Telenfermagem como estratégia de cuidado a crianças com cuidados contínuos e complexos após alta hospitalar

Purpose – The purpose of this paper is to focus on the Integrated Care Transitions Project between the emergency department (ED) of a university hospital and primary health care (PHC) services in a large city in Southern Brazil was the focus of this study. Care transitions occurred through telephone contact for patients discharged from the ED to PHC. Design/methodology/approach – This descriptive, exploratory qualitative research collected data via semi-structured interviews (n=14) including interns of health disciplines, advisors for interns, nurses, and physicians from the ED and PHC Family Unit. A thematic analysis of the data were conducted. Findings – ED providers felt they gained increased knowledge of the care networks available for patients in the community. Connection between the providers in ED and PHC facilitated confidence in the services provided in the community and increased continuity of care for patients’ needs. The PHC providers recognized integration promoted communication and better care planning for patients discharged from ED. Integrated care made the work in the PHC easier and benefited the users. Research limitations/implications – The study evaluated a program available in one hospital. Generalizability may be limited as services in the ED were provided by professional residents and their advisors, not employees of the hospital. Practical implications – Shared information by different health services leads to better care for patients and greater job satisfaction for providers. Originality/value – Care transitions are not well-managed in health care; there is limited research focusing on care transitions from ED to community. For providers and patients, this program assisted in building capacity and networks for transitions in care.

Barriers to expanding primary care roles for chiropractors: the role of chiropractic as primary care gatekeeper

Pharmaceutical services is a direct service and responsible to patients relating to pharmaceutical products aimed to improve the quality of life of patients. Quality of pharmaceutical services can be assessed based on outpatient satisfaction. The aim of the study was to compare the satisfaction of outpatients with pharmaceutical services in hospitals and primary health care. This study used a cross-sectional comparative study design and was conducted in February-November 2017 in 11 provinces, each province consisting of 2 districts/cities selected purposively. Samples were outpatients who got medicines in hospitals or primary health care at least 31 patients in each pharmacy. Satisfaction was assessed by the dimension of responsiveness, reliability, collateral, friendliness, and physical evidence. Data was collected by the questionnaires and analyzed using chi-square test. The results of the study show that outpatient satisfaction with pharmaceutical services in hospital and primary health care was 90,9% and 96.6%, respectively. The largest percentage of outpatients in hospitals and primary health care are in the age group of 40-59 years, female, has further education, and not working/housewives. There were significant differences in the age group, gender, and education of outpatients between hospitals and primary health care. There was no significant relationship between the characteristics (age, sex, education, occupation) of outpatients and satisfaction with pharmaceutical services in hospitals and primary health care

