Effectiveness Of Primary Health Care Research Articles

Perceived Healthcare Priorities, Barriers, and Preferences When Selecting Private or Governmental Healthcare Services Among a Sample of University Affiliates from Saudi Arabia.

This study aims to measure the perceived healthcare priorities, barriers, and preferences when selecting private or governmental healthcare services among a sample of university affiliates from Saudi Arabia. This study utilized a cross-sectional design to reach targeted adults on the Jazan University campus. Data were collected during personal interviews. The questionnaires measured participant demographics, perceived healthcare priorities, barriers, and preferences when selecting private or governmental healthcare services. A chi-squared test was used to detect statistically significant differences between demographic and clinical characteristics according to preferences in their healthcare-seeking behavior. A total of 3083 university affiliates participated in this investigation. The mean age of the participants was 28 years, 49.6% of whom were males. Among the sample, 63% were students, and the remaining were university staff. The health condition perceived as most important was diabetes, and most of the sample viewed primary healthcare as the most vital service. The healthcare-seeking behavior of the sample indicated a higher preference for using governmental healthcare services. However, notable barriers related to the availability of appointments, long waiting times when visiting a healthcare facility, and healthcare costs were identified. Preference for private healthcare services was higher among females, expatriates, non-Arabic speaking affiliates, those with higher socioeconomic status, and health insurance owners (p-values < 0.05). Additionally, higher utilization of private healthcare services was noted among participants who frequently visit dentists and physicians and those performing consistent, routine medical checkups (p-values < 0.05). The findings indicate the importance of strengthening the role of primary healthcare to address the health needs required for preventing and managing chronic diseases, such as diabetes. Additionally, enhancing access to and effectiveness of primary healthcare may reduce the impact of healthcare barriers associated with limited appointments and prolonged waiting times.

The Primary Health Care Services in a Philippine Province

The study aimed to assess the effectiveness of primary health care (PHC) in selected municipalities in Batangas, focusing on various health programs. It involved 384 respondents from different municipalities. The questionnaire was the primary data collection instrument, validated by experts and based on national health programs provided by the Department of Health. The findings revealed that the majority of respondents were females aged 40 to 50, with a high school education, and primarily from Barangay Buli, Taal, Batangas. The effectiveness of PHC services varied across different health programs. Programs like maternal and child health, Expanded Program on Immunization, tuberculosis control, and dental health were considered effective. However, diarrheal disease and STD/AIDS prevention programs were rated less effective. Significant differences were observed when assessing the effectiveness of PHC services based on respondent profiles. Respondents aged 51 and above had a more positive view of PHC effectiveness, except for the Diarrheal Disease program. Females generally perceived PHC services as more effective than males, except for specific programs. Educational attainment also influenced the perceptions of effectiveness. Recommendations included requesting increased budget allocation, building facilities, and using social media for awareness campaigns to improve PHC services.The proposed action plan was suggested for future implementation and evaluation. Future research should explore the delivery of PHC services using different variables, specifically focusing on service delivery in PHC.Keywords: Primary health care; Health programs; Effectiveness; Survey method

Challenges of Health Informatics Systems in Primary Health Care

Health informatics systems are indispensable implements for cultivating the eminence and effectiveness of primary health care. Health informatics systems are formed of databases and figures regarding all clinical facilities. The utilization of health informatics systems helps both healthcare providers and patients in the management of disorders and disease risks and in developing well-being. However, there are a number of challenges to the application and practice of health informatics systems in the settings of primary health care. These challenges embrace; the absence of capital and money, the absence of technical skill, the absence of user recognition and approval, information quality problems, safety and confidentiality concerns, incorporation with other systems, and interoperability deficiency. Human, cultural, and financial barriers with deficiency of technical proficiency, deficiency of a relation between clinicians and patients, worries about information privacy, absence of administration guidelines, bureaucracy, lack of training, English language barrier, the degree of workload due to the time shortness during clinical settings, infrastructure concerns e.g. availability of the electricity, computers, and internet, also high turnover in IT among healthcare are also some challenges that should be addressed. These challenges can hold back the capacity of health informatics systems to comprehend their complete perspective in primary health care. To address these challenges, it is essential to provide sufficient capital and funds, offer practice and maintenance for users, overcome information quality concerns, apply safety and confidentiality procedures, incorporate health informatics systems with other systems, and endorse interoperability. By overcoming these challenges, health informatics systems can play a major role in developing the quality and efficiency of primary health care.

