scholarly journals Capitation-Based Financing Hampers the Provision of Preventive Services in Primary Health Care

2016 ◽  
Vol 4 ◽  
Author(s):  
János Sándor ◽  
Karolina Kósa ◽  
Magor Papp ◽  
Gergő Fürjes ◽  
László Kőrösi ◽  
...  
2021 ◽  
Vol 37 (6) ◽  
pp. 535-548
Author(s):  
Tiago Costa ◽  
◽  
Diana Catarina Coelho Leitão ◽  

Objetivos: Identificar situações sugestivas de hipertensão secundária (HS). Rever a fisiopatologia, manifestações clínicas e/ou laboratoriais, diagnóstico e tratamento das principais formas de HS, bem como estabelecer o papel do médico de família na sua abordagem à luz da evidência mais recente. Fontes de dados: MEDLINE/PubMed, The Cochrane Library, UpToDate, U.S. Preventive Services Task Force e normas de orientação clínica da Direção-Geral da Saúde. Métodos: Foi realizada a pesquisa de artigos científicos em plataformas online de medicina baseada em evidência utilizando as palavras-chave Secondary Hypertension e Primary Health Care. A pesquisa foi realizada em julho de 2019, sendo a seleção dos artigos feita com base no título, conteúdo do resumo e data de publicação. Foram também consultadas normas de orientação clínica e guidelines. Resultados: A HS deve ser suspeita em contexto de hipertensão resistente, início de hipertensão antes dos 30 anos num utente sem fatores de risco, elevação súbita ou instabilidade da pressão arterial basal, hipertensão maligna ou acelerada, início de hipertensão diastólica em idosos, hipertensão associada a distúrbios hidro-eletrolíticos ou hipertensão associada a clínica sugestiva de determinada etiologia específica. Em crianças e adolescentes, as principais causas de HS são as doenças do parênquima renal, ao passo que nos adultos as etiologias mais comuns incluem a síndroma da apneia obstrutiva do sono, doenças do parênquima renal, estenose da artéria renal, hiperaldosteronismo primário e feocromocitoma. O reconhecimento de manifestações clínicas e/ou laboratoriais sugestivas da etiologia da HS deve orientar a realização dos testes de rastreio para posterior tratamento ou referenciação. Conclusão: Avaliar em todos os utentes hipertensos a existência de causas secundárias não é custo-efetivo, pelo que apenas devem ser estudados os utentes com características sugestivas de HS. A realização e interpretação dos testes de rastreio de forma adequada é fundamental para a referenciação e tratamento dos utentes com HS.


Author(s):  
Mariatul Fadillah ◽  
Murwani Emasrissa Latifah

Background: Health care services are any efforts that are self-administered or done jointly within an organization to maintain and improve health, prevent and cure diseases and restore the health of individuals, families, groups and/or communities. Promotional and preventive services are conducted by individuals or groups in improving health and preventing the occurrence of outcomes unwanted by the community. Community Primary Health Care Centers (Puskesmas) are primary health care centers for the community which serve as the location of the new family doctors internship program in Indonesia.Objectives: The purpose of this study is to investigate the perception of internship doctors on the promotion and preventive services at the Puskesmas where they are placed for internship.Methods: This research is a quantitative analytical study with cross-sectional research design through the distribution of a questionnaire in the form of a Google survey form to all internship doctors in 571 Puskesmas in Indonesia. The questionnaire contains a list of questions that have been categorized according to the parent theory used, namely the Lawrence Green theory. The samples obtained in this study included 218 internship doctors.Results: From this study it was found that as many as 130 people (59.6%) of intern doctors who conducted promotive and preventive health services at Puskesmas came from State Universities. As many as 86 people (39.4%) of interns who conducted promotive and preventive health services at Puskesmas were 25 years old, with 143 (65.6%) females and 184 people (84.4%) unmarried. From the results of logistic regression analysis of Awareness Level, Knowledge Level, Time, Potential Revenue and Government Support, all factors have significant influence on the internship doctors’ perceptions on the promotive and preventive health care services (p<0.05).Conclusion: In this research, there are profiles and factors that significantly influence the internship doctor’s perceptions on health promotion and preventive services at Puskesmas.


Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Chris Rouen ◽  
Alan R. Clough ◽  
Caryn West

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.


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