Background: Access to care is top of mind for everyone. Nova Scotia, a province in eastern Canada is on an expedited journey to world-class health care. Informed by the provincial health strategy, Action for Health, partners across the province, including community are changing primary health care and hospital services. Approach: Transformation examples in primary health care and hospital services focused on person-centered approaches grounded in community partnerships and assets, quality and safety, analytical and experiential information, and health equity will be shared. Focus is on the health needs of people across the lifespan aligned with the knowledge and competencies of collaborative health teams and the use of technology, process improvements and innovation. For hospital services, we are improving patient journeys from admission to discharge with the introduction of a provincial quality collaborative involving interprofessional teams 24/7 along with codesigning a discharge hub. Along with our care coordination centre, these interventions foster further action and accountability across government departments and with community organizations and services to get people back to the place they call home. In primary health care, we are building team-based models where everyone works to full scope and people needs are matched to the best provider. The teams create collaborative primary health care homes situated within health neighbourhoods, so people have coordinated health and social services. This is all situated within widespread commitment to standardized operational excellence and strategic approaches to health workforce and service planning. To support the significant change across the system, we launched a Leadership Academy and Transformation certification to support the development of leaders. Clinicians, researchers, and leaders across the health system engaged with patients and the public to inform this work through a health system wide public engagement campaign to inform health transformation. Community Health Boards are working with communities to identify health priorities and the public is engaged in local design, implementation and evaluation of health initiatives. Results: Patient and clinician stories of success as well as health needs data, workforce data and process and outcome measures will be shared. For hospital services, we added inpatient capacity comparable to adding 70 extra beds per year, increased access to care with 28,000 more DI appointments compared to 209-20; 8,000 more CT scans; 8500 more ultrasounds. With increased bed availability, on average we provided inpatient services for ~20 patients more per day compared to last year and reduced transfer time from the ED to inpatient units by 50%. For primary health care, more than 8,000 patients were attached to a primary care provider in the last year; 8% increase in primary care appointments; 5,000 mobile clinic visits; 95,000 pharmacy clinic visits; 48,000 virtual care appointments and the introduction of a health care navigation app with more than 250,000 downloads to date. Positive feedback from Nova Scotians who have used the multiple primary health care options. Implications: Important learning on multiple, simultaneous, coordinated actions to close the gap in the health workforce and to provide the public with options for clinical services matched to their needs. It is important have quality data, design and feedback processes for public engagement and the need to support health leaders as change agents as well as the utility of technology as an option for health services. The work requires a commitment to system and service partnership, a spirit of possibility, perseverance and the space for teams to learn, fail, adapt and scale innovation. Next steps are to continue with the roll out of success across the health system, continue to learn from patients, families, communities, clinicians and continue to evaluate interventions individually and as they connect for system transformation.

Analysis of primary health care utilisation in south-western Finland—a tool for management