Improving the quality of life for premature infants through the continuity of care approach: A literature review

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; The agenda for strengthening the global health architecture is to improve quality of life for premature infants. Premature births increase the morbidity and mortality of newborns, necessitating innovation in primary health care. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Objectives:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; This study was conducted to examine innovation programs with a continuity of care approach in primary health care for premature infants in an effort to strengthen the global health architecture. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Methods:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; A literature review method was used to analyze articles obtained using databases such as Science Direct and Google Scholar. The researcher used the key words “continuity of care” and “premature infants”. The inclusion criteria were full-text journal articles published from January 2020-December 2022 in English-language journals. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; This study obtained ten articles that correspond to the continuity of care approach for premature infants. The articles included four qualitative studies, three quantitative studies, one mixed-method study, one literature review, and one systematic review. There are three themes related to the continuity of care for premature infants, including (1) Primary healthcare with information continuity, relationships continuity, and management continuity; (2) Continuity of care in the antenatal, natal, and postnatal periods; (3) The continuity of care on premature infant approach improves the outcome of premature infant care, the ability of parents, and health service quality. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Conclusions:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; A continuity of care approach can increase the achievement of adequacy, equity, efficiency, and effectiveness in primary health care for premature infants. Joint synergy between the community, health services, and health policymakers is essential in efforts to strengthen the quality of life for premature infants.&lt;/em&gt;&lt;/p&gt;

Analysis of the trend in the morbidity of the population of the Russian Federation considering the factors affecting the availability of general medical services

Introduction. The morbidity is one of the key indicators used to assess the level of public health and demonstrating the level of accessibility of medical care to the population and the effectiveness of primary health care. &#x0D; The aim was to analyze the trend in the morbidity of the population in the Russian Federation, considering factors affecting the availability of general medical services, in the context of the subjects of the Russian Federation. &#x0D; Material and methods. The study based on information from the federal static observation form No. 12 “Information on the number of diseases registered in patients living in the service area of a medical organization” for 2018–2021. &#x0D; Results. In the Russian Federation from 2018 to 2021, general morbidity increased by 2.6%, while newly identified morbidity increased by 9.4%. The Ivanovo region had the largest rate of rise in general morbidity (24.9%), Stavropol Krai — the highest newly identified morbidity (34.7%). When assessing the influence of various factors on the level of morbidity using the method of stable regression, the level of provision of the population with doctors was revealed to have the greatest influence, which is confirmed by the presence of a strong direct dependence.&#x0D; Limitations. The data from the federal static observation form No. 12 “Information on the number of diseases registered in patients living in the service area of a medical mamnagement” for 2018–2021 for 85 subjects of the Russian Federation were examined to determine the morbidity of the population of the Russian Federation that is able-bodied and over the working age.&#x0D; Conclusion. The morbidity rate in the Russian Federation during the period under review tends to increase. It is an integral indicator of the availability of medical care and the detection of diseases, which influenced by a variety of factors, including the availability of primary care doctors, the strength of the medical managemorganization, the degree of hospitalization, the average number of visits to doctors.

EPH158 Assessment of the Effectiveness of Primary Health Care By Health Care Managers

to determine the effectiveness of the use and readiness to work under existing epidemic conditions of primary care, to develop management solutions to improve the work of primary health care organizations, including aspects of staffing, drugs and medical devices, equipment and transport, as well as aspects of prevention and readiness to work under epidemiological risks; management system and organization of medical care; system of professional development of medical.

The Relationship between Covid-19 Fatality and Satisfaction from Quality Health Care in Oecd Countries

Background/aim: The relationship between COVID-19 fatality and quality health care in OECD countries was aimed to be examined, considering the effectiveness of primary health care, the effectiveness of secondary health care. Materials and methods: Data from OECD countries were collected from open-access websites. Dependent variable is COVID-19 fatality, independent variables are effectiveness of primary health care, the effectiveness of secondary health care, gross domestic product, median age, number of hospital beds, number of intensive care unit beds, number of doctors and nurses, number of computed tomography scanners, educational status and air pollution. Spearman Rho correlation and partial correlation were used in the analysis of the data, and generalized linear regression analysis was performed. Results: A statistically significant relationship was found between case fatality rates and the effectiveness of secondary health care (p&lt;0,05). The relationships between case fatality rates and other health, demographic indicators are not statistically significant. In Generalized Linear Model (GLM-Logit Model) analysis results, only the effectiveness of secondary health care (p&lt; 0,01) and the number of hospital beds (p&lt;0,05) were found to be statistically significant. Conclusion: Satisfaction with quality health care is not associated with COVID-19 fatality. As the effectiveness of secondary health care increases, the fatality of COVID-19 decreases. The effectiveness of primary health care has no effect on COVID-19 fatality.

