Private Primary Health Care Centers Research Articles

Assessment of medication discrepancies with point prevalence measurement: how accurate are the medication lists for Swedish patients?

BackgroundMedication discrepancies are common, potentially harmful and may result from poor medication information across medical records. Our aim was to describe current medication discrepancy rates, types and severity in hospital, primary and specialized outpatient care in Sweden, as well as comparing these with previous measurements.MethodsParticipants visiting health care in Skåne in November 2020 were randomly selected to include 100 adult patients each in public and private primary health care centers, hospitals and outpatient care. Within 2 weeks after a health care visit or hospital admission, a pharmacist medication reconciliation was performed to identify any discrepancies. Two general practitioners assessed their potential to cause harm. Descriptive and comparative statistics were used.ResultsIn total, 405 patients (mean age 61.6 years, median 6.5 medications) were included in the analysis. The majority (72%) of the included patients had ≥1 medication list discrepancy. Total number of discrepancies was 1038 (average 2.6 per patient), with a significantly higher discrepancy rate (4.5) noted in specialized outpatient care (p < 0.001). Overall, unintentional addition (44%) or omission (39%) of drug were most frequent. Out of all discrepancies, 20.7% were rated to have moderate (18.2%) or high (2.5%) potential risk of harm. Cardiovascular, nervous system and antidiabetic medications were more often involved in potentially harmful discrepancies. When compared with previous measurements, the proportion of accurate medication lists significantly improved in primary care compared to 2018 (34% vs 20%, p = 0.0011), as well as a decrease in overall discrepancy rate (p = 0.0029).ConclusionMedication discrepancies were in general abundant despite a recent health care visit, both in hospital care and primary care, with the highest number in specialized outpatient care. A considerable share was classified as potentially harmful thus implying a major threat to medication safety.

Patients’ Satisfaction in Public and Private Primary Health Care: A Study in Karawang Regency, West Java, Indonesia

Background : Primary health care is the foundation of the Sustainable Development Goals (SDGs) to achieve Universal Health Coverage (UHC). Patient satisfaction with the health services acquired is one of the factors to achieve the UHC target. This study aimed to determine patients’ satisfaction in public and private primary health care centers. Methods : This quantitative analytic study with a cross-sectional method was conducted in five sub-districts of Karawang Regency based on community satisfaction surveys. The instrument used was a standard questionnaire with nine dimensions and filled with a survey approach by the respondents. Data was transformed from ordinal to numeric using Rach modelling. Then, numerical data were analysed with Chi Square Test in IBM SPSS Statistic 23 Version to determine differential between public and private groups. Results : In total, 193 respondents were included of whom 123 patients were from public health centers (Pusat Kesehatan Masyarakat, Puskesmas) and 70 from private primary care (clinic). Three dimensions had differences in satisfaction, including the requirements (p=0.001); systems, mechanisms, and procedures (p=0.001); and service time (p=0.001). The other six dimensions such as cost (p=0.534); product specification type of service (p=0.213); implementer competence (p=0.163); implementer behavior (p=0.000); handling of complaints, suggestions, and advances (p=0.448); and facilities infrastructure (p=0.063) were not proven to have differences in satisfaction. Overall, patients’ satisfaction level at Puskesmas (67.5%) was lower than at clinics (88.6%) (p=0.001). Conclusion : Patients’ satisfaction with the Puskesmas is lower than the clinic. Further study with a larger sample size and more complete dimension is needed.

