A voz dos utilizadores dos cuidados de saúde primários da região de Lisboa e Vale do Tejo, Portugal

Background: In 2005, the Portuguese government launched a primary care (PC) reform. After a promising start, the reform is still incomplete and has been compromised by low investment. The incomplete nature of the reforms has resulted in the coexistence of different models of care delivery and heterogeneity in resource allocation and performance. PC has been extensively evaluated, but little is known about the patients’ views and preferences regarding PC and the ongoing reform. Aim: This study aims to examine patients’ experiences of and preferences for PC in Portugal and to explore their experience of the recent reforms. Methods: A qualitative study was undertaken which collected data from eight focus groups in the city of Braga, Portugal. Participants were recruited with the collaboration of eight local institutions. Focus groups’ discussions focused on patients’ experiences of and preferences for PC as well as their views on the reforms. Audio recordings were transcribed and analysed using an inductive thematic content analysis. Findings: The majority of participants perceived that the reform was positive. However, the improvements achieved by the reform were insufficient to lead to most participants having a positive experience of PC delivery in Portugal. Participants’ satisfaction/dissatisfaction with primary care was strongly associated with interpersonal relations and communication with doctors. Participants valued continuity of care, but felt the levels of responsiveness, flexibility and coordination in the current system were still unsatisfactory. Access and waiting times were seen as challenging and led participants to seek PC from emergency departments and private doctors. Policy Implications: The perception of increased inequity and the lack of effective choice undermined the social acceptability of the reform. Policies aimed at improving doctor–patient communication and continuity of care, as well as choice, may therefore lead to better satisfaction and more efficient use of health care settings.

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“…These results are consistent with previous evidence. (Ferreira and Antunes, 2009 ; Ferreira et al ., 2010 ; Ferreira and Raposo, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Patients’ experiences and preferences for primary care delivery: a focus group analysis

Norwood

Correia

Veiga

et al. 2019

Prim Health Care Res Dev

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“…In Portugal, the health service is based on a universal system access to medical care, comprehensive and free, funded by taxation and complemented by public insurance funds and private and direct payments [ 24 ]. Contrary to Switzerland, where the choice of a doctor is free and multiple doctors are allowed, in Portugal, the choice the doctor is not allowed to patients, the waiting time before being received by a doctor is sometimes long, which is troublesome during a sudden illness [ 25 , 26 ]. Hence, obtaining an appointment might be easier in Switzerland than in Portugal, thus increasing the likelihood of diagnosing and adequately managing cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and management of cardiovascular risk factors in Portuguese living in Portugal and Portuguese who migrated to Switzerland

et al. 2015

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BackgroundInformation regarding the health status of migrants compared to subjects who remain in the country of origin is scarce. We compared the levels and management of the main cardiovascular risk factors between Portuguese living in Porto (Portugal) and Portuguese migrants living in Lausanne (Switzerland).MethodsCross-sectional studies conducted in Porto (EPIPorto, 1999 to 2003, n = 1150) and Lausanne (CoLaus, 2003 to 2006, n = 388) among subjects aged 35–65 years. Educational level, medical history and time since migration were collected using structured questionnaires. Body mass index, blood pressure, cholesterol and glucose levels were measured using standardized procedures.ResultsPortuguese living in Lausanne were younger, more frequently male and had lower education than Portuguese living in Porto. After multivariate adjustment using Poisson regression, no differences were found between Portuguese living in Porto or in Lausanne: prevalence rate ratio (PRR) and (95% confidence interval) for Portuguese living in Lausanne relative to Portuguese living in Porto: 0.92 (0.71 - 1.18) for current smoking; 0.78 (0.59 - 1.04) for obesity; 0.81 (0.62 - 1.05) for abdominal obesity; 0.82 (0.64 - 1.06) for hypertension; 0.88 (0.75 - 1.04) for hypercholesterolemia and 0.92 (0.49 - 1.73) for diabetes. Treatment and control rates for hypercholesterolemia were higher among Portuguese living in Lausanne: PRR = 1.91 (1.15 - 3.19) and 3.98 (1.59 - 9.99) for treatment and control, respectively. Conversely, no differences were found regarding hypertension treatment and control rates: PRR = 0.98 (0.66 - 1.46) and 0.97 (0.49 - 1.91), respectively, and for treatment rates of diabetes: PRR = 1.51 (0.70 - 3.25).ConclusionsPortuguese living in Lausanne, Switzerland, present a similar cardiovascular risk profile but tend to be better managed regarding hypercholesterolemia than Portuguese living in Porto, Portugal.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1659-8) contains supplementary material, which is available to authorized users.

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“…We used the Portuguese version of the EUROPEP, adapted by Ferreira et al 11 This instrument features 37 items that assess the level of satisfaction from the perspective of users. The items are rated on likert type scale of five points (0 = bad; 4 = excellent).…”

Section: Methodsmentioning

confidence: 99%

“…: preparation on what to expect of hospital care, other experts, or other care workers); (5) accessibility (e.g. : ease to make an appointment in the family health units (FHU)) 2 , 8 , 10 , 11 , 14 - 16 , 26 .…”

Section: Introductionmentioning

confidence: 99%

Portuguese version of the EUROPEP questionnaire: contributions to the psychometric validation

2016

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OBJECTIVE To assess the construct validity and reliability of the Portuguese version of the European Task Force on Patient Evaluation of General Practice Care questionnaire.METHODS We applied the Portuguese version of the European Task Force on Patient Evaluation of General Practice Care to 392 users of 20 Family Health Units from the North of Portugal. The validity of the construct was evaluated by exploratory factor analysis, with the Principal Axis Factoring method, by orthogonal rotation (varimax procedure), by the Kaiser normalization criteria (eigenvalue ≥ 1). The factorability of the data matrix was verified by the Kaiser-Meyer-Olkin and Bartlett’s sphericity test. We estimated the reliability by the indicator of internal consistency Cronbach’s alpha. To analyze the correlations between satisfaction and loyalty, we used the Pearson correlations. The predictor effect of satisfaction on loyalty was analyzed by simple linear regression.RESULTS Satisfaction presented five robust and well individualized dimensions – medical care, nursing care, clinical secretariat services, accessibility, and organization of services – with alpha values between 0.86 and 0.97, good levels of internal consistency. The loyalty showed alpha value of 0.72, considered a reasonable internal consistency. The satisfaction was predictive of loyalty.CONCLUSIONS The Portuguese European Task Force on Patient Evaluation of General Practice Care questionnaire is a robust and reliable instrument to measure the satisfaction and loyalty of users of the Family Health Units.

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A voz dos utilizadores dos cuidados de saúde primários da região de Lisboa e Vale do Tejo, Portugal

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Cited by 8 publications

References 12 publications

Patients’ experiences and preferences for primary care delivery: a focus group analysis

Patients’ experiences and preferences for primary care delivery: a focus group analysis

Prevalence and management of cardiovascular risk factors in Portuguese living in Portugal and Portuguese who migrated to Switzerland

Portuguese version of the EUROPEP questionnaire: contributions to the psychometric validation

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