Staff competencies and patient care effectiveness in primary healthcare (pilot study)

Background: The aim of the study was to determine the correlation between hard and soft competences of primary care physicians and the effectiveness of patient care, which may be of significant importance both in the process of managing medical entities and in order to take appropriate actions aimed at increasing the effectiveness of care. Methods: The population studied in this study were primary care physicians employed at the Medical and Diagnostic Center (MDC) in Siedlce, Poland. In the study, doctors' qualifications were measured by the number of specializations held by a physician, and experience was measured by the total number of years of work as a doctor and the length of work as a specialist at MDC (in years). The data was collected in a questionnaire survey. Physicians' social competences were measured by the Social Competence Profile (PROKOS). As there are no measures of treatment effectiveness at the level of individual workplaces, apart from measuring patient satisfaction, its original definition was adopted and 14 indexes were developed, which were calculated on the basis of anonymized data from CMD information systems. Results: The social competences of the surveyed primary care physicians were clearly lower than the competences of the doctors surveyed in the standardization study. The exception was social activism. The scales of individual dimensions of social competences were characterized by very high reliability. The individual dimensions of soft skills of all surveyed primary care physicians were strongly correlated with each other. The overall work experience and work experience of primary care physicians at MDC, analyzed under hard competences, showed no correlation. The factor analysis performed for 14 original indexes of effectiveness showed that 5 of the original indexes created a very reliable scale. Conclusions: The selection of a strong scale consisting of five original effectiveness indexes is a step towards the development of a uniform index of the effectiveness of patient care in primary care, which will be a significant contribution to science.

Perceptions of nurses and physicians on pay-for-performance in hospital: A systematic review of qualitative studies.

This study aimed to systematically examine perceptions of nurses and physicians on pay-for-performance in hospital. Pay-for-performance projects have proliferated over the past two decades, most systematic reviews of which solely focused on its effectiveness in primary health care and the physicians' or nurses' attitudes. However, systematic reviews of qualitative approaches for better examining perceptions of both nurses and physicians in hospital were lacking. Electronic databases were systematically searched with date from the inception to 31 December 2020. Meta-aggregation synthesis methodology and the conceptual framework of the theory of planned behaviour were used to summarize findings. A total of nine studies were included. Three major synthesized themes were identified: (1) perceptions of the motivation effects and positive outcomes, (2) perceptions about the design defects and negative effects and (3) perceptions of the obstacles in the implementation process. To maximize the intended positive effects, nurses' and physicians' perceptions should be considered and incorporated into the project design and implementation stage. The paper gives enlightenment to nurse managers on improving and advancing the cause of nurses when planning for or evaluating their institutions' policies on pay-for-performance in the future research.

Advanced Nursing Practice as a panacea for healthcare in Poland

Abstract Introduction. Advanced Nursing Practice (ANP) is a relatively new concept in Poland. In order to be introduced, it needs a legal basis. There are specific regulations in Europe, yet they are only a framework for more detailed legislation in every member state of the European Union. Aim. To discuss Advanced Nursing Practice principles and the benefits for the national healthcare system resulting from implementing ANP in Poland. Discussion. Advanced Nursing Practice was defined in the 1950s in the United States of America. Presently in Europe and in Poland a definition by the International Council of Nurses (ICN) is applied. ICN has also defined the scope of competences for nurses of Advanced Practice. In Poland there already exist some regulations which substantially cover this scope. ANP implementation can naturally start in hospital settings. In ambulatory field ANP gives hope for effective transformation, namely increasing the efficiency and effectiveness of Primary Healthcare (pol. POZ) centers (comparable to General Practice in other countries). Conclusions. Effective implementation of ANP in Poland requires a slight modification of existing legal acts, a properly developed educational system and proven solutions or concepts derived from other European countries’ experience.

Pathways to Enable Primary Healthcare Nurses in Providing Comprehensive Primary Healthcare to Rural, Tribal Communities in Rajasthan, India.