Transferable strategies and actions for increasing health assessments for people with an intellectual disability In Australia, people living with an intellectual disability comprise about 1–3% of the population and, compared with the general population, experience worse health outcomes.1 Poorer participation in primary health care of people with an intellectual disability contributes to high levels of undetected and unmanaged health issues and premature deaths from preventable causes.2 A positive development to address these inequities is the roll-out of a $6.5 million Primary Care Enhancement Program over 4 years (2020–2024). The Enhancement Program will be developed through four lead Primary Health Networks (PHNs), with a view to a national rollout across all PHNs. The aim of the Enhancement Program is to increase the skills and ability of general practitioners and other health care professionals to provide effective primary health care for people with intellectual disability.3 To achieve this aim, a key focus of the Enhancement Program is to increase the uptake of the existing Medicare Benefits Schedule (MBS) preventive health assessments to strengthen equity of primary health care access and to support the delivery of evidence-based preventive health to people with intellectual disability (Supporting Information).3 In Australia, there is some evidence to support the use of preventive health assessments for people with an intellectual disability.4 The evidence suggests that yearly preventive health assessments performed in the primary health care setting pick up on unmet health needs in the area of health screening, health promotion, and identification of unrecognised disease.4 Health assessments are a mechanism to support the delivery of evidence-based preventive health care. While people with intellectual disability might in general seem to share few characteristics with Aboriginal and Torres Strait Islander people (hereafter respectfully referred to as Indigenous), these groups have some common challenges when accessing primary health care. These include complexity of health needs, limitations on identification of being Indigenous or having an intellectual disability in clinical information systems, discrimination, clinical inertia, and communication barriers. For both groups, effective clinical practice requires attention to social determinants of health as well as specific medical needs.5, 6 As part of a long-standing Indigenous primary health care continuous quality improvement (CQI) research collaboration, we have knowledge of the barriers to and enablers of the uptake of preventive health assessments — specifically, the MBS item 715 for Indigenous people.7, 8 As such, we have identified some positive actions that may potentially be transferrable to people living with an intellectual disability, along with strategies to inform the effective roll-out of this new program. There is currently no dedicated MBS item on health assessments for people living with an intellectual disability. The 2009 Medicare review resulted in the merging of MBS items dedicated to health assessments for people with intellectual disability with four time-based MBS items (MBS 701, brief; 703, standard; 705, long; or 707, prolonged) for other target groups.9 With the collapse of different health assessments into the single newer MBS item, the ability to identify the extent to which health assessments are being provided to different target groups, such as people living with an intellectual disability, has been lost.9 Given this, PHNs now cannot track uptake or implementation of health assessments for people with an intellectual disability. It is impossible to extract the relevant data from administrative systems at the primary health care level or Department of Health level. Having a dedicated Indigenous-specific health assessment (MBS item 715) has enabled research and evaluation on barriers and enablers of implementation, and data about uptake have informed subsequent policy development.5 Reinstatement of a dedicated and adequately remunerated MBS item is vital to building the evidence base to inform health policy and the provision of health services for people with an intellectual disability through contributing to understanding of who is receiving health assessments and who is not. This will in turn enable development of targeted strategies for increasing uptake. The inability of existing primary health care electronic clinical information systems to systematically identify people living with an intellectual disability will limit the ability of primary health care to identify eligible patients and invite them for a health assessment. Therefore, we recommend that clinical information systems in primary health care are upgraded to enable the easy identification of people living with an intellectual disability, and that primary health care staff are appropriately trained to use these systems. Any patient identifier established in the primary health care setting should be able to be linked to other relevant data systems. Identifying people living with intellectual disability in data systems is particularly important for piloting the new Australian National Disability Data Asset, which will bring together data from multiple sources, including primary health care, to improve the ability to measure and improve outcomes for people with disability.10 A useful point of reference for Australian primary health care is the United Kingdom model, in which people with intellectual disability must be identified at primary health care services. This requirement is supported by a legislative framework and is part of a long term National Health Service plan for providing targeted health services.11 It has been observed that Indigenous health assessments do not necessarily reflect the health aspirations and goals of Indigenous people.12 This learning can be used to ensure that health assessments for people living with intellectual disability are evidence-based, developed with input from people with intellectual disability and carers, and reviewed regularly. Electronic templates can be developed for use in common general practice clinical information systems. With appropriate ethics approval and consent, the data collected can be used for CQI and research purposes to improve implementation of health assessments and ultimately health outcomes. Implementing CQI processes has been shown to be effective in improving the delivery of Indigenous-specific health assessments and evidence-based preventive health care.8 We therefore recommend supporting CQI activities to increase the uptake of health assessments for people living with an intellectual disability. This could include a target in the Practice Incentive Program Quality Improvement program (such as, proportion of people living with an intellectual disability who have had a health assessment), or supporting primary health care to develop locally relevant CQI processes. Although prevalence studies have identified that certain medical conditions and risk factors occur more frequently in people with intellectual disability, there are currently no national clinical guidelines for the delivery of best practice primary health care for people living with an intellectual disability.1 Furthermore, there have been recent calls for the inclusion of intellectual disability into standard clinical guidelines as a specific population that requires distinctive consideration.13 Such guidelines would be a reference point for assessing quality of care for improvement purposes and for building the capacity of GPs and other providers, similar to the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people.14 Although there has been increased uptake of Indigenous-specific health assessments, there are continuing gaps in providing appropriate follow-up care, which is essential for ensuring benefit from health assessments.7, 8, 15 We recommend increasing awareness of relevant follow-up MBS items, in addition to health assessments. Investment in the Enhancement Program appears primarily targeted at improving skills and abilities of GPs to improve the quality of care for people with intellectual disability. Yet, there is clear evidence of the value of addressing both demand- and supply-related determinants to improve access to health assessments.5 For example, an effective strategy in increasing the uptake of Indigenous-specific health assessments has been marketing campaigns targeted at community members to increase their awareness of the importance and availability of the assessments. Therefore, we recommend a similar awareness campaign targeting community, carers and disability service providers about the availability of these health assessments for people living with intellectual disability. Naturally, not all learning from experience of Indigenous health assessments is transferable. For example, a preference for health assessments to be conducted by a clinician of the same culture or experience may not apply. While discrimination may be a common factor affecting health and wellbeing, it will be experienced and manifest in different forms to influence health assessment implementation. Australia lacks legislative, policy and regulatory frameworks required to support or enact improving health outcomes for people with intellectual disability. People living with disability are neglected, as a group with specific needs, in both the current draft of the 10-year National Preventive Health Strategy and Australia's Long Term National Health Plan.16, 17 Recognition in relevant frameworks would be a pivotal starting point for addressing the health needs of people living with an intellectual disability. In conclusion, we welcome this commitment to investing in improving access to primary health care and health outcomes for people living with an intellectual disability. We believe there is a unique opportunity to reflect on, and learn from, the experience of implementing Indigenous-specific health assessments, and to apply these learnings to the campaign for increased access to health assessments for this important group. Despite emerging evidence of the benefits of health assessments, there is a clear need to continue to evaluate their effectiveness in different contexts. Multifaceted strategies and action are required at the primary health care centre and service level, in the community, and at patient and policy levels to increase health assessments and follow-up for people living with an intellectual disability. The development of this manuscript would not have been possible without the active support, enthusiasm and commitment of staff in participating primary health care services, and members of the Centre for Research Excellence in Strengthening Systems for Indigenous Health Care Equity and the Centre for Research Excellence in Disability and Health. No relevant disclosures. Not commissioned; externally peer reviewed. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Before 1999, few treatment services for nicotine-addicted smokers existed in England. When national treatment services were introduced, those responsible for setting them up liaised closely with primary care health services. Setting up an entirely new national service, treating a new category of patient (smokers motivated to stop) was an ambitious aim and this paper documents the problems encountered in the early stages of this process. To describe the principal challenges encountered and solutions employed by those setting up the services during the initial period of smoking cessation service implementation. Qualitative, semistructured interviews with 50 smoking cessation staff in two former English health regions conducted in autumn 2001. Two principal factors which slowed the initial development of smoking cessation services were: (i) the lack of a work-force with experience in smoking cessation methods and (ii) the fact that services were set up outside existing primary and secondary care health services in England. As few training courses in smoking cessation were available, many services provided their own in-house training for staff appointed as smoking cessation advisers. Consequently, senior service staff devoted a lot of effort to training new staff which meant that they had less time to spend on other important tasks which were necessary for service implementation. Smoking cessation services needed to develop relationships with primary care health services in order to generate referrals and find venues for the delivery of smoking cessation interventions. Liaising with primary care physicians was time-consuming, however, and some primary care physicians were opposed to the ideas that service staff had for the interface between primary care and smoking cessation services. As new smoking cessation services were not set up within existing primary or secondary health care services, service staff had to spend large amounts of time on this process of negotiation and overcoming scepticism from some primary health care physicians. If smoking cessation services are set up in other countries, rapid implementation would be facilitated by ensuring that adequate numbers of health professionals trained in smoking cessation methods are available to staff services. Additionally, locating new smoking cessation services within existing health providers' services may speed up service implementation, but this option may not suit all health systems.

