Integrated care in community health centers in Belgium. An exploratory study on the provision of care by general practitioners, nurses and social workers

Abstract. Community Health Centers (CHCs) take the frontline position of health services in Indonesia. To be able to perform their functions properly, CHCs require human resources (HR) as a driving force. One of the human resources required is a general practitioner. The policy of utilization GP sat CHCs in Jakarta provides flexibility for sub-district health centers as the implementing agency in the management of human resources. One of the variables that influence the process of policy implementation is the capability of the implementing agencies indicated through their management capabilities.This study aims to describe the policy implementation on the utilization of general practitioners at Kemayoran sub-district health centers. The research was conducted using a mixed method combining qualitative and quantitative approach. The results confirm that there has been an imbalance proportion between the workload of general practitioners at village health centers and sub-district health centers, due to the absence of standardized rules regarding the placement of general practitioners, in addition to lower capacity of the human resources available. One of the recommendations proposed is the improvement of management using a simulation model of general practitioners based on balanced workload forecasting.Keywords: policy implementation, utilization of general practitioner, forecasting, simulation model

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Capability for Change at Community Health Centers Serving Asian Pacific Islanders: An Exploratory Study of a Cancer Screening Evidence-based Intervention

Asian Pacific Journal of Cancer Prevention ◽

10.7314/apjcp.2013.14.12.7451 ◽

2013 ◽

Vol 14 (12) ◽

pp. 7451-7457 ◽

Cited By ~ 4

Author(s):

Hee Yon Sohng ◽

Alan Kuniyuki ◽

Jane Edelson ◽

Rosy Chang Weir ◽

Hui Song ◽

...

Keyword(s):

Cancer Screening ◽

Community Health ◽

Exploratory Study ◽

Community Health Centers ◽

Pacific Islanders ◽

Health Centers ◽

Evidence Based ◽

Asian Pacific Islanders ◽

Asian Pacific

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Caracterização de hipertensos de unidade de saúde em Curitiba, Paraná

Revista de Enfermagem UFPE on line ◽

10.5205/reuol.348-11415-1-le.0203200809 ◽

2008 ◽

Vol 2 (3) ◽

pp. 270

Author(s):

Ezia Maria Corradi ◽

Camila Aparecida Araújo ◽

Jussara Do Rocio Machado ◽

Mário Humberto Esteves

Keyword(s):

Community Health ◽

Exploratory Study ◽

Community Health Centers ◽

Medication Use ◽

Low Risk ◽

Health Centers ◽

Health Unit ◽

Hypertensive Patients ◽

City State ◽

Program Data

ABSTRACTThe aim of this descriptive-exploratory study is characterize the reasons of abandonment of the hypertensive patients by the Hypertensive Patients Program from a Health Unit at Curitiba city, State of the Paraná, Brazil. The users of low risk, totalizing 203 ones, of which, 44 had been selected those residents at micron-areas around. Domiciliary visit was carried through, which 13 users had been located. In this occasion the collection of data instrument was applied to identify to the current conditions of health and the reasons of the abandonment of the Program. Data had been organized and analyzed based on descriptive statistic and argued with endorsement of literature. The results showed the age between 51 and 60 years (69%); 61.5% with alteration of the blood pression in the 1, 2 and 3 of risk; 77% in medication use. Amongst the reasons of absence of the program 14% it affirmed not to have time, 14% for feeling themselves well, 21% had complaints in the attendance and, or not trusting the Program. The 84,6% of the inactives has the controlled hypertension, but with risks to the health; they has unfamiliarity about the illness, its gravity, forms to coexist it and as to carry through the necessary control. Descriptors: hypertension; community health centers; nursing.RESUMOEstudo descritivo-exploratório com o objetivo de caracterizar os motivos de abandono de portadores de hipertensão arterial ao Programa de Hipertensão Arterial de uma Unidade de Saúde de Curitiba, Paraná, Brasil. Participaram 203 usuários de risco baixo, dos quais, foram selecionados aqueles residentes em micro-áreas de abrangência, correspondendo a 44. Foi realizada visita domiciliar, com a qual foram localizados 13 usuários. Nessa ocasião foi aplicado o instrumento de coleta de dados para identificar condições atuais de saúde e motivos do abandono ao Programa. Os dados foram organizados e analisados com base na estatística descritiva e discutidos com respaldo da literatura. Os resultados mostraram a faixa etária entre 51 e 60 anos (69%); 61,5% com alteração da PA entre os estágios 1, 2 e 3 de risco; 77% em uso de medicação. Dentre os motivos de afastamento do programa 14% afirmaram não ter tempo, 14% por sentir-se bem, 21% com queixas no atendimento e, ou não confiarem no Programa. Concluí-se que 84.6% dos inativos apresentam hipertensão controlada, mas com risco de conseqüências à saúde; há desconhecimento acerca do que é a doença, sua gravidade, formas de conviver com ela e como realizar o controle necessário. Descritores: hipertensão; unidade básica de saúde; enfermagem.RESUMEN El objetivo de este estudio descriptivo-exploratorio es caracterizar las razones de abandono de los pacientes hipertensos de un Programa de Pacientes Hipertensos de uma Unidad de Salud en la ciudad de Curitiba, Estado de Paraná, Brasil. Los usuarios de bajo riesgo totalizando 203, de los cuales, 44 habían sido seleccionados en torno a las áreas vizinhas. Visita domiciliaria se llevó a cabo que localizaron 13 usuarios. En esta ocasión, la recopilación de instrumento de datos se aplicó a identificar a las actuales condiciones de salud y las razones del abandono del Programa. Los datos han sido organizados y analizados descriptivo de la forma y argumentó con el aval de la literatura. Los resultados mostraron la edad entre los 51 y los 60 años (69%); 61,5% con alteración de la presión sanguínea en el 1, 2 y 3 de riesgo, 77% en el uso de fármacos. Entre las razones de ausencia del programa el 14% afirmó no disponer de tiempo, el 14% para sentirse bien, un 21% en las denuncias y la asistencia, o no confiar en el Programa. El 84,6% de los inactivos se ha controlado la hipertensión, pero con riesgos para la salud, sino que ha desconocimiento sobre la enfermedad, su gravedad, las formas de coexistir y, como para llevar a cabo el control necesario. Los resultados demostraron la edad entre 51 y 60 años (el 69%); 61.5% con la alteración de la presión arterial en el 1, los 2 y los 3 del riesgo; el 77% en uso de medicación. Entre las razones de la ausencia del programa el 14% afirmó no tener tiempo, 14% no tener síntomas de hipertensión, 21% tenían quejas en la atención y, o confiando en el programa. El 84.6% de los inactives tiene la hipertensión controlada, pero con riesgos a la salud; tienen poco saber sobre la enfermedad, su gravedad, formas a coexistir él y el control necesario. Descriptores: hipertensión; centros de salud; enfermería.

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