Development, validation and reliability of a questionnaire for assessment of physician's knowledge, attitude and practices (KAPs) regarding foodborne diseases in the Kingdom of Saudi Arabia

Background: The burden of foodborne illness is considered to be high across the world. Based on the Knowledge-Attitude-Practice (KAP) model, physician’s awareness is essential for conducting individualized treatments, thus reducing the burden of foodborne illness. However, there have been no validated questionnaires specific to the awareness of physicians with foodborne diseases. This study aims to develop and validate a KAP questionnaire for physicians to assess their awareness about the diagnosis and management of foodborne illness. Methods The questionnaire was developed in three phases: a comprehensive literature review, face and content validity, followed by a reliability test by internal consistency. A cross-sectional study was designed in Abha, Saudi Arabia. Physicians (n=125) were opportunistically recruited from both public and private primary healthcare centers. The questionnaire’s content and validity were confirmed by experts in their corresponding fields. After signing the informed consent, the study participants received the questionnaire to evaluate their KAPs on foodborne diseases. Results: A total of 160 physicians from both public and private primary health care centers were approached to enrol 125 study participants into the survey (response rate 78.13%). Of the 31 items designed for assessing the KAP of physicians on foodborne illnesses, three items were excluded after Cronbach’s α analysis. In total, 29 items were included in the final set of the questionnaire. Results of different validity and reliability analyses suggest the questionnaire has a high face and content validity as well as good reliability in internal consistency and stability. Conclusions: This study introduces a newly developed questionnaire with good reliability and validity values that can assess physician’s awareness of foodborne disease. The awareness questionnaire, as a study instrument, had a favourable acceptance among physicians. It is a sound method for evaluating and measuring levels of foodborne disease-related awareness among physicians in Abha, Saudi Arabia.

Evaluation of the Cold Chain Expanded Program on Immunization at Governmental and Private Health Care Centers in Riyadh City, Saudi Arabia

Objective: Vaccine storage is essential to ensure optimal vaccine effectiveness. Cold chain is a series of storage and transport links, designed to keep the vaccine at the correct temperature till it reaches the user. To evaluate the Cold Chain Expanded Program on Immunization at Governmental and Private Health Care Centers in Riyadh city, Saudi Arabia.&#x0D; Methods: A cross-sectional study was conducted from March to May 2021 in government and private primary health care centers of Riyadh, Saudi Arabia were included. Data collection was carried out using standardized check list developed by Saudi Ministry of Health (MOH) and World Health Organization (WHO). Data were analysed using IBM SPSS Statistics 26 (C) and IBM SPSS 26 (IBM Inc.)&#x0D; Results: The results showed that the mean score of Room and Refrigerator Elements for governmental PHCs was 8.8(±0.82), while it was 8.3(±1.86) for private PHCs. The mean temperature monitoring device score for government PHCs was 4.0 (0.0), and the 3.65 (±0.92) for PHCs centers. The mean temperature chart (record keeping) score for governmental PHCs was 2.55(±0.5) and 1.8(±1.2) for private PHCs. The mean maintenance and operations score for governmental PHCs was 4.6 (±0.49), while it was 4.1 (±0.84) for private PHCs. The mean scores of all cold chain components differed significantly between government and private facilities (p=0.000).&#x0D; Conclusion: Our study highlights the cold chain management programs Saudi Arabia. More importantly governmental PHC centers in the current settings comply with the standards to the guidelines, provided by Saudi Ministry of Health and WHO, was observed, in comparison to private PHC centers.

Development, validation and reliability of a questionnaire for assessment of physician's knowledge, attitude and practices (KAPs) regarding foodborne diseases in the Kingdom of Saudi Arabia

