La pediatría de atención primaria en el sistema público de salud del siglo xxi. Informe SESPAS 2012

Abstract

Today in our country, the primary care pediatrician is the first contact between children and adolescents with the health system, being also a highly resolving specialist that addresses over 90% of the health needs of this population, monitors growth and development and participates in all activities of prevention, health promotion and health education within primary care teams with nurses and family doctors. Witnessing rapid and profound demographic, social, cultural, scientific and technological changes as well as the demands and expectations of health care for citizens, which should enhance the value and response capacity of primary care. These changes also affect infant morbidity and health care priorities in child and adolescent, posing new challenges for primary care practice and reinforce the role of the pediatrician in primary care. Primary care is not only the gateway to the health system. Primary care teams have to take responsibility for the care of people assigned to coordinate the necessary resources and advising citizens on their health problems and his itinerary care by the health system. It identifies the need to foster teamwork within the health department involved nursing staff to take care activities in this age group. It aims to foster a model based on cooperation and complementarity. A recent systematic review recommended maintaining the figure of the pediatrician in primary care teams and strengthen their specific role as first point of contact with the child's health care system, found significant benefits for children.

Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China

“…Small private outpatient clinics and pharmacy clinics in urban and rural areas are also considered PCFs. The policy is similar to the “gatekeeping system” or “family doctor system” that has played a very important role in the health systems in many countries, such as Germany[7], the United Kingdom[8], Spain[9], Switzerland and the Netherlands[10].…”

“…According to the fifth National Health Service Survey in 2013, 19.9% and 34.8% of patients opted for care provided by higher-tier hospitals in rural and urban areas, respectively[14]. Previous researches have showed that a considerable number of residents still choose higher-tier hospitals for the initial treatment[9, 15], even for common conditions such as chronic conditions[16, 17]. Existing reasons for residents bypassing local PCFs[18] are related to residents' distrust[19], dissatisfaction[20], concerns about the lack of medical equipment[21] and so on.…”

Patients’ Willingness on Community Health Centers as Gatekeepers and Associated Factors in Shenzhen, China

“…2–5 The gatekeeper policy has been widely established in many western countries, such as Germany, 6,7 Spain, 8 the United Kingdom, 9,10 and the Netherlands. 11,12 In the last 5 years, China's healthcare reform has made substantial progress in expansion of the insurance coverage, and strengthening of the infrastructure of primary healthcare facilities.…”

Crecemos en Europa

“…Aprendemos cómo trabajan los pediatras de cabecera en Europa, sus diferentes sistemas sanitarios, destacando la singularidad de nuestro gran sistema sanitario público en un país occidental como es España. Podremos comunicar y demostrar las bondades de los centros de salud españoles como entorno adecuado que acerca el pediatra a las familias 5 . Podremos publicitar junto a los profesionales europeos, en estos momentos de cambios en políticas sanitarias, el ahorro de costes y los mejores resultados en salud de los pediatras de AP para los niños y sus familias.…”