IntroductionThe availability of quality primary health care (PHC) services in Nigeria is limited. The PHC system faces significant challenges and the improvement and expansion of PHC services is constrained by low government spending on health, especially on PHC. Out-of-pocket (OOP) expenditures dominate health spending in Nigeria and the reliance on OOP payments leads to financial burdens on the poorest and most vulnerable populations. To address these challenges, the Nigerian government has implemented several legislative and policy reforms, including the National Health Insurance Authority (NHIA) Act enacted in 2022 to make health insurance mandatory for all Nigerian citizens and residents. Our study aimed to determine the costs of providing PHC services at public health facilities in Kaduna and Kano, Nigeria. We compared the actual PHC service delivery costs to the normative costs of delivering the Minimum Service Package (MSP) in the two states.MethodsWe collected primary data from 50 health facilities (25 per state), including PHC facilities—health posts, health clinics, health centers—and general hospitals. Data on facility-level recurrent costs were collected retrospectively for 2019 to estimate economic costs from the provider’s perspective. Statewide actual costs were estimated by extrapolating the PHC cost estimates at sampled health facilities, while normative costs were derived using standard treatment protocols (STPs) and the populations requiring PHC services in each state.ResultsWe found that average actual PHC costs per capita at PHC facilities—where most PHC services should be provided according to government guidelines—ranged from US$ 18.9 to US$ 28 in Kaduna and US$ 15.9 to US$ 20.4 in Kano, depending on the estimation methods used. When also considering the costs of PHC services provided at general hospitals—where approximately a third of PHC services are delivered in both states—the actual per capita costs of PHC services ranged from US$ 20 to US$ 30.6 in Kaduna and US$ 17.8 to US$ 22 in Kano. All estimates of actual PHC costs per capita were markedly lower than the normative per capita costs of delivering quality PHC services to all those who need them, projected at US$ 44.9 in Kaduna and US$ 49.5 in Kano.DiscussionBridging this resource gap would require significant increases in expenditures on PHC in both states. These results can provide useful information for ongoing discussions on the implementation of the NHIA Act including the refinement of provider payment strategies to ensure that PHC providers are remunerated fairly and that they are incentivized to provide quality PHC services.

