Les soins de santé primaires sont souvent évoqués, mais rarement définis. Cet article explore ce concept compris parfois différemment et révèle deux conceptions distinctes des soins de santé primaires, toutes deux issues de la Déclaration d’Alma Ata. Tant que l’expression « soins de santé primaires » pourra faire référence à deux types de contenus distincts, soit un niveau de soins, soit une approche globale du système de santé, il sera utile, en attendant un consensus sur sa définition, de la clarifier lors de son utilisation.
Given the sociodemographic challenges facing the Belgian primary care system, it is essential to strengthen interprofessional collaboration (IPC) between healthcare providers. Therefore, our aims for this study were to assess IPC between general practitioners (GPs) and nurses; identify target priorities for improving IPC; and facilitate the planning and implementation of the proposed improvement strategies. Based on diversity criteria, six groups of GPs and nurses were chosen for a participatory action research. Participants performed a SWOT analysis of their IPC to identify strengths and weaknesses of their collaboration practice configurations. Main factors limiting IPC were related to the type of financing system which impeded or facilitated multidisciplinary team meetings, a weak functional integration, and a lack of interprofessional education. Overall, communication and task delegation were co-identified as common priorities. Actions prioritized by each group were related to these two priorities and accounted for local, specific needs. Communication could be supported through improved tools and dedicating time for multidisciplinary team meetings. Task delegation was more challenging and raised questions related to nurses' training, legislation, and payment systems. IPC seems to be easier to achieve when healthcare professionals belong to the same organization and consider themselves a team.
Introduction: Coordination between levels of care is not facilitated in the Belgian health system. Indeed, patients have uninhibited access to every level of care, there is no gatekeeping system, and few structural coordination between levels of care. On one hand, the occurrence of more complex care situations in the ambulatory setting is enhancing the need for coordination while on the other hand, hospitals face financial constraints to provide care in the community.
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