Background: The burden of foodborne illness is considered to be high across the world. Based on the Knowledge-Attitude-Practice (KAP) model, physician’s awareness is essential for conducting individualized treatments, thus reducing the burden of foodborne illness. However, there have been no validated questionnaires specific to the awareness of physicians with foodborne diseases. This study aims to develop and validate a KAP questionnaire for physicians to assess their awareness about the diagnosis and management of foodborne illness. Methods The questionnaire was developed in three phases: a comprehensive literature review, face and content validity, followed by a reliability test by internal consistency. A cross-sectional study was designed in Abha, Saudi Arabia. Physicians (n=125) were opportunistically recruited from both public and private primary healthcare centers. The questionnaire’s content and validity were confirmed by experts in their corresponding fields. After signing the informed consent, the study participants received the questionnaire to evaluate their KAPs on foodborne diseases. Results: A total of 160 physicians from both public and private primary health care centers were approached to enrol 125 study participants into the survey (response rate 78.13%). Of the 31 items designed for assessing the KAP of physicians on foodborne illnesses, three items were excluded after Cronbach’s α analysis. In total, 29 items were included in the final set of the questionnaire. Results of different validity and reliability analyses suggest the questionnaire has a high face and content validity as well as good reliability in internal consistency and stability. Conclusions: This study introduces a newly developed questionnaire with good reliability and validity values that can assess physician’s awareness of foodborne disease. The awareness questionnaire, as a study instrument, had a favourable acceptance among physicians. It is a sound method for evaluating and measuring levels of foodborne disease-related awareness among physicians in Abha, Saudi Arabia.

Development, validation and reliability of a questionnaire for assessment of physician's knowledge, attitude and practices (KAPs) regarding foodborne diseases in the Kingdom of Saudi Arabia.

Background:The burden of foodborne illnessisconsidered to behigh across the world.Basedonthe Knowledge-Attitude-Practice(KAP) model, physician's awareness is essentialforconductingindividualized treatments, thus reducingtheburdenof foodborne illness. However, there have been no validated questionnaires specific to the awareness of physicians with foodborne diseases.This study aims to develop and validateaKAPquestionnaire for physiciansto assess their awarenessaboutthediagnosis and managementof foodborneillness. MethodsThe questionnaire was developed in three phases: a comprehensive literature review, face and content validity, followed by a reliability test by internal consistency. A cross-sectional study was designed in Abha,Saudi Arabia. Physicians (n=125) wereopportunisticallyrecruited from both public and private primary healthcarecenters.The questionnaire'scontent and validity were confirmed by experts in their corresponding fields. After signing the informed consent, the study participants received the questionnaire to evaluate theirKAPson foodborne diseases. Results:A totalof160 physicians from both public and private primary health carecenterswere approached to enrol125study participantsintothe survey(response rate78.13%). Of the 31itemsdesigned for assessing theKAPof physicians on foodborne illnesses, threeitems were excluded afterCronbach'sα analysis. In total, 29 items wereincluded inthe final set of the questionnaire.Results of different validity and reliability analyses suggestthe questionnaire hasahigh faceandcontent validity as well as good reliability in internal consistencyand stability. Conclusions:This study introduces a newly developed questionnaire with good reliability and validity values that can assess physician's awarenessof foodborne disease.The awareness questionnaire,as a study instrument,hadafavourable acceptanceamong physicians. It is a sound method for evaluating and measuring levels of foodborne disease-related awareness among physicians in Abha, Saudi Arabia.

Interventions for prudent antibiotic use in primary healthcare: an econometric analysis

BackgroundRational antibiotic prescribing is crucial to combat antibiotic resistance. Optimal strategies to improve antibiotic use are not known. Strama, the Swedish strategic program against antibiotic resistance, has been successful in reducing antibiotic prescription rates. This study investigates whether two specific interventions directed toward healthcare centers, an informational visit and a self-evaluation meeting, played a role in observed reduction in rates of antibiotic prescriptions in primary healthcare.MethodsThe study was a retrospective, observational, empirical analysis exploiting the variation in the timing of the interventions and considering past prescriptions through use of estimations from dynamic panel data models. Primary healthcare data from 2011 to 2014 were examined. Data were from public and private primary healthcare centers in western Sweden. The key variables were prescription of antibiotics and indicator variables for the two interventions.ResultsThe first intervention, an educational information intervention, decreased the number of prescriptions among public healthcare centers, but this effect was only temporary. We found no proof that the second intervention, a self-evaluation meeting at the healthcare center, had an impact on the reduction of prescriptions.ConclusionsSingle educational interventions aimed at influencing rates of antibiotic prescriptions have limited impact. A multifaceted approach is needed in efforts to reduce the use of antibiotics in primary health care.

