The experience of continuity with the primary care provider with schoolchildren
DOI:
https://doi.org/10.5712/rbmfc8(29)739Keywords:
Primary Health Care, Continuity of Patient Care, Child Health, Health Services CoverageAbstract
Objective: To know the schoolchildren experience of continuity of care according to their caregivers’ perspective and to analyse its association with the type of Primary Health Care provider (PHC) (doctor or health center) and its funding modality (public versus private, or social security). Methods: A cross-sectional study was carried out in four elementary schools in the city of Cordoba, Argentina, in 2011. Caregivers of children between 9 and 13 years old responded to a self-administered questionnaire that included the Primary Care Assessment Tool (AR-PCAT-CE) to measure the continuity function (affiliation and interpersonal continuity subdomains), the type of PHC providers, and children’s socio-demographic characteristics. Mean scores of affiliation and interpersonal continuity were obtained, and a value ?3 was considered optimal. Results: Eighty-nine percent of the respondents (n=230) were schoolchildren’s mothers. PHC provider was mainly (79.9%) a first level PHC unit, a hospital or a clinic, publicly funded in 60.5% of cases. The mean scores of the degree of affiliation to their PHC provider were 3.30 and 3.27 (p=0.86) when referring to a doctor and center, respectively, and the mean scores for interpersonal continuity were 3.47 and 3.09 (p=0.01), respectively. Among those who identified a health center as PHC provider, the affiliation score was 3.18 for public centers and 3.51 for social security or private centers (p=0.04). Conclusions: Caregivers report stronger affiliation when the PHC provider is private or a social security center; and a better experience of interpersonal continuity when they identify a physician as their provider rather than a health center.Downloads
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Starfield B. Atención primaria. Equilibrio entre necesidades de salud, servicios y tecnología. Barcelona: Masson, S.A; 2001.
Haggerty JL, Reid RJ, Freeman GK, Starfield BH, Adair CE, McKendry R. Continuity of care: a multidisciplinary review. BMJ. 2003;327 (7425):1219-1221. [acceso en 2011 Abr 5] Disponible en: http://dx.doi.org/10.1136/bmj.327.7425.1219
The Johns Hopkins Primary Care Policy Center. Primary Care Assessment Tools [Internet]. Baltimore: Johns Hopkins University. [acceso en 2011 Abr 5] Disponible en: http://www.jhsph.edu/pcpc/pca_tools.html
Saultz JW, Albedaiwi W. Interpersonal Continuity of Care and Patient Satisfaction: A Critical Review. Ann FamMed 2004 2:445-451; [acceso en 2011 Abr 5] Disponible en: http://dx.doi.org/10.1370/afm.91
Reid R, Haggerty J, McKendry R. Defusing the confusion: concepts and measures of continuity of healthcare. Ottawa: Canadian Health Services Research Foundation; 2002. [acceso en 2011 Abr 5] Disponible en: http://www.cfhi-fcass.ca/Migrated/PDF/ResearchReports/CommissionedResearch/cr_contcare_e.pdf
Starfield B, Cassady C, Nanda J, Forrest CB, Berk R. Consumer experiences and provider perceptions of the quality of primary care: implications for managed care. J Fam Pract 1998; 46(3):216-26. http://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-primary-care-policy-center/PCAT%20pubs/Starfield%201998.pdf
Ministerio de Salud de la Nación, Consejo Federal de Salud. Bases del Plan Federal de Salud, Buenos Aires, 2004. [acceso en 2011 May 20] Disponible en: http://test.e-legis-ar.msal.gov.ar/leisref/public/showAct.php?id=732
