BMC primary care最新文献

{"title":"The role of family health centres in preventing paediatric emergency department usage of parents of children with non-urgent conditions.","authors":"Ahmet Butun","doi":"10.1186/s12875-024-02673-1","DOIUrl":"10.1186/s12875-024-02673-1","url":null,"abstract":"<p><strong>Background: </strong>Overcrowding in paediatric emergency departments (PEDs) has become a global public health issue, reducing healthcare quality, increasing dissatisfaction, and driving up costs. Overcrowding in PEDs not only affects patient satisfaction and healthcare costs but also can lead to burnout among healthcare professionals. This burnout could potentially result in suboptimal care for truly severe cases, ultimately increasing morbidity and mortality rates among patients requiring urgent attention. This study aims to determine how family health centres can reduce paediatric visits to PEDs and provide recommendations for alleviating overcrowding.</p><p><strong>Methods: </strong>This study is a descriptive cross-sectional study. Participants were parents whose children were admitted to the PED at a tertiary hospital located in southeast Turkey. The data were collected between 15/05/2024-26/08/2024. This study was completed with 657 parents. A convenience sampling method was used to recruit participants. SPSS 11.5 software was used for data analysis.</p><p><strong>Results: </strong>The mean age of the parents and children brought to the PED was 31.99 ± 8.51 years and 4.20 ± 4.08 years, respectively. Of the children, 32.1% were admitted to the PED due to fever. Majority of parents (65%) visited the PED outside working hours. 8.8% of parents considered their child's health condition as \"very urgent\", 54.5% of them considered it as \"urgent\". The majority of parents thought that the PEDs were overcrowded (82.2%). 50.4% of the parents stated that they trusted the PED, and 52.7% stated that they were satisfied with the PED. More than half of the parents (61.8%) stated that they did not visit their family health centre before visiting the PED. 10.8% of parents reported that they had never visited a family health centre in the last year. Majority of parents (62.7%) stated that they will visit the PED again if their children have the same health problems in the future.</p><p><strong>Conclusion: </strong>Improving the use of family health centres, introducing out-of-hours services, and enhancing parents' health literacy could shift non-urgent visits from PEDs to primary care settings. In addition, making parents more aware of services provided in family health centres could affect parents' health-seeking behaviours and choose to use their GP rather than PED for their children with non-urgent conditions.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"420"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing primary care concepts in higher education: a mixed method study in Flanders (Belgium).","authors":"Lotte Vanneste, Sam Pless, Sandra Martin, Emily Verté, Roy Remmen, Pauline Boeckxstaens, Peter Pype, Reini Haverals, Dagje Boeykens, Dominique Van de Velde, Patricia De Vriendt","doi":"10.1186/s12875-024-02670-4","DOIUrl":"10.1186/s12875-024-02670-4","url":null,"abstract":"<p><strong>Background: </strong>The policy shift towards person-centred integrated primary care systems drives interest in primary care across higher education programs. In Flanders, the Primary Care Academy (PCA) is established to support this policy shift. The PCA focusses on the concepts of goal-oriented care, self-management, and interprofessional collaboration to support the shift towards integrated care and to integrate them in curricula in order to strengthen and develop a futureproof health system. Therefore, the aim of this study is if and how lecturers implement these concepts in the curriculum and what they need for a successful implementation.</p><p><strong>Methods: </strong>A sequential explanatory mixed method study design was used combining quantitative and qualitative data. A cross-sectional survey was sent to 276 Flemish health care education programs. Qualitative data was collected through focus groups in which lecturers participated.</p><p><strong>Results: </strong>The results showed that 89% of the higher education programs address goal-oriented care, self-management, and interprofessional collaboration with regard to primary care. Further analysis of courses within the programs reveals that the concept of self-management is covered in only 58%, while goal-oriented care (73%) and interprofessional collaboration (80%) appear more frequently. The level at which the themes are addressed in the courses are often limited to an introduction. The focus groups revealed that primary care is present in education programs, however lecturers are limited aware where primary care is integrated in their own and other programs. Lectures expressed a need for more collaboration between research, education and practice in developing educational content. When new concepts are introduced, lecturers want them to be translated into educational content, learning objectives and competencies.</p><p><strong>Conclusions: </strong>The study shows that the concepts of goal-oriented care, self-management, and interprofessional collaboration are present in higher education programs to a varying degree. Lecturers are eager to implement these new primary concepts but they lack collaboration between education, research and practice. Lecturers indicate the need for a competence profile for primary care professionals as common framework to guide curriculum development.