Areas model as a first contact assessment tool in an IAPT team in England

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021317 ◽  
Author(s):  
Lina Li ◽  
Chenwen Zhong ◽  
Jie Mei ◽  
Yuan Liang ◽  
Li Li ◽  
...  

ObjectiveCurrent healthcare reform in China has an overall goal of strengthening primary care and establishing a family practice system based on contract services. The objective of this study was to determine whether contracting a general practitioner (GP) could improve quality of primary care.DesignA cross-sectional study using two-stage sampling conducted from June to September 2014. Propensity score matching (PSM) was employed to control for confounding between patients with and without contracted GP.SettingThree community health centres in Guangzhou, China.Participants698 patients aged 18–89 years.Main outcome measuresThe quality of primary care was measured using a validated Chinese version of primary care assessment tool (PCAT). Eight domains are included (first contact utilisation, accessibility, continuity, comprehensiveness, coordination, family-centredness, community orientation and cultural competence from patient’s perceptions).ResultsA total of 692 effective samples were included for data analysis. After PSM, 94 pairs of patients were matched between the patients with and without contracted GPs. The total PCAT score, continuity (3.12 vs 2.68, p<0.01), comprehensiveness (2.31 vs 2.04, p<0.01) and family-centredness (2.11 vs 1.79, p<0.01) were higher in patients who contracted GPs than those did not. However, the domains of first contact utilisation (2.74 vs 2.87, p=0.14) and coordination (1.76 vs 1.93, p<0.05) were lower among patients contracted with GPs than in those who did not.ConclusionOur findings demonstrated that patients who had a contracted GP tend to experience higher quality of primary care. Our study provided evidence for health policies aiming to promote the implementation of family practice contract services. Our results also highlight further emphases on the features of primary care, first contact services and coordination services in particular.


2020 ◽  
Vol 73 (3) ◽  
Author(s):  
Glaucia Margarida Bezerra Bispo ◽  
Eduarda Maria Duarte Rodrigues ◽  
Amanda Cordeiro de Oliveira Carvalho ◽  
Kenya Waleria de Siqueira Coêlho Lisboa ◽  
Roberto Wagner Júnior Freire Freitas ◽  
...  

ABSTRACT Objectives: to evaluate the “access to first contact” attribute, from the perspective of Primary Care Health professionals. Methods: an evaluative and cross-sectional study, carried out from February to March 2017. The sample consisted of 163 health professionals, of both genders, who worked in the basic care of the Municipality of Juazeiro do Norte, Ceará. Access to first contact was evaluated by the Primary Care Assessment Tool (PCATool). The 6.60 mark was used as the cut-off point for the evaluated attribute. Results: access to first contact reached a score of 3.3, denoting a low degree of orientation for Primary Health Care. Nurses were the ones who evaluated the attribute more negatively (p=3.2). Conclusions: access to first contact obtained a low score, pointing to the fragility of the Family Health Strategy as a gateway to the Brazilian Unified Health System (Sistema Único de Saúde).


2019 ◽  
Vol 61 (3) ◽  
pp. 77
Author(s):  
Graham Bresick ◽  
Klaus B. Von Pressentin ◽  
Robert Mash

Introduction: In 2018 governments reaffirmed their commitment to implementing primary health care (PHC) in the Astana Declaration. South Africa has introduced a number of health reforms to strengthen PHC and enable universal health coverage (UHC). UHC requires access to quality primary care and progress needs to be measured. This study aimed to evaluate the quality of South African primary care using the Primary Care Assessment Tool (PCAT).Methods: A descriptive cross-sectional survey used data derived from a previous analytical observational study. Data from 413 patients, 136 health workers and 55 managers were analysed from 30 community health centres across four provinces of South Africa. Scores were obtained for 10 key domains and an overall primary care score. Scores were compared in terms of respondents, provinces and monthly headcount.Results: Patients rated first contact accessibility, ongoing care and community orientation as the poorest performing elements ( 50% scoring as ‘acceptable to good’); first contact utilisation, informational coordination and family-centredness as weaker elements ( 66% scoring as ‘acceptable to good’); and comprehensiveness, coordination, cultural competency and availability of the PHC team as stronger aspects of primary care (≥ 66% or more scoring as ‘acceptable or good’). Managers and providers were generally much more positive about the performance of PHC.Conclusion: Gaps exist between PHC users’ experience of care and what PHC staff believe they provide. Priorities to strengthen South African primary care include improving access, informational and relational continuity of care, and ensuring the implementation of community-orientated primary care. The PCAT is a useful tool to measure quality of primary care and progress with UHC.