Background: Emerging health needs and uneven distribution of human resources of health have led to poor access to quality healthcare in rural areas. Rural pathways provide an approach to plan and evaluate strategies for ensuring availability, retention, motivation, and performance of human resources for health in rural areas. While effectiveness of primary healthcare (PHC) nurses to deliver primary health care is established, there is not enough evidence on ways to ensure their availability, retention, motivation, and performance. The paper draws on the program experience and evidence from a primary healthcare network (AMRIT Clinics), in which nurses play a central role in delivering primary healthcare in rural tribal areas of Rajasthan, India, to bridge this gap.Methods: Rural, tribal areas of Rajasthan have limited access to functional healthcare facilities, despite having a high burden of diseases. We used the rural pathway approach to describe factors that contributed to the performance of the nurses in AMRIT Clinics. We analyzed information from the human resource information system and health management information system; and supplemented it with semi-structured interviews with nurses, conducted by an independent organization.Results: Most nurses were sourced from rural and tribal communities that the clinics serve; nurses from these communities were likely to have a higher retention than those from urban areas. Sourcing from rural and tribal communities, on-going training in clinical and social skills, a non-hierarchical work environment, and individualized mentoring appear to be responsible for high motivation of the primary healthcare nurses in AMRIT Clinics. Task redistribution with due credentialing, intensive and on-going training, and access to tele-consultation helped in sustaining high performance. However, family expectations to perform gendered roles and pull of government jobs affect their retention.Conclusion: Rural and remote areas with healthcare needs and scarcity of health provisions need to optimize the health workforce by adopting a multi-pronged pathway in its design and implementation. At the same time, there is a need to focus on structural factors that affect retention of workforce within the pathway. Our experience highlights a pathway of up-skilling PHC nurses in providing comprehensive primary healthcare in rural and remote communities in Low and Middle-Income Countries (LMICs).

Expenditure trends in ambulatory care sensitive conditions in Piauí, Brazil, 2009 a 2018

Abstract Introduction Hospitalizations for ambulatory care sensitive conditions (ACSC) are an indicator that assesses the effectiveness of Primary Health Care. Such hospitalizations burden the public health budget and use the resources that could subsidize other health actions. Aim Analyze expenditure trends in hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) in Piauí, Brazil, from 2009 to 2018. Methods Ecological time-series study based on data from the Hospital Information System (SIH). For temporal trend analysis, a linear regression model was built using the Stata version 14 program. Results US$ 119,559,009.56 (Average = US$ 6,292,579.45/year) was spent on ACSC, representing 17.3% of the total hospitalizations (US$ 690,714,037.24). 2010 was the period with the highest cost (14.8%). In contrast, 2018 was the year with the lowest expenditure (5.8%). 23.7% of the costs went to hospitalizations for gastroenteritis. There was a significant decrease in total expenses with ACSC (β = -1.27; 95%CI: -1.65; -0.89; p &amp;lt; 0.001). There was also a reduction in expenses per individual hospitalized, while in 2009, the average expenditure was US$ 230.97/hospitalization, in 2018 it was US$ 157.30/ hospitalization, representing a significant reduction of 31.9%, (β = -12.4; 95%CI: -18.2; -6.6; p = 0.001). The “asthma” and “hypertension” groups showed the greatest cost reductions, 84.8% and 80.7%, respectively. However, an increase in spending on diseases related to prenatal and childbirth (4.1 times) and skin infection (3.9 times) was identified. Conclusions Part of the cost reduction is explained by the reduction of hospitalizations for ACSC. The reduced spending averages are compatible with lower hospitalizations by most expensive groups. Linked to these findings, it is observed that Brazil has faced a period of recession since 2015. To this end, additional research must be carried out to relate the expansion of health coverage with the results presented. Key messages The costs of hospitalizations for PHC-sensitive conditions reflect the policy of inducing health system coverage, being lower for greater coverage. The evaluation of the cost of specific groups allows the induction of PHC policies focusing on the specific care for each group with a higher cost so as not to burden the health system.

The Effect of Access to Primary Care Physicians on Avoidable Hospitalizations: A Time Series Study in Rural Areas of Tehran Province, Iran.