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"418"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to establishing teledermatoscopy in primary health care in Sweden.","authors":"Nils Hernström, Åsa Ingvar","doi":"10.1186/s12875-024-02678-w","DOIUrl":"10.1186/s12875-024-02678-w","url":null,"abstract":"<p><strong>Introduction: </strong>Teledermatoscopy (TDS) has proven to be effective and reliable for diagnosis of skin malignancies. The factors that determine the success of implementation of TDS are largely unknown.</p><p><strong>Objectives: </strong>To investigate barriers to implementation of TDS in primary health care (PHC) at center and individual level.</p><p><strong>Methods: </strong>Following introduction of TDS, cross-sectional quantitative data and free text comments were collected by surveys sent to PHC centers and PCH practitioners. Successful implementation was defined as regularly sent cases at center level and self-reported usage at individual level. Factors associated with implementation were evaluated with Chi-square, Kruskal-Wallis test and logistic regression.</p><p><strong>Results: </strong>93/117 (78.2%) of PHC centers and 239/725 (32.9%) of PHC practitioners answered the surveys. 54.8% (n = 51) of PHC centers and 64.3% (n = 153) of PHC practitioners had implemented TDS. There was a strong association between hardware arrival before introduction and TDS usage at center level (OR 6.0; 95% CI 1.5-24.3). At individual level, male sex was positively associated with usage (OR 1.9; 95%, CI 1.0-3.4), and for every year of increased age, the chance of using TDS decreased with 3% (OR 1.0, 95% CI 0.9-1.0). No other factor was associated with implementation. \"Good\" was the most common overall impression (54.8%), and the majority found no problems using the system (> 85%). The most common complaint was technical issues followed by no added value.</p><p><strong>Conclusions: </strong>Successful implementation of TDS was strongly associated with hardware arrival at center level, and to male sex and younger age at individual level. Satisfaction was overall high.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"417"},"PeriodicalIF":2.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary care in rural areas: a qualitative study on medical students' images and experiences of working in rural areas in southern Germany.","authors":"Jan Gehrmann, Niklas Barth, Tom Brandhuber, Pascal O Berberat, Sophie Gigou, Antonius Schneider","doi":"10.1186/s12875-024-02677-x","DOIUrl":"10.1186/s12875-024-02677-x","url":null,"abstract":"<p><strong>Background: </strong>Rural areas are increasingly moving back into the focus of social research, especially in the context of health care. As the shortage of general practitioners (GP) in rural areas is a significant challenge in Germany, there are several programs to counteract underuse effectively, acutely, and sustainably. One of those programs is 'Beste Landpartie Allgemeinmedizin' (BeLA), which was developed to strengthen primary care in rural areas and to sustainably promote young doctors to work as general practitioners in rural regions through didactical and financial support. The program includes an accompanying qualitative study exploring the motivational structures of medical students from a sociological perspective. For this study, the nexus of working in rural areas from the perspective of medical students with different forms of rural experiences was of interest.</p><p><strong>Methods: </strong>Qualitative interviews have been conducted at regular intervals on an ongoing basis since 2020 to investigate motivational retention effects during the program. The current 33 interviews were analysed using the sociological conceptual framework of spatial methods.</p><p><strong>Results: </strong>The images and experiences of working in rural areas condition medical education in various ways. In addition to general images of living and working in rural areas in a biographical dimension, the idea of working as a GP in rural areas includes images of specific medical competencies and is conditioned by different medical tasks. From such a perspective, the images and attributions of working in primary care in a rural region demonstrate particularities, challenges, and the potential attractiveness of working in rural regions.</p><p><strong>Discussion: </strong>The images and experiences of rural areas condition medical education in various ways and shape the expectations and the decision-making of possibly working in rural areas. The particularities, opportunities, and challenges of working in rural areas, which relate to both professional aspects and social life, are a major factor in the attractiveness of a potential rural practice. Didactical and educational curricula need to adapt the various attributions of working in rural areas.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"416"},"PeriodicalIF":2.