To assess knowledge and practice of primary eye care among primary healthcare workers known as community health extension workers in Funtua district of Nigeria. Cross-sectional mixed method study among health workers employed in government-owned primary healthcare facilities. Quantitative data were obtained using self-administered questionnaires and checklists, while qualitative data by modified Delphi technique, role plays and observation. A score of 1 was given for each correct answer, while a total score of ≥60% was considered 'good'. Eighty three of 88 health workers participated (94%) in the questionnaire survey; while 16 of them were selected for the qualitative survey. Good scores regarding the knowledge of common eye diseases were obtained by 68.7%, but only 26.4% of them could identify their most important features. Participants could undertake 3 of 5 steps in visual acuity testing. Skills in recognising common eye diseases and their management were weak; while practice was often not according to the guidelines. Community health extension workers displayed good knowledge of common eye diseases. Areas of weakness are recognition and interpretation of eye signs, and practice rarely follows the guidelines. Preventive medicine was neglected; community health extension workers require practical retraining and supervision to achieve integration of primary eye care into primary healthcare services.

Objective: World Health Organization (WHO) identified a gap in meeting mental health care needs in the health services. To bridge this gap, at Yarmouk Primary Health Care Center and Capital Health District area in Kuwait, it was decided to implement a best practice model, for integrating mental health services into primary health care services in Kuwait. Methodology: Implementation of the best practice model, for integrating mental health services into primary care services in Kuwait’s health system was initiated in 2008. It involved the integration of cost–effective, feasible evidence-based interventions for mental health conditions in Primary Health Care (PHC) and other priority health programs. It envisioned a mental health component in PHC, to enhance access to mental health care and improve identification and treatment rates for priority mental disorders, to provide holistic care for particularly disabling comorbid physical and mental health problems, and to engage in mental health promotion. Results: The program was initiated in 12 primary mental health care clinics in the Capital Health District area in Kuwait. Two hundred (200) Family Physicians and General Practitioners, were trained in psychiatric integration within the primary health care system. Regular evaluation of the performance of physicians working in primary mental health clinics in the program was ensured. Periodic evaluation of psychiatric patient visits in the Primary mental health clinics was conducted for quality improvement. Mental health awareness days and educational sessions were organized. Discussion: A practice model for integrating mental health services into primary care was developed in Kuwait, involving stakeholders. Its favorable impact on mental health in the community is undergoing scrutiny. Limitations such as human resource shortage and, movement of trained physicians from primary care to other administrative departments in the Ministry of Health (MOH), coupled with a lack of relevant data and the need for better coordination between stakeholders, were identified. Issues regarding electronic health records, patient confidentiality, and quality of services were identified. Stigma related to mental health issues resulted in a delay in implementing the integration. Conclusion: With increasing psychiatric illnesses and a lack of adequate specialized mental health services, addressing this issue at the primary care level offers an attractive cost-effective option to deal with the crisis. Keywords: Mental Health, Primary Health Care, Integration, Health system, Family Physician

This paper deals with the some of the important variable factors relating to health care in Saudi Arabia, with special emphasis on primary health. Other aspects considered are the financial influen...