2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Jie Mei ◽  
Yuan Liang ◽  
LeiYu Shi ◽  
JingGe Zhao ◽  
YuTan Wang ◽  
...  

Introduction. With Chinese health care reform increasingly emphasizing the importance of primary care, the need for a tool to evaluate primary care performance and service delivery is clear. This study presents a methodology for a rapid assessment of primary care organizations and service delivery in China.Methods. The study translated and adapted the Primary Care Assessment Tool-Adult Edition (PCAT-AE) into a Chinese version to measure core dimensions of primary care, namely, first contact, continuity, comprehensiveness, and coordination. A cross-sectional survey was conducted to assess the validity and reliability of the Chinese Rapid Primary Care Assessment Tool (CR-PCAT). Eight community health centers in Guangdong province have been selected to participate in the survey.Results. A total of 1465 effective samples were included for data analysis. Eight items were eliminated following principal component analysis and reliability testing. The principal component analysis extracted five multiple-item scales (first contact utilization, first contact accessibility, ongoing care, comprehensiveness, and coordination). The tests of scaling assumptions were basically met.Conclusion. The standard psychometric evaluation indicates that the scales have achieved relatively good reliability and validity. The CR-PCAT provides a rapid and reliable measure of four core dimensions of primary care, which could be applied in various scenarios.


2014 ◽  
Vol 48 (spe) ◽  
pp. 122-128 ◽  
Author(s):  
Simone Albino da Silva ◽  
Denismar Alves Nogueira ◽  
Camila Maria da Silva Paraizo ◽  
Lislaine Aparecida Fracolli

Objective To assess primary health care attributes of access to a first contact, comprehensiveness, coordination, continuity, family guidance and community orientation. Method An evaluative, quantitative and cross-sectional study with 35 professional teams in the Family Health Program of the Alfenas region, Minas Gerais, Brazil. Data collection was done with the Primary Care Assessment Tool - Brazil, professional version. Results Results revealed a low percentage of medical experts among the participants who evaluated the attributes with high scores, with the exception of access to a first contact. Data analysis revealed needs for improvement: hours of service; forms of communication between clients and healthcare services and between clients and professionals; the mechanism of counter-referral. Conclusion It was concluded that there is a mismatch between the provision of services and the needs of the population, which compromises the quality of primary health care.





2017 ◽  
Vol 25 ◽  
pp. e14442
Author(s):  
Inês Leoneza ◽  
Elisabete Pimenta Araújo Paz ◽  
Raphael Mendonça Guimarães ◽  
Adelson Antonio Castro