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personality and interest in general practice: results from an online survey among medical students.","authors":"Maike Krauthausen, Tobias Leutritz, Martin J Koch, Pamina E Hagen, Sarah König, Anne Simmenroth","doi":"10.1186/s12875-024-02682-0","DOIUrl":"10.1186/s12875-024-02682-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The growing shortage of General Practitioners (GPs) is a Europe-wide challenge, particularly in rural areas. In Germany, the situation is worsened by an ageing workforce of GPs and insufficient training of new doctors. Many newly qualified physicians choose careers outside primary care or prefer to work part-time to balance work and family life. To address this problem, it is essential to understand the factors that influence medical students' specialty choice, and then to take action to encourage them to specialise in General Practice (GP). In addition to medical school experiences, rural placements, or characteristics of the specialty, personality traits have been shown to influence students' specialty decisions. A well-researched approach to assessing personality is the Five-Factor Model, which measures personality on the dimensions openness (to experience), conscientiousness, extraversion, agreeableness, and neuroticism. Using the findings about the links between students' personalities and an increased interest in a career in General Practice may be an approach to raising the number of GPs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We aimed to examine how students' personality traits influence their interest in General Practice and their current intention to pursue General Practice as a specialty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In March 2021, we started an ongoing online survey among medical students at the University of Würzburg and assessed cross-sectional data about the 'Big Five' personality traits and aspects of career choice. Until December 2022, we invited three cohorts of first-year beginners, and one cohort each of third-, fifth- and sixth-year students via email to participate in the survey. For statistical analysis, we performed linear regression and extended it into a path model to examine the relationship between students' personality traits, their interest in General Practice, and whether they would currently choose General Practice for their future specialty. We controlled for possible confounding effects of age, gender, and current semester by using covariates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Higher levels of agreeableness and neuroticism predicted greater interest in GPs, whereas higher levels of conscientiousness and openness predicted less interest in GPs. The effects of extraversion were unclear. Age was a significant predictor of interest, with older age associated with greater interest in General Practice. Gender was not a significant predictor of interest in General Practice, and the results for semester were inconclusive. The interest in General Practice is a predictor of the intention to choose GP as a specialty. The personality dimensions show an indirect predictive effect on the intention to choose GP, mediated by interest in GP. In total, R² = 7.7% of the variance of the interest in GP was explained by the combination of personality dimensions and covariates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/s","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"415"},"PeriodicalIF":2.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the German living guideline \"Protection against the Overuse and Underuse of Health Care\" - an online survey among German GPs.","authors":"Lisette Warkentin, Martin Scherer, Thomas Kühlein, Felix Pausch, Dagmar Lühmann, Cathleen Muche-Borowski, Susann Hueber","doi":"10.1186/s12875-024-02657-1","DOIUrl":"10.1186/s12875-024-02657-1","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the awareness and use of the German guideline \"Protection against the overuse and underuse of health care\" from the general practitioners' (GPs') perspective. In addition, the study assessed how GPs perceive medical overuse and what solutions they have for reducing it.</p><p><strong>Methods: </strong>We performed a cross-sectional online survey with recruitment from 15.06. to 31.07.2023. Participants were members of the German College of General Practitioners and Family Physicians (DEGAM). The main outcomes were the awareness and use of the guideline.</p><p><strong>Results: </strong>The analysis included data from 626 physicians. 51% were female and the median age was 50 years. The guideline is known by 81% of the participants, 32% read it in more detail. The majority considered the guideline a helpful tool in reducing overuse (67%). Almost 90% wished to have more guidelines with clear do-not-do recommendations. Physicians indicated in mean (M) that 30.2% (SD = 19.3%) of patients ask them for medical services that they do not consider to be necessary and that M = 30.2% (SD = 18.1%) of all GP services can be attributed to medical overuse. About half of the participants thought that overuse is a moderate or major problem in their practice (52%) and in general practice overall (58%). More participants rated that it is especially a problem in specialist (87%) and inpatient care (82%). Changes in the reimbursement system, raising awareness for the problem and more evidence-based guidelines were considered helpful in mitigating overuse.</p><p><strong>Conclusions: </strong>Although the guideline is seen as a useful tool in mitigating medical overuse, there is still further potential for its implementation and utilisation. GPs see more overuse in the inpatient and outpatient specialist areas than in their area of practice. Instead of self-critically approaching the problem, the proposed strategies are aimed at the healthcare system itself.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"414"},"PeriodicalIF":2.