the potential role of Divisions of General Practice (DGPs) and Primary Health Care Networks/Partnerships (PCN/Ps) in Australia, in addressing the challenges of ensuring access to a comprehensive range of primary health care services that are well coordinated and address population health needs. Responsibility for contracting and commissioning gives PCOs considerable leverage to influence the availability and range of primary health care services. A capitation-based funding system and associated patient enrolment enables a population focus and care over time, while aligned regional and local planning boundaries between PCOs and other health service planning boundaries also help with more coordinated approaches to planning, service development and service delivery. These elements are largely absent in the Australian health care system and set significant limitations on the role of DGPs and PCN/Ps. While DGPs can contribute to improving general practice quality and access to multidisciplinary care, and PCN/Ps can improve coordination, their scope of responsibilities and authority will need to be significantly strengthened to enable them to take a comprehensive approach to ensuring access to primary health care, service coordination and addressing population health needs.

scholarly journals Portugal's primary health care human resources assessment

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Oliveira Miranda ◽  
P Santos Luis ◽  
M Sarmento
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Human Resources ◽  
Health Professional ◽  
Health Care Services ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
The Mean

Abstract Background Primary health care services are the cornerstone of all health systems. Having clear data on allocated human resources is essential for planning. This work intended to map and compare the primary health care human resources of the five administrative regions (ARS) of the Portuguese public health system, so that better human resources management can be implemented. Methods The chosen design was a descriptive cross sectional study. Each of the five ARS were divided into primary health care clusters, which included several primary health care units. All of these units periodically sign a “commitment letter”, where they stand their service commitments to the covered population. This includes allocated health professionals (doctors, nurses), and the information is publicly accessible at www.bicsp.min-saude.pt. Data was collected for 2017, the year for which more commitment letters were available. Several ratios were calculated: patients/health professional; patients/doctor (family medicine specialists and residents); patients/nurse and patients/family medicine specialist. Mean, standard deviation, minimum and maximum values were calculated. Results National patients/health professional ratio was 702 with the mean of the 5 ARS calculated at 674+-7.15% (min 619, max 734) whilst the national patients/doctor ratio was 1247 with the mean of the 5 ARS calculated at 1217+-7.17% (min 1074, max 1290). National patients/nurse ratio was 1607 with the mean of the 5 ARS calculated at 1529+-13.08% (min 1199, max 1701). Finally, national patients/family medicine specialist ratio was 1711 with the mean of the 5 ARS calculated at 1650+-6,36% (min 1551, max 1795). Conclusions Human resources were differently spread across Portugal, with variations between the five ARS in all ratios. The largest differences occur between nursing staff, and may translate into inequities of access, with impact on health results. A more homogeneous human resources allocation should be implemented. Key messages Human resources in the Portuguese primary health care services are not homogeneously allocated. A better and more homogeneous allocation of human resources should be implemented to reduce access health inequities.

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