Objetivo: analisar o grau de orientação oferecida por unidades primárias em relação ao atributo acesso de primeiro contato na perspectiva de usuários hipertensos. Método: estudo transversal de avaliação com uso do Primary Care Assessment Tool-Brasil. Os dados foram coletados com 373 hipertensos maiores de 20 anos, no município de Macaé, Brasil. Resultados: verificou-se a predominância das seguintes características individuais: 49% tinham entre 40 a 59 anos; 74% pertenciam ao gênero feminino; 38,1% apresentaram ensino fundamental incompleto; 59,5% tinham renda de até 2 salários mínimos. Obteve-se escore de 7,65 para acesso de primeiro contato, superior à média de 6,6 do escore padrão, e um escore de 2,40 para acessibilidade. Conclusão: os resultados apontam utilização satisfatória das unidades no que refere ao acesso de primeiro contato e insatisfatória quanto à acessibilidade aos serviços, o que mostra necessidade de investimentos na reorganização do processo de atendimento às demandas e prioridades dos usuários.ABSTRACTObjective: to analyze the degree of orientation offered by primary units in relation to the attribute first contact access from the perspective of hypertensive users. Methods: cross-sectional study using Primary Care Assessment Tool-Brazil. Data were collected with 373 hypertensive patients over 20 years of age, in the city of Macaé, Brazil. Results: the predominance of the following individual characteristics was verified: 49% were between 40 and 59 years old; 74% were female; 38.1% had incomplete elementary education; 59.5% had income of up to 2 minimum wages (about US$548.00). A score of 7.65 was obtained for first contact access, superior to the mean of 6.6 of the standard score, and a score of 2.40 for accessibility. Conclusion: the results indicate a satisfactory use of the units in relation to first contact access and unsatisfactory related to accessibility to services, which shows the need for investments in the reorganization of the process of meeting the demands and priorities of users.RESUMENObjetivo: analizar el grado de orientación ofrecida por unidades primarias en relación al atributo acceso de primer contacto en la perspectiva de usuarios hipertensos. Método: estudio transversal de evaluación con uso de Primary Care Assessment Tool-Brasil. Los datos fueron recolectados con 373 hipertensos mayores de 20 años, en el municipio de Macaé, Brasil. Resultados: se verificó la predominancia de las siguientes características individuales: el 49% tenía entre 40 a 59 años; el 74% pertenecía al género femenino; 38,1% presentaron enseñanza fundamental incompleta; el 59,5% tenía ingresos de hasta 2 salarios mínimos (alrededor de US$ 548.00). Se obtuvo una puntuación de 7,65 para acceso de primer contacto, superior a la media de 6,6 de la puntuación estándar, y una puntuación de 2,40 para accesibilidad. Conclusión: los resultados apuntan utilización satisfactoria de las unidades en lo que se refiere al acceso de primer contacto e insatisfactorio en cuanto a la accesibilidad a los servicios, lo que muestra necesidad de inversiones en la reorganización del proceso de atención a las demandas y prioridades de los usuarios. DOI: http://dx.doi.org/10.12957/reuerj.2017.14442


2020 ◽  
Vol 73 (suppl 5) ◽  
Author(s):  
Rafaela Simão de Abrantes ◽  
Débora Lana Alves Monteiro ◽  
Aline de Paula Rêgo Graciano Luz ◽  
Ricardo Alves de Olinda ◽  
Wilton Wilney Nascimento Padilha

ABSTRACT Objective: to assess the presence and extent of Primary Health Care attributes in Campina Grande, Paraíba. Method: this is a cross-sectional study with 202 professionals from the Basic Health Units. The Primary Care Assessment Tool, Brazil, was used, which includes eight attributes of primary care whose scores were converted into a scale from 0 to 10, with those considered satisfactory > 6.60. Result: the general score mean was 7.6, but First contact access obtained a score of 3.7. Dental surgeons attributed the worst scores for all attributes (p <0.05). Permanent education activity was associated with a high general score (p <0.01). Conclusion: with the exception of First contact access, the other attributes are present, but initiatives by teams and managers are necessary for its expansion, with permanent education being the main strategy in this process.


2021 ◽  
Vol 45 ◽  
pp. 1
Author(s):  
Javier Mariani ◽  
Daniel Ferrante ◽  
Gabriel Battistella ◽  
Martín Langsam ◽  
Freddy Pérez ◽  
...  

