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[应用于圣地亚哥孔查利初级卫生保健工作者的初级保健评估工具]

[Primary Care Assessment Tool applied to primary health care workers from Conchalí, Santiago].

作者信息

Pesse-Sorensen Karen, Fuentes-García Alejandra, Ilabaca Juan

机构信息

Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

Programa de Políticas, Sistema y Gestión en Salud, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile.

出版信息

Rev Med Chil. 2019 Mar;147(3):305-313. doi: 10.4067/S0034-98872019000300305.

Abstract

BACKGROUND

The Chilean public health system is based on Primary Health Care (PHC), whose assessment is challenging due to the heterogeneity of services and multi-dimensionality of expected results. The Primary Care Assessment Tool was adapted and validated for Chile.

AIM

To analyze, from the provider's perspective, the structure and functioning of the health centers, to determine the achievement of PHC's core functions: access, continuity, coordination, comprehensiveness of care, cultural competence, family centeredness and community orientation.

MATERIAL AND METHODS

All professionals working in primary care in a commune of Metropolitan Santiago were invited to answer an online version of the Primary Care Assessment Tool.

RESULTS

One hundred and nine professionals (51% of those invited) from four Family Health Centers, two Community Health Centers, and a Community Mental Health Center, answered the online questionnaire. Their distribution by profession and health units does not resemble the whole research population, which should be considered when interpreting the results. Data show a good performance of the system: general and domain specific scores are all near three for a maximum score of four. Family centeredness obtained the highest score, whereas cultural competence had the lowest.

CONCLUSIONS

Reinforcing intercultural skills and a wider approach to psycho-social problems is recommended to strengthen the new healthcare model implementation.

摘要

背景

智利公共卫生系统以初级卫生保健(PHC)为基础,由于服务的异质性和预期结果的多维度性,对其进行评估具有挑战性。初级保健评估工具已针对智利进行了改编和验证。

目的

从提供者的角度分析卫生中心的结构和功能,以确定初级卫生保健核心功能的实现情况:可及性、连续性、协调性、护理的全面性、文化能力、以家庭为中心和社区导向。

材料与方法

邀请了在圣地亚哥首都大区一个公社从事初级保健工作的所有专业人员回答初级保健评估工具的在线版本。

结果

来自四个家庭健康中心、两个社区健康中心和一个社区心理健康中心的109名专业人员(占受邀人员的51%)回答了在线问卷。他们按职业和卫生单位的分布与整个研究人群不同,在解释结果时应予以考虑。数据显示该系统表现良好:总体得分和特定领域得分在满分4分的情况下均接近3分。以家庭为中心得分最高,而文化能力得分最低。

结论

建议加强跨文化技能以及对心理社会问题采取更广泛的方法,以加强新医疗模式的实施。

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