Cassady CE, Starfield B, Hurtado MP, et al. Measuring consumer experiences with primary care. Pediatrics. 2000; 105(4 Pt 2):998-1003. [acceso en 2011May 20] Disponible en: http://pediatrics.aappublications.org/content/105/Supplement_3/998.full.html
Berra S, Audisio Y, Mántaras J, Nicora V, Mamondi V, Starfield B. Adaptación cultural y al sistema de salud argentino del conjunto de instrumentos para la evaluación de la Atención Primaria de la Salud. Rev Argent Salud Pública. 2011; 2(8):6-14. [acceso 2012 Mar 15] Disponible en: http://www.saludinvestiga.org.ar/rasp/articulos/volumen8/art-orig-adaptacion-cultural.pdf
Berra S, Hauser L, Audisio Y, Mántaras J, Nicora V, de Oliveira MMC, et al. Validez y fiabilidad de la versión argentina del PCAT-AE para evaluar la atención primaria de salud. Rev Panam Salud Publica. 2013;33(1):30–9. [revista en la internet] [acceso 2013 Feb 25] Disponible en: http://dx.doi.org/10.1590/S1020-49892013000100005
Haggerty JL, Pineault R, Beaulieu MD, Brunelle Y, Gauthier J, Goulet F, et al. Patients’ experiences of primary care in Quebec before major reforms. Can FamPhysician. 2007; 53:1056-1057. [acceso en 2011 Nov 5] Disponible en: http://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-primary-care-policy-center/PCAT%20pubs/Haggerty%202001.pdf
Stevens GD, Shi L. Effect of Managed Care on Children's Relationships With Their Primary Care Physicians: Differences by Race. Arch Pediatr Adolesc Med. 2002; 156(4):369-377. [acceso en 2011 Nov 5] Disponible en: http://dx.doi.org/10.1001/archpedi.156.4.369
Haggerty JL, Pineault R, Beaulieu MD, Brunelle Y, Gauthier J, Goulet F, Rodrigue J. Practice Features Associated With Patient-Reported Accessibility, Continuity, and Coordination of Primary Health Care. Ann Fam Med. 2008 6:116-123. [acceso en 2012 Mar 15] Disponible en: http://dx.doi.org/10.1370/afm.802
Castro RC, Knauth DR, Harzheim E, Hauser L, Duncan BB. Avaliação da qualidade da atenção primária pelos profissionais de saúde: comparação entre diferentes tipos de serviços. Cad Saude Publica. 2012 Sep; 28(9):1772-84. http://dx.doi.org/10.1590/S0102-311X2012000900015
Pasarín MI, Rocha KB, Rodríguez-Sanz M, Berra S, Borrell C. Un paso más en el estudio de las desigualdades sociales en la provisión de atención primaria desde la perspectiva de la población. Med Clin (Barc). 2011; 137(Supl 2):49-54. http://dx.doi.org/10.1016/S0025-7753(11)70029-X
Harzheim E, Duncan BB, Stein AT, Cunha CR, Goncalves MR, Trindade TG, Oliveira MM, Pinto ME. Quality and effectiveness of different approaches to primary care delivery in Brazil. BMC Health Serv Res. 2006 Dec 5;6:156. http://dx.doi.org/10.1186/1472-6963-6-156
Grupo PCAT.UY, Pizzanelli M, Ponzo J, Buglioli M, Toledo A, Casinelli M, Gómez A. Validación de Primary Care Assessment Tool (PCAT) en Uruguay. Rev Med Urug 2011; 27(3):187-189. Disponible en: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S0303-32952011000300009&lng=es.
Dahrouge, S, W. Hogg, et al. (2010). An evaluation of gender equity in different models of primary care practices in Ontario. BMC Public Health 10:151 http://dx.doi.org/10.1186/1471-2458-10-151
Jatrana SH, P. Crampton P, Richardson K. (2011). Continuity of care with general practitioners in New Zealand: results from SoFIE-Primary Care." The New Zealand medical journal 124(1329):16-25. http://journal.nzma.org.nz/journal/124-1329/4536/
Tsai et al. Usual source of care and the quality of medical care experiences: a cross-sectional survey of patients from a Taiwanese community. Med Care. 2010; 48(7):628-34. http://dx.doi.org/10.1097/MLR.0b013e3182459f45
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