Primary Care And Health System Performance: Adults' Experiences In Five Countries

Schoen, Cathy; Osborn, Robin; Huynh, Phuong Trang; Doty, Michelle M.; Davis, Karen; Zapert, Kinga; Peugh, Jordon

doi:10.1377/hlthaff.w4.487

Cited by 202 publications

(189 citation statements)

References 12 publications

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“…7 Concerns about access to and the quality of ED care are widespread. In a community-based survey of 1,400 adults in each of five countries (Canada, Australia, United Kingdom, New Zealand, United States) conducted in 2001 8 and repeated in 2004, 9 Americans and Canadians were the most likely to have used EDs and the most likely to say they received ''fair or poor'' care. They were also among the most likely to have waited more than 2 hours for ED care.…”

Section: Ré Sumémentioning

confidence: 99%

Prioritizing performance measurement for emergency department care: consensus on evidencebased quality of care indicators

Schull

Guttmann

Leaver

et al. 2011

CJEM

101

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Background: The evaluation of emergency department (ED) quality of care is hampered by the absence of consensus on appropriate measures. We sought to develop a consensus on a prioritized and parsimonious set of evidence-based quality of care indicators for EDs. Methods: The process was led by a nationally representative steering committee and expert panel (representatives from hospital administration, emergency medicine, health information, government, and provincial quality councils). A comprehensive review of the scientific literature was conducted to identify candidate indicators. The expert panel reviewed candidate indicators in a modified Delphi panel process using electronic surveys; final decisions on inclusion of indicators were made by the steering committee in a guided nominal group process with facilitated discussion. Indicators in the final set were ranked based on their priority for measurement. A gap analysis identified areas where future indicator development is needed. A feasibility study of measuring the final set of indicators using current Canadian administrative databases was conducted.

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Section: Ré Sumémentioning

confidence: 99%

Prioritizing performance measurement for emergency department care: consensus on evidencebased quality of care indicators

Schull

Guttmann

Leaver

et al. 2011

CJEM

101

View full text Add to dashboard Cite

show abstract

“…Diversas são as evidências de que os sistemas organizados pela coordenação da atenção primária à saúde alcançam melhores resultados quando comparados com os que não a utilizam com essa função 38,39 . Entretanto, para que seus efeitos sejam ainda mais efetivos, são necessárias também ações que busquem a inter-relação com outros setores tanto do campo da saúde como fora dele, como meio de oportunizar a construção de modelos que contribuam para a solução dos problemas da população nos seus diversos recortes.…”

Section: Metodologiaunclassified

Internações por condições sensíveis à atenção primária em Campo Grande, Mato Grosso do Sul, Brasil, 2000 a 2009

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2012

Cad. Saúde Pública

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Este estudo analisou a correlação entre a evolução da cobertura do Estratégia Saúde da Família (ESF) e a taxa das internações por condições sensíveis à atenção primária (ICSAP), em Campo Grande, Mato Grosso do Sul, Brasil, no período de 2000 a 2009. O estudo de caráter ecológico foi conduzido utilizando-se os dados do Sistema de Informações Hospitalares (SIH), disponíveis no site do Departamento de Informática do SUS (DATASUS) e do Instituto Brasileiro de Geografia e Estatística (IBGE). Na análise estatística foram utilizados o coeficiente de correlação linear de Pearson e sua significância. Campo Grande apresentou correlação inversa seguindo a tendência do país de redução das referidas internações. Na apreciação por categorias de internações observou-se uma correlação direta com a tuberculose pulmonar, a angina pectoris e as doenças relacionadas ao pré-natal e parto. Os resultados sugerem que o aumento da cobertura do ESF tem contribuído para a queda nas taxas de internações por ICSAP.

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“…The Commonwealth Fund has done international comparative surveys of health systems, including information on the prevalence of those forgoing medication or recommended tests and treatments because of cost. 15 However, it is very difficult to compare Canadian provinces or the prevalence over time because of the relatively small country samples and the differences in sampling frames from year to year.…”

Section: Measures Of Health Care Affordability and Economic Accessibimentioning

confidence: 99%

Development of a measure of health care affordability applicable in a publicly funded universal health care system

Haggerty

Lévesque²

2015

Can J Public Health

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OBJECTIVE: Direct measures of health care affordability from the user perspective are needed to monitor equitable access to publicly funded health care in Canada. The objective of our study was to develop a survey-based measure of health care affordability applicable to the Canadian context. METHODS:We developed items after focus group exploration of access and cost barriers in the health care trajectory. We administered an initial instrument by telephone to a randomly-selected sample of 750 respondents in metropolitan, rural, and remote settings in Quebec. After analysis we developed a new, self-administered version eliciting the frequency of problem access due to five affordability dimensions. This version was mailed to a subset of participants. We conducted exploratory and confirmatory factor analysis. We used ordinal logistic regression modelling to examine how individual items and the subscale score predicted indicators of difficult access. We looked for effect modification by income categories. RESULTS:The five items load on a single construct with good internal consistency (α = 0.77). The overall score, 0 to 5, reflects the sum of problems with health care affordability due to direct and indirect costs. The item and subscale scores are sensitive to income status, with affordability problems more prevalent among low-income than high-income respondents. Each unit increase in the subscale score predicts increased likelihood of unmet needs (OR = 1.54), emergency room use (OR = 1.41), and delay-related health problem aggravation (OR = 1.80).DISCUSSION: This subscale reliably and validly measures cost barriers to medically necessary services in Canada, and can potentially be applied in other settings with publicly funded health systems. It can be used to monitor and compare health care equity.KEY WORDS: Primary health care; accessibility of health services; Canada; health care disparities; outcome and process assessment (health care) La traduction du résumé se trouve à la fin de l'article.

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Primary Care And Health System Performance: Adults' Experiences In Five Countries

Cited by 202 publications

References 12 publications

Prioritizing performance measurement for emergency department care: consensus on evidencebased quality of care indicators

Prioritizing performance measurement for emergency department care: consensus on evidencebased quality of care indicators

Internações por condições sensíveis à atenção primária em Campo Grande, Mato Grosso do Sul, Brasil, 2000 a 2009

Development of a measure of health care affordability applicable in a publicly funded universal health care system

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