BackgroundAvoidable hospitalizations (AHs) are defined as hospitalizations that could have been prevented through timely and effective services. AHs are, therefore, an indicator used to evaluate the access and effectiveness of primary health care services.MethodsA retrospective time-series study spanning 8 years (2006–2013) was conducted to determine the relationship between AHs and gender, age, and access to primary health care physicians in rural areas in Tehran province, the capital of Iran. The total number of avoidable hospitalizations was 22,570; logistic regression was estimated for each year separately.ResultsTotal hospitalizations and AHs increased during the study period, especially during the first 3 years of the study. AHs, as a percentage of total hospitalizations, did not change significantly throughout the study years. This value was 22.3% during the first year of study and varied between 17% and 19.6% from 2007 to 2013. No statistically significant relationship was seen between AH occurrence and access to a physician during the study years.ConclusionIncreasing access to primary health care physicians cannot necessarily result in decreased AHs. Considering the factors influencing AHs while designing and implementing the family physicians program is important to achieve the expected results regarding the effectiveness of primary health care services.

Mobile primary health care clinics for Indigenous populations in Australia, Canada, New Zealand and the United States: a scoping review protocol.

The objective of this review is to explore and examine the available evidence on mobile primary health care clinics for Indigenous populations in Australia, Canada, New Zealand and the United States. Despite the evidence for the effectiveness of primary health care in improving health outcomes, accessing primary care services is often problematic for Indigenous populations in Australia, Canada, New Zealand and the United States. Improving the accessibility of primary health care services for Indigenous populations is considered essential to alleviating the burden of disease and improving well-being. The review will consider literature that discusses the implementation of a mobile primary health clinic for Indigenous populations. Mobile primary health care clinics targeting Indigenous populations of all ages will be included in this review. Transportable clinics (e.g. van, truck or bus) fitted with health care equipment that deliver health services in a defined geographical area will be included. Only literature published in English from 1 January 2006 will be included. Ovid MEDLINE, CINAHL, Embase, Cochrane Database of Systematic Reviews and SocINDEX will be searched, as well as gray literature sources. The full-text of selected literature will be retrieved and assessed in detail against the inclusion criteria by two independent reviewers. Data will be extracted by two independent reviewers, and a narrative summary will be provided on the objectives, concepts and results of the review question.

Ethnic and racial inequalities in hospital admissions due to avoidable causes in under-five Brazilian children, 2009-2014

There has been a global increase in hospital admissions for primary care-sensitive conditions (PCSCs) as an indicator of effectiveness in primary health care. This article analyzes ethnic and racial inequalities in cause-related hospitalizations in under-five children in Brazil as a whole and the country's five major geographic regions, with an emphasis on PCSCs and acute respiratory infections (ARIs). Using data from the Hospital Information Systems of the Brazilian Unified National Health System (SIH/SUS), 2009-2014, the authors calculated proportions, rates, and rate ratios for PCSCs, adjusted by sex and age after multiple imputation of missing data on color/race. The principal causes of hospitalization were respiratory tract infections (37.4%) and infectious and parasitic diseases (19.3%), and indigenous children were proportionally the most affected. Crude PCSC rates (per 1,000) were highest in indigenous children (97.3; 95%CI: 95.3-99.2), followed by brown or mixed-raced children (40.0; 95%CI: 39.8-40.1), while the lowest rates were in Asiandescendant children (14.8; 95%CI: 14.1-15.5). The highest adjusted rate ratios for PCSCs were seen among indigenous children compared to white children - 5.7 (95%CI: 3.9-8.4) for Brazil as a whole, reaching 5.9 (95%CI: 5.0-7.1) and 18.5 (95%CI: 16.5-20.7) in the North and Central, respectively, compared to white children. ARIs remained as important causes of pediatric hospitalizations in Brazil. Alarming ethnic and racial inequalities were observed in PCSCs, with indigenous children at a disadvantage. Improvements are needed in living conditions, sanitation, and subsistence, as well as guaranteed timely access to high-quality primary health care in the more vulnerable population groups, especially the indigenous peoples of the North and Central, in order to mitigate the health inequalities and meet the guidelines of the SUS and the Brazilian Constitution.

Gestão na atenção primária: implicações nas cargas de trabalho de gestores

To identify which aspects of primary health care management, evidenced in current literature, can influence manager workloads. Integrative literature review with data collection conducted in April 2016, in five databases, with articles published in English, Spanish and Portuguese between 2006 and 2016. The results of the 78 studies were organized into two macro categories: increased workloads, especially due to the challenge of managing a new care model and deficits in working conditions; and workloads reduction related to the training of the teams and managers, the autonomy and the support for the managers. In addition to identifying factors that increase and decrease the workloads of managers, this study highlights the promising line of research, given the importance of management for the health sector and effectiveness of Primary Health Care.