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between evaluation factors and star ratings for Japanese community healthcare institutions in electronic word-of-mouth reviews: an observational study.","authors":"Hiroki Maita, Yuki Kanezaki, Takashi Akimoto, Tadashi Kobayashi, Takahiro Hirano, Hiroyuki Kato","doi":"10.1186/s12875-024-02668-y","DOIUrl":"10.1186/s12875-024-02668-y","url":null,"abstract":"<p><strong>Background: </strong>Internet reviews have become increasingly crucial for both healthcare providers and patients. Electronic word-of-mouth (eWOM) reviews on internet sites often comprise textual content with numerical ratings. In this study, we aimed to identify the evaluation factors of community healthcare institutions regarding eWOM reviews and the impact of each evaluation factor on the institution's ratings.</p><p><strong>Methods: </strong>An observational study was conducted to qualitatively and quantitatively analyse eWOM data posted on Google for randomly selected healthcare institutions in Hirosaki, Japan from September to October 2022. For qualitative data, the authors repeatedly read the eWOM text, coded it, and categorised related sections. For quantitative analysis, a multivariate analysis using a linear regression model was conducted with the categorised factors from the qualitative analysis as explanatory variables and eWOM ratings as response variables.</p><p><strong>Results: </strong>Twenty medical institutions (two hospitals and 18 clinics) were randomly extracted from the registry. A total of 147 eWOM texts from each institution were analysed, and coding was performed for 474 segments in the texts. In the qualitative analysis, the evaluated factors in eWOM texts for medical institutions were categorised as communication (evaluation factor for communication with healthcare providers), clinical practice (evaluation factor for the clinical practice of healthcare providers), and medical institution (evaluation factor for the characteristics of medical institutions). According to the multiple regression analysis, the partial regression coefficients for the explanatory variables of positive communication, clinical practice, and medical institution evaluations were 1.04 (95% confidence interval 0.70 to 1.39), 0.65 (95% confidence interval 0.27 to 1.04), and 0.75 (95% confidence interval 0.35 to 1.15), respectively, with the number of ratings as the response variable. Partial regression coefficients for the explanatory variables of negative communication, clinical practice, and medical institution evaluations were - 1.52 (95% confidence interval - 1.88 to -1.16), -0.90 (95% confidence interval - 1.28 to -0.52), and - 0.24 (95% confidence interval - 0.60 to 0.12), respectively.</p><p><strong>Conclusion: </strong>We quantitatively and qualitatively analysed the eWOM reviews and ratings of healthcare institutions posted on Google. Three evaluation factors were identified: communication, clinical practice, and medical institution. Our study revealed that communication significantly impacts ratings.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"413"},"PeriodicalIF":2.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When clinicians and patients disagree on vaccination: what primary care clinicians can learn from COVID-19-vaccine-hesitant patients about communication, trust, and relationships in healthcare.","authors":"Natalie Purcell, Hajra Usman, Nicole Woodruff, Haley Mehlman, Leah Tobey-Moore, Beth Ann Petrakis, Karen Anderson Oliver, Adam Kaplan, Jeffrey M Pyne, Jennifer K Manuel, Beth M DeRonne, Dan Bertenthal, Karen H Seal","doi":"10.1186/s12875-024-02665-1","DOIUrl":"10.1186/s12875-024-02665-1","url":null,"abstract":"<p><strong>Background: </strong>In the United States, discourse on COVID-19 vaccination has become polarized, and the positions of public health officials are met with skepticism by many vaccine-hesitant Americans. This polarization may impact future vaccination efforts as well as clinician-patient relationships.</p><p><strong>Methods: </strong>We interviewed 77 vaccine-hesitant patients and 41 clinicians about COVID-19 vaccination communication in primary care as part of a Veterans Affairs (VA) trial evaluating a vaccine-communication intervention. This paper reports the findings of a qualitative analysis focused on one aspect of those interviews-the disconnect between primary care clinicians' and patients' perceptions about COVID-19 vaccination communication and decision-making.</p><p><strong>Results: </strong>Rapid qualitative analysis of semi-structured interviews revealed fundamental differences in how clinicians and patients understood and described the reasoning, values, and concerns underlying COVID-19 vaccine hesitancy. These differences were significant and value-laden; they included negative judgments that could undermine communication between clinicians and patients and, over time, erode trust and empathy.</p><p><strong>Conclusion: </strong>We advocate for empathic listening and suggest communication strategies to bridge the divide between clinicians and vaccine-hesitant patients.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"412"},"PeriodicalIF":2.