Objective. Evaluate primary health care functions from the perspective of patients with tuberculosis from slums in the city of Buenos Aires, Argentina. Methods. Cross-sectional observational study with adult patients with tuberculosis (TB) and without TB (NoTB), living in slums (S) and outside them (NoS). Participants’ perceptions were evaluated using the Primary Care Assessment Tool for users (abbreviated version), which measures four main domains (first contact, ongoing care, coordination with specialists, and comprehensiveness) and selected secondary domains. A Likert scale was used, ranging from “No, not at all” (1 point) to “Yes, definitely” (4 points). Scores ≥ 3 were considered to indicate adequate performance of functions. Averages were calculated for each domain, as well as two overall scores: with and without secondary domains. Results. 83 participants were included (20 TB-S, 21 TB-NoS, 19 NoTB-S, and 23 NoTB-NoS). The evaluated functions were perceived as inadequate. The TB-S group gave the lowest overall scores, not reaching 3 points in any domain. There were no significant differences in domains or overall scores between groups. Participants with TB gave lower scores in all domains, except in family-centered care, where they gave a significantly higher score than NoTB participants. The overall score without secondary domains was lower for TB participants than for the NoTB groups. Conclusions. According to the perception of participants with TB and without TB, primary health care functions are not satisfactory, either in slums or outside them.


PEDIATRICS ◽  
2000 ◽  
Vol 105 (Supplement_3) ◽  
pp. 998-1003 ◽  
Author(s):  
Charlyn E. Cassady ◽  
Barbara Starfield ◽  
Margarita P. Hurtado ◽  
Ronald A. Berk ◽  
Joy P. Nanda ◽  
...  

Objective. To assess the adequacy of the Primary Care Assessment Tool-Child Edition (PCAT-CE) for evaluating the attainment of the key characteristics of primary care services for children and youth. Design. Community-based telephone survey. Setting. Specific political subdivision in Washington, DC. Participants. Four hundred fifty parents/guardians of offspring 18 years of age or less. Measures. Reliability, validity and principal component analysis of 5 scales representing key aspects of the 4 cardinal domains of primary care included in the PCAT-CE. In addition, 2 subdomains (first contact use and extent of affiliation with a primary care source) were included as indices to describe overall patterns of use and affiliation with the particular source of care. Results. Most scales had adequate internal consistency, test-retest reliability, and construct validity. The principal components factor analysis yielded 5 separate factors. These corresponded to the subdomains of first contact accessibility; coordination of care; characteristics of the professional-patient relationship over-time; and comprehensiveness (both services available and indicated services received). Conclusions. Psychometric assessment supported the integrity and general adequacy of the PCAT-CE for assessing the characteristics and quality of primary care for children and youth. Testing of revised versions in a variety of different settings is underway. A major component of this testing is to explore the possibility of reducing the number of items while retaining sufficient detail about each component of primary care to make judgements about people's experiences with that care.


2020 ◽  
Vol 63 (4) ◽  
pp. 1071-1082
Author(s):  
Theresa Schölderle ◽  
Elisabet Haas ◽  
Wolfram Ziegler

Purpose The aim of this study was to collect auditory-perceptual data on established symptom categories of dysarthria from typically developing children between 3 and 9 years of age, for the purpose of creating age norms for dysarthria assessment. Method One hundred forty-four typically developing children (3;0–9;11 [years;months], 72 girls and 72 boys) participated. We used a computer-based game specifically designed for this study to elicit sentence repetitions and spontaneous speech samples. Speech recordings were analyzed using the auditory-perceptual criteria of the Bogenhausen Dysarthria Scales, a standardized German assessment tool for dysarthria in adults. The Bogenhausen Dysarthria Scales (scales and features) cover clinically relevant dimensions of speech and allow for an evaluation of well-established symptom categories of dysarthria. Results The typically developing children exhibited a number of speech characteristics overlapping with established symptom categories of dysarthria (e.g., breathy voice, frequent inspirations, reduced articulatory precision, decreased articulation rate). Substantial progress was observed between 3 and 9 years of age, but with different developmental trajectories across different dimensions. In several areas (e.g., respiration, voice quality), 9-year-olds still presented with salient developmental speech characteristics, while in other dimensions (e.g., prosodic modulation), features typically associated with dysarthria occurred only exceptionally, even in the 3-year-olds. Conclusions The acquisition of speech motor functions is a prolonged process not yet completed with 9 years. Various developmental influences (e.g., anatomic–physiological changes) shape children's speech specifically. Our findings are a first step toward establishing auditory-perceptual norms for dysarthria in children of kindergarten and elementary school age. Supplemental Material https://doi.org/10.23641/asha.12133380


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