Assessment of Primary Healthcare System in Areas Covered by Family Physician Project in Southeastern Iran

Khalil Kalavani, Zohre Eskandarizadeh, R. Dehnavieh
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Abstract

Background: Community's health depends on the primary healthcare sector of a country. In recent years, health systems have sought to assess the quality of services provided. Therefore, this study was conducted to evaluate the primary health care system with the Primary Care Assessment Tool (PCAT) in areas covered by the family physician in southeastern Iran. Methods: This was a descriptive-analytical study conducted cross-sectionally. It was performed on 330 recipients of services in health centers implementing the family physician project at Kerman, Bam, Jiroft and Rafsanjan Universities of Medical Sciences. The sampling method in this study was multistage. The instrument used in this study (PCAT) was based on the principles of primary care and is used as a tool to evaluate primary care. Data were analyzed using Kruskal-Wallis test in the SPSS 19 software. Results: The findings of this study were in 2 groups of adults and children according to the categorization of the questionnaire. Regarding adults, the highest average score of the questionnaire was related to first encounter - utilization in Jiroft University of Medical Sciences, first encounter - access in Bam University, continuity of care in Rafsanjan University, coordination in Jiroft University, coordination of information systems in Kerman, comprehensiveness of services available in Bam, comprehensiveness of services provided in Rafsanjan's family-oriented care in Kerman, community-oriented care in Kerman, and cultural aspects of care in Rafsanjan University of Medical Sciences. The difference between the average score in the dimension of the first encounter - utilization and the dimension of comprehensiveness of the services available in universities was significant (p < 0.05). In children, the highest average score was in the questionnaire is in the dimension of first encounter - utilization in Jiroft University of Medical Sciences, first encounter - access in Jiroft University, continuity of care in Rafsanjan University, coordination in Rafsanjan University, coordination of information systems in Kerman, comprehensiveness of services available in Rafsanjan. The comprehensiveness of services provided in Kerman, family-oriented care in Kerman, community-oriented care in Kerman, and cultural aspects of care in Jiroft University of Medical Sciences. The difference between the average score in the dimensions of the first encounter - utilization, coordination, coordination of information systems, comprehensiveness of available services, comprehensiveness of provided services, family-oriented care among universities was significant (p < 0.05). Conclusion: The present study demonstrated that various aspects of primary care in the areas covered by the family physician project in southeastern Iran had a relatively satisfactory status. The difference in the mean score of primary care in the studied universities shows that although the basic physical structures and hardware of the family physician program are available, it is crucial to provide the necessary facilities to maintain and improve the quality of services provided.
伊朗东南部家庭医生项目覆盖地区的初级卫生保健系统评估
背景:社区卫生取决于一个国家的初级卫生保健部门。近年来,卫生系统试图评估所提供服务的质量。因此,本研究旨在利用初级保健评估工具(PCAT)对伊朗东南部家庭医生所覆盖地区的初级卫生保健系统进行评估。方法:这是一项横断面描述性分析研究。在克尔曼、巴姆、吉罗夫特和拉夫桑詹医科大学实施家庭医生项目的保健中心对330名服务对象进行了调查。本研究采用多阶段抽样方法。本研究中使用的仪器(PCAT)是基于初级保健的原则,并被用作评估初级保健的工具。数据在SPSS 19软件中采用Kruskal-Wallis检验进行分析。结果:本研究结果按问卷分类分为成人和儿童两组。对于成年人来说,问卷平均得分最高的是在吉洛夫特医科大学的第一次就诊利用、在巴姆大学的第一次就诊获取、在拉夫桑詹大学的护理连续性、在吉洛夫特大学的协调性、在克尔曼的信息系统协调性、在巴姆提供的服务的综合性、在克尔曼的拉夫桑詹的面向家庭的护理所提供的服务的综合性、在克尔曼的面向社区的护理所提供的服务的综合性。以及拉夫桑詹医科大学护理的文化方面。第一次接触-利用维度的平均得分与高校可获得服务的综合维度的平均得分差异有统计学意义(p < 0.05)。在儿童方面,问卷中平均得分最高的是在吉洛夫特医科大学的第一次就诊-利用、吉洛夫特大学的第一次就诊-获得、拉夫桑詹大学护理的连续性、拉夫桑詹大学的协调、克尔曼信息系统的协调、拉夫桑詹提供的服务的全面性。克尔曼所提供的服务的全面性,克尔曼所提供的以家庭为导向的护理,克尔曼所提供的以社区为导向的护理,以及吉尔洛夫特医科大学所提供的文化方面的护理。各高校在初诊利用、协调性、信息系统协调性、可获得服务的全面性、提供服务的全面性、面向家庭的护理等维度上的平均分差异有统计学意义(p < 0.05)。结论:本研究表明,在伊朗东南部家庭医生项目覆盖的地区,初级保健的各个方面都有相对满意的状况。所研究的大学初级保健平均得分的差异表明,尽管家庭医生项目的基本物理结构和硬件是可用的,但提供必要的设施以保持和提高所提供的服务质量至关重要。
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