Understanding patient satisfaction and loyalty in public and private primary health care.

Background: The quality of health centers, patient satisfaction, and loyalty are three key factors that enable health care providers to improve their services and cost-effectiveness. This study, therefore, aims to determine patient satisfaction and loyalty in public and private primary health care centers.Design and Methods: Data were obtained from a cross-sectional design of 1470 self-administered questionnaires and analyzed based on mean, standard deviation, and correlation coefficients.Results: The results showed respectively a strong and moderate correlation between patient satisfaction and loyalty in private (r=0.767) and public (r=0.54) primary health care centers, respectively. In addition, in both centers patients received adequate medical services, with social aspects as the least important factors affecting patient satisfaction.Conclusions: In conclusion, primary health care practices need to recognize the needs that influence patients’ satisfaction and loyalty, to improve the quality of their services.Significance for public healthPatient satisfaction affects all dimensions of healthcare services, including patient retention, which is the key factor that determines their return to the same center. The provision of high standard health services, staff motivation, and showing appreciation help to retain patients. It is important to determine the driving forces that influence patients’ choice to return for more services in order to implement effective strategies for maintaining their loyalty. This paper describes the correlation between patient satisfaction and loyalty in public and private primary health care.

Is it possible to gain energy at work? A questionnaire study in primary health care.

The area of regenerative work is still close to unexplored. The aim was to explore the possibility for employees to gain energy at work. Questionnaire to all employees (n = 599) from different professions in public and private primary health care centers in one health care district in Sweden. The questionnaire, which had a salutogenic perspective, included information on self-rated health, psychosocial work environment and experiences, recovery, social climate, and energy. Having an energy-building experience was defined by a positive response to two combined questions regarding energy at work. Analyses were performed with bivariate correlation and multiple logistic regression. The response rate was 84%. Health and energy correlated positively (r = 0.54). In total, 44.5% of the employees reported having an energy-building experience. Predictors for having an energy-building experience were recovery [positive odds ratio (POR) = 2.78], autonomy (POR = 2.26), positive workplace characteristics (POR = 2.09), and internal work experiences (POR = 1.88). The results support the hypothesis that it is possible to gain energy at work, an area that is still close to unexplored. There is a high correlation between energy and health. Employees' energy-building experiences relate to well-being at work and correlates to recovery, autonomy, positive workplace characteristics, and positive internal work experiences. This knowledge can help in improving future work environment development.

Assessing Physicians' Diagnostic Practices on Foodborne Illnesses in Saudi Arabia: A Cross Sectional Study

Background: Foodborne illnesses are significant public health issues given they contribute to increasing the global burden of diseases. Incidents of Food-borne diseases are increasing due to the presence of newly emerging pathogenesis. Appropriate diagnostic practices among physicians reduce the magnitude of the problem nationally. Therefore, the aim of the current study is to evaluate the diagnostic practices of Foodborne illnesses among public and private primary health care physicians in the Kingdom of Saudi Arabia. Methodology: A cross-sectional study was conducted in thirty public and private primary health care centers in the city of Abha during the period of October 2017 to March 2018. A structured questionnaire was developed based on the previously published literature and was used to collect the data related to the diagnostic practices among the physicians. Results: One hundred and twenty-five physicians participated in this study. Approximately 49% of the physicians had ‘adequate’ diagnostic practicing skills. No significant difference in diagnostic practice of food-borne illness between the public and private health care physicians. However, the study found a positive correlation between the level of clinical practice, age, gender, area of speciality, years of experience and the number of patients per week. Conclusion: Given that the diagnostic practice skills among physicians were ‘adequate’, there has been a recommendation for newly hired physicians to enroll in a diagnosis and management of Foodborne diseases training program to improve their diagnostic practices.

Recovery, work-life balance and work experiences important to self-rated health: A questionnaire study on salutogenic work factors among Swedish primary health care employees.