International and Russian Experience in Primary Health Care Organization

In this study, they presented the analysis of current views on the important link in medical care provision to the population, namely, primary health care. According to the Alma-Ata Declaration on the organization of primary health care this type of medical assistance has made it possible to carry out reforms within this area in many countries, which has led to effective results (the reduction of infant mortality, the increase of life expectancy and a number of other indicators). In this paper, they performed the analysis of Russian and foreign sources of literature on the topic under study between 1978 and 2018. It has been established that primary health care is regarded as the most effective instrument of health protection than specialized medical care according to the experience of Russian Federation, a number of countries in Europe, Asia and the African continent, Australia and the United States. The performed analysis clearly shows that the experience of some countries demonstrates the correlation between the general coverage of primary health care and the achievement of public health indicative indicators. At the same time, the question is raised about the expediency of certain aspect replacement concerning the provision of specialized medical care by the doctors of general practice, i.e. primary health care. The obtained results can be interpreted as an evidence base for the necessity and an undeniable effectiveness of primary health care as a central link in the health care system.

Quality circles for quality improvement in primary health care: Their origins, spread, effectiveness and lacunae- A scoping review.

Quality circles or peer review groups, and similar structured small groups of 6–12 health care professionals meet regularly across Europe to reflect on and improve their standard practice. There is debate over their effectiveness in primary health care, especially over their potential to change practitioners’ behaviour. Despite their popularity, we could not identify broad surveys of the literature on quality circles in a primary care context. Our scoping review was intended to identify possible definitions of quality circles, their origins, and reported effectiveness in primary health care, and to identify gaps in our knowledge. We searched appropriate databases and included any relevant paper on quality circles published until December 2017. We then compared information we found in the articles to that we found in books and on websites. Our search returned 7824 citations, from which we identified 82 background papers and 58 papers about quality circles. We found that they originated in manufacturing industry and that many countries adopted them for primary health care to continuously improve medical education, professional development, and quality of care. Quality circles are not standardized and their techniques are complex. We identified 19 papers that described individual studies, one paper that summarized 3 studies, and 1 systematic review that suggested that quality circles can effectively change behaviour, though effect sizes varied, depending on topic and context. Studies also suggested participation may affirm self-esteem and increase professional confidence. Because reports of the effect of quality circles on behaviour are variable, we recommend theory-driven research approaches to analyse and improve the effectiveness of this complex intervention.

What are the effective elements in patient-centered and multimorbidity care? A scoping review

BackgroundInterventions to improve patient-centered care for persons with multimorbidity are in constant growth. To date, the emphasis has been on two separate kinds of interventions, those based on a patient-centered care approach with persons with chronic disease and the other ones created specifically for persons with multimorbidity. Their effectiveness in primary healthcare is well documented. Currently, none of these interventions have synthesized a patient-centered care approach for care for multimorbidity. The objective of this project is to determine the particular elements of patient-centered interventions and interventions for persons with multimorbidity that are associated with positive health-related outcomes for patients.MethodA scoping review was conducted as the method supports the rapid mapping of the key concepts underpinning a research area and the main sources and types of evidence available. A five-stage approach was adopted: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies; (4) charting the data; and (5) collating, summarizing and reporting results. We searched for interventions for persons with multimorbidity or patient-centered care in primary care. Relevant studies were identified in four systematic reviews (Smith et al. (2012;2016), De Bruin et al. (2012), and Dwamena et al. (2012)). Inductive analysis was performed.ResultsFour systematic reviews and 98 original studies were reviewed and analysed. Elements of interventions can be grouped into three main types and clustered into seven categories of interventions: 1) Supporting decision process and evidence-based practice; 2) Providing patient-centered approaches; 3) Supporting patient self-management; 4) Providing case/care management; 5) Enhancing interdisciplinary team approach; 6) Developing training for healthcare providers; and 7) Integrating information technology. Providing patient-oriented approaches, self-management support interventions and developing training for healthcare providers were the most frequent categories of interventions with the potential to result in positive impact for patients with chronic diseases.ConclusionThis scoping review provides evidence for the adaption of patient-centered interventions for patients with multimorbidity. Findings from this scoping review will inform the development of a toolkit to assist chronic disease prevention and management programs in reorienting patient care.

Association between hospitalisation for ambulatory care-sensitive conditions and primary health care physician specialisation: a cross-sectional ecological study in Curitiba (Brazil)

IntroductionHospitalisation for ambulatory care-sensitive conditions (HACSCs) is frequently used as an indicator of the quality and effectiveness of primary healthcare (PHC) services around the world. The aim of the present...