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming community-based primary health care delivery through comprehensive performance measurement and reporting: examining the influence of context.","authors":"Sabrina T Wong, Manpreet Thandi, Ruth Martin-Misener, Sharon Johnston, William Hogg, Fred Burge","doi":"10.1186/s12875-024-02659-z","DOIUrl":"10.1186/s12875-024-02659-z","url":null,"abstract":"<p><strong>Background: </strong>Community-based primary health care represents various community-based health care (CBPHC) models that incorporate health promotion and community development to deliver first-contact health services. Learning health systems (LHSs) are essential for improving CBPHC in which feedback from relevant stakeholders is used to continuously improve health systems with the goal of achieving population health and health equity. Performance reporting is one way to present data to clinicians and decision makers to facilitate a process of reflection, participation, and collaboration among partners to improve CBPHC.</p><p><strong>Methods: </strong>Our objective was to obtain feedback on a regional CBPHC performance portrait through key informant interviews. We used purposive convenience sampling to recruit participants who were clinicians in primary care and/or decision-makers in primary care at a regional level. The performance portrait summarized results of survey questions asked of patients, providers, and primary care organizations. The portrait was organized by the 10 pillars of the Patient's Medical Home (PMH) model. Interview questions specifically asked about portrait content, formatting, interpretability, utility, and dissemination strategies. Content analysis was used to analyze interview data.</p><p><strong>Results: </strong>We completed 19 interviews with key informants from the Canadian provinces of Nova Scotia (n = 8), Ontario (n = 6) and British Columbia (n = 5). We coded transcripts into four content areas: (1) Usability as influenced by content and interpretability, (2) Formatting, (3) Utility, and (4) Dissemination. Using data and reporting back to clinicians and decision-makers about how their practices and jurisdictions are performing in primary care in meaningful ways is important. Our results suggest having available methodology notes, including the analysis used to develop any scoring, sampling and sample sizes, and interpretation of the statistics is necessary.</p><p><strong>Conclusions: </strong>This research was the first to create a comprehensive performance portrait using data driven by factors that are important to primary care partners. We obtained important feedback on the portrait in the context of usability, formatting, utility, and dissemination. This data needs to be used to provide feedback in continuous cycles to evaluate and improve CBPHC models as part of a LHS.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"410"},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decentralizing and task sharing within the primary health system improved access and quality of ANC services in Amhara and Oromia regions: pre-post health facility data.","authors":"Solomon Abebe, Shoa Girma, Abeba Ayele, Tarik Taye, Melissa Morrison, Dedefo Teno, Gebeyehu Asire, Addisie Worku, Della Berhanu","doi":"10.1186/s12875-024-02663-3","DOIUrl":"10.1186/s12875-024-02663-3","url":null,"abstract":"<p><strong>Background: </strong>Improved access to quality antenatal care (ANC) promotes healthy behaviors and early complication management, enhancing maternal and newborn outcomes. The Enhancing Nutrition and Antenatal Infection Treatment for Maternal and Child Health (ENAT) intervention in Ethiopia aimed to increase newborn birth weight by improving ANC utilization and quality. ENAT task shared and decentralized ANC services to facilitate early contact and point of care (POC) testing and management of maternal infections and anemia. This study assessed if task sharing and decentralization improved utilization and quality of ANC services at primary health care facilities.</p><p><strong>Methods: </strong>The study assessed changes in ANC coverage and quality before and after the ENAT intervention, in 65 health centers and 303 health posts across Amhara and Oromia regions of Ethiopia. The intervention task shared ANC services at health centers (Augst 2018-January 2021) and then decentralized services to health posts (February 2021-February 2022). Using descriptive analyses, this study assessed, between baseline and endline, changes in coverage in the proportion of women who: enrolled early into ANC; had at least one ANC contact; and had four or more ANC contacts. Similarly, the study separately assessed each quality indicator through changes in the proportion of iron and folic acid supplementation, and deworming tablets, and POC testing and treatment for anemia, syphilis, and asymptomatic bacteriuria at baseline, phase I and phase II.</p><p><strong>Results: </strong>ANC utilization and quality improved in the 368 sites. Between baseline and endline the proportion of women having an ANC contact before 16 weeks of gestational age increased from 6 to 37%, while those receiving at least one ANC contact and four or more ANC contacts increased from 74 to 91% and 45-57%, respectively. Iron and folic acid supplementation and deworming increased from 44 to 97% and from 44 to 79%, respectively. In the final 12 months of the intervention, 87%, 80%, and 87% of pregnant women attending ANC received POC testing for anemia, syphilis, and asymptomatic bacteriuria, respectively.</p><p><strong>Conclusions: </strong>Our findings suggest that bringing ANC services closer to communities can increase early ANC contact and enhance the coverage and quality of services, leading to better maternal and newborn health outcomes.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"411"},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}