BACKGROUND:There is a lack of information on positive work factors among health care workers.OBJECTIVE:To explore salutogenic work-related factors among primary health care employees.METHOD:Questionnaire to all employees (n = 599) from different professions in public and private primary health care centers in one health care district in Sweden. The questionnaire, which had a salutogenic perspective, included information on self-rated health from the previously validated SHIS (Salutogenic Health Indicator Scale), psychosocial work environment and experiences, recovery, leadership, social climate, reflection and work-life balance.RESULTS:The response rate was 84%. A multivariable linear regression model, with SHIS as the dependent variable, showed three significant predictors. Recovery had the highest relationship to SHIS (β= 0.34), followed by experience of work-life balance (β= 0.25) and work experiences (β= 0.20). Increased experience of recovery during working hours related to higher self-rated health independent of recovery outside work.CONCLUSION:Individual experiences of work, work-life balance and, most importantly, recovery seem to be essential areas for health promotion. Recovery outside the workplace has been studied previously, but since recovery during work was shown to be of great importance in relation to higher self-rated health, more research is needed to explore different recovery strategies in the workplace.

SATISFACTION LEVEL OF PATIENTS, PHYSICIANS, AND PRIVATE PRIMARY HEALTHCARE CENTER MANAGERS WITH CHRONIC DISEASE MANAGEMENT PROGRAM IN INDONESIA

Objective:Program PengelolaanPenyakitKronis (PROLANIS) or Chronic Disease Management Program (CDMP) is a healthcare system that was conducted by Healthcare and Social Security Agency in Indonesia to improve patients’ quality of life. The objective of this study was to analyze level satisfaction of patients, physicians, and private Primary Healthcare Centers (PHCs) with this program, focusing on hypertension care.Methods:This study was conducted in 7 private PHCs in Bandung City, Indonesia. A cross sectional study was performed to measure patient satisfaction with PSQ-18 on 143 PROLANIS patients with hypertension. A total number of 8 physicians and 7 private PHC managers were involved in this study. Level satisfaction of physicians and private PHC managers were observed by using in-depth interviews.Results:The results showed that patient satisfaction was estimated to be 68.52±8.54, which could be interpreted that patient satisfy with PROLANIS. In-depth interviews showed that physicians did not satisfy with PROLANIS due to several factors (e.g., unintegrated prescription systems, lack of medicines, uncompleted laboratory facilities, lack of physicians, unintegrated referral services, and lack of collaboration between primary and secondary healthcare system). On the other hand, private PHC managers were quite satisfied with PROLANIS due to its linearity with other activities in private PHCs.Conclusion:Level satisfaction of patients with PROLANIS is quite good, while physicians might not satisfy with this program. In particular, private PHC managers confirmed that they are satisfied with this program

Prevalence of VP4 and VP7 genotypes of human rotavirus in Ecuadorian children with acute diarrhea

The objective of the present study was to determine rotavirus etiology and prevalence of the different rotavirus serotypes in Ecuadorian children younger than 5 years of age with gastroenteritis. Children (729) less than 5 years of age with acute diarrhea from either public or private primary health care centers in 10 different provinces of Ecuador, between March 2006 and August 2006 were included in the study. Rotavirus infection was diagnosed using a commercial immunoenzymatic test. Rotavirus isolated from stool samples was genotyped. Rotavirus was detected in the feces of 269 of the 729 children (37%) with diarrhea. The most prevalent G genotypes were G9 (46.1%) and G2 (27.2%), while the predominant P genotypes were P[8] (57%) and P[4] (29.5%). Among the single infections, the predominant P/G combinations were: P[8]G9 (56.9%) and P[4]G2 (32.6%). The present countrywide survey is one of the major studies for one single season in Latin America and the first in its class in Ecuador. The value of expanding laboratory capability throughout Latin America in order to monitor rotavirus strains over time, with special attention directed at those strains obtained from children who experience vaccine failure, is critical. Only continuous monitoring of rotavirus disease burden and genotype surveillance will provide this information.