The implementation of the primary health care (PHC) approach requires essential health system inputs, including structures, policies, programs, organization, and governance. Effective health system governance (HSG) is crucial in PHC systems and services, as it can significantly influence health service delivery. Therefore, understanding HSG in the context of PHC is vital for designing and implementing health programs that contribute to universal health coverage (UHC). This scoping review explores how health system governance contributes to delivering PHC services aimed at achieving UHC. We conducted a scoping review of published evidence on HSG in the delivery of PHC services toward UHC. Our search strategy focused on three key concepts: health system governance, PHC, and UHC. We followed Arksey and O'Malley's scoping review framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist to guide our methodology. We used the World Health Organization's framework on HSG to organize the data and present the findings. Seventy-four studies were included in the final review. Various functions of HSG influenced PHC systems and services, including:1) formulating health policies and strategic plans (e.g., addressing epidemiological and demographic shifts and strategic financial planning), 2) implementing policy levers and tools (such as decentralization, regulation, workforce capacity, and supply chain management), 3) generating intelligence and evidence (including priority setting, monitoring, benchmarking, and evidence-informed decision-making), 4) ensuring accountability (through commitments to transparency), and 5) fostering coordination and collaboration (via subnational coordination, civil society engagement, and multisectoral partnerships). The complex interplay of these HSG interventions operates through intricate mechanisms, and has synergistic effects on PHC service delivery. PHC service delivery is closely linked to HSG functions, which include formulating strategic policies and plans responsive to evolving epidemiological and demographic needs, utilizing digital tools, decentralizing resources, and fostering multisectoral actions. Effective policy implementation requires robust regulation, evidence-based decision-making, and continuous monitoring. Accountability within health systems, alongside community engagement and civil society collaboration, is vital for realizing PHC principles. Local health institutions should collaborate with communities-end users of these systems-to implement formal rules and ensure PHC service delivery progresses toward UHC. Sociocultural contexts and community values should inform decision-making aligning health needs and services to achieve universal access to PHC services.

Background: According to the World Health Organization, healthy aging is the process of developing and maintaining functional abilities that make the elderly happy. The increase in the elderly population requires more attention. In particular, health services at the primary health care level face problems related to the limited capacity of overall health services, especially in terms of health promotion and preventive health issues. It is necessary to improve the quality of health care services for the elderly to prevent greater health problems among the elderly population.Objectives: Understand the need to provide holistic health services for healthy aging and use their capabilities, and strengthen cooperation among health professionals in achieving healthy aging.Discusion: Primary health care is pointed out that primary health care should provide comprehensive services in a holistic manner to support a healthy aging process. Therefore, a well-structured, integrated, and cross-industry collaborative primary care system is needed. The system should include changes in professional behavior, coordination of care, and participation of patients' families and communities in comprehensive health care. This can be achieved through inter-professional education, continuous training and education of primary health care professionals, as well as primary health care services and cross-level health care technology innovation.Conclusions: Healthy aging is not just the absence of disease. Everyone in health and social care at all levels can play a role to help improve healthy aging. To make the elderly healthy, starting from the prevention of young health problems, it requires collaboration between health workers, primary health care and other health service levels, and health care that cooperates with patients, families, and communities.Keywords: healthy aging, primary care, preventive, health worker

BackgroundImproved Primary Health Care (PHC) utilisation is central to reducing the unacceptable morbidity and mortality rates characterising populations living in remote communities. Despite poorer health, significant inequity characterises the funding of PHC services in Australia’s most remote areas. This pilot study sought to ascertain what funding is required to ensure equitable access to sustainable, high quality primary health care irrespective of geographical remoteness of communities.MethodsHigh performing remote Primary Health Care (PHC) services were selected using improvement measures from the Australian Primary Care Collaboratives Program and validated by health experts. Eleven PHC services provided data relating to the types of services provided, level of service utilisation, human resources, operating and capital expenses. A further four services that provide visiting PHC to remote communities provided information on the level and cost of these services. Demographic data for service catchment areas (including estimated resident population, age, Indigenous status, English spoken at home and workforce participation) were obtained from the Australian Bureau of Statistics 2011 census. Formal statistical inference (p-values) were derived in the linear regression via the nonparametric bootstrap.ResultsA direct linear relationship was observed between the total cost of resident PHC services and population, while cost per capita decreased with increasing population. Services in smaller communities had a higher number of nursing staff per 1000 residents and provided more consultations per capita than those in larger communities. The number of days of visiting services received by a community each year also increased with population. A linear regression with bootstrapped statistical inference predicted a significant regression equation where the cost of resident services per annum is equal to $1,251,893.92 + ($1698.83 x population) and the cost of resident and visiting services is equal to $1,378,870.85 + ($2600.00 x population).ConclusionsThe research findings provide empirical evidence based on real costs to guide funding for remote PHC services that takes into account the safety and equity requirements for a minimum viable service. This method can be used as a transparent, coordinated approach to ensure the equitable delivery of sustainable, high quality PHC in remote communities. This will in turn contribute to improved health outcomes.

Problem: Laboratory medicine, medical-biochemical diagnosis in primary health care is much represented. By organization of family medicine medical-biochemical diagnosis is defined as a branch of diagnostic services in primary health care. For these actions is necessary in the morning prior to admission of users and their demands that all jobs are properly prepared. On previous day should be provided and prepared: accessories, reagents and machines. Morning daily routine work of preceding control and calibration equipment, methods and process quality control of work in the laboratory. Only after the fulfillment of the procedures followed overview of search control of samples. After validating the results of daily quality control and after they met the criteria can be analytically examined samples from users. These procedures are not sufficiently familiar to users and doctors, for that are very often necessary the direct telephone communication between them. To make the results of laboratory tests needed are huge material resources. This is evident in the economic analysis where laboratory tests are valued with a score of: search by type and material resources expended for analytical examination. These technical and financial performances of laboratory medicine are not appropriately classified as blatant as that in other industries, technology and other primary health care (PHC) and family medicine (FM). Goal: The overall objective of the research is to define a model of efficiency (or effectiveness) of medical-biochemical diagnosis for users with the requirements of units of family medicine (FM), in a representative sample of patients in the unit for the laboratory diagnosis of the Primary Health Care Center Gracanica. Confirm what is the usefulness of the application of laboratory diagnosis in family medicine. Determine the frequency of the need for laboratory tests in the therapeutic treatment of major diseases. Evaluate the need for using laboratory diagnostics to try to prevent major diseases. Material and methods: The study included a total of 1000 respondents. All subjects were users of primary health care in Primary Health Care Center Gracanica (Tuzla Canton) in primary health care units have received requests for laboratory diagnosis. This paper is an analysis of the representation requirements for the laboratory diagnosis by doctors in primary health care and the most frequent diseases in primary care. An analysis is made of laboratory test results, based on requests for laboratory diagnosis by doctors and illnesses in primary care. Made is analysis of the presence of normal and pathological laboratory test results from the request for the laboratory diagnosis by doctors in primary health care. Made is an analysis of the most common laboratory tests requests, and based on requests for laboratory diagnosis by doctors in primary health care and the most frequent diseases in primary health care. Incorporated is the economic analysis of labor