Primary care in a post-communist country 10 years later

Liseckienė, Ida; Boerma, W.G.W.; Milašauskienė, Žemyna; Valius, Leonas; Misevičienė, Irena; Groenewegen, Peter

doi:10.1016/j.healthpol.2006.11.011

Cited by 14 publications

(5 citation statements)

References 7 publications

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“…Health education and disease prevention are among the most important tasks of a new primary health care system. Several studies examined the changes in GP task profiles during the implementation of health care reform in Lithuania [17, 18]. However, surveys assessing the extent of counselling on health behaviour in primary health care are lacking.…”

Section: Introductionmentioning

confidence: 99%

Nutrition and physical activity counselling by general practitioners in Lithuania, 2000–2014

2019

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Background Primary health care plays a crucial role in providing recommendations on a healthy diet and physical activity to assist patients in weight management. The study aimed to evaluate health behaviour counselling provided by general practitioners (GPs) for adults with overweight and obesity in Lithuania between 2000 and 2014. Methods Eight biennial postal surveys to independent nationally representative random samples of Lithuanians aged 20–64 were conducted. Response rates varied from 41.1 to 74%, with a decreasing trend over time. The data of 5867 participants who visited a GP at least once during the last year and had BMI of ≥25.0 kg/m 2 were analysed. Respondents were asked about GP advice on nutrition and physical activity and changes in their health behaviour during the last year. Results The proportion of persons with overweight who reported GP advice on nutrition increased from 23.6% in 2000 to 37.5% in 2010 and advice on physical activity from 11.9 to 17.2% respectively; however, later both proportions decreased slightly. The likelihood of reporting was higher in respondents with higher BMI, more chronic conditions and frequent contact with a GP. Respondents who were living in cities, older and highly educated women were all more likely to report being advised on physical activity. Men and women who received advice from a GP more often reported changes in health behaviour as compared with non-advised individuals. Conclusions Despite increasing trends, the rate of GP advice on nutrition and physical activity reported by patients with overweight and obesity remains low in Lithuania. GP advice appears to have a significant impact on attempts by patients to change behaviour related to weight control. Therefore, there is an obvious need to make additional efforts to increase the frequency of GP counselling and to identify and address barriers to advising patients with overweight.

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Section: Introductionmentioning

confidence: 99%

Nutrition and physical activity counselling by general practitioners in Lithuania, 2000–2014

2019

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“…In addition, Macinko et al [ 16 ] found that a well-established health system seems to have a considerable influence on health consequences globally. The authors also noted that numerous European countries have re-educated district physicians and primary care specialists doctors into general practitioners across Europe and introduced gatekeeping [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Primary Health Care: Our Experience From an Urban Primary Health Care Center in Greece

Galanakos¹,

Bablekos²,

Tzavara³

et al. 2023

Cureus

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This observational study reported patient data derived from the emergency files of a primary health care (PHC) center in Greece, with the aim of providing potential solutions for a well-organized, well-structured, and effective social healthcare system. This series was conducted at a single urban PHC center in Greece between August 2017 and March 2020. A total of 83,592 patient visits were registered. The mean patient age was 42.5 years (range: three months to 93 years). Demographics, presenting complaints, and the need for patients who visited the healthcare center to be referred to tertiary hospitals were examined. Further perspectives and future strategies to strengthen the national PHC system were addressed. The most common reasons for visits were pathological (33.6%), followed by general surgery (21.2%) and orthopedics (18.1%). Pediatric conditions accounted for 12% of visits, cardiological conditions accounted for 8.6%, and dental problems accounted for 6.8%. The majority of the patients (n = 81,317, 97.3%) were managed within the health center, and only 2.7% of cases (n = 2275) needed to be referred to a secondary or tertiary healthcare structure. Reasons for patient referral included the severity or complexity of the patient's situation, lack of a specific medical specialty, and the unavailability of overnight laboratory tests. The PHC center remains the cornerstone of a high-quality healthcare system. A well-structured PHC unit can improve health outcomes and decongest secondary and tertiary health care.

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“…Lithuania also has polyclinics in the biggest cities, which probably paves the way for private practices also to accommodate specialist services within their organization. There is evidence from Lithuania that service provision patterns of retrained district therapists and paediatricians have changed since the early 1990s, showing a stronger role as doctors of first contact and more involvement in chronic disease management [45]. Moreover, GPs better address the health needs of families and people are more satisfied with their GPs than with district doctors [46] and [47].…”

Section: [Box 4][box 5][box 6]mentioning

confidence: 99%

Strengthening weak primary care systems: Steps towards stronger primary care in selected Western and Eastern European countries

et al. 2013

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European health care systems are facing diverse challenges. In health policy, strong primary care is seen as key to deal with these challenges. European countries differ in how strong their primary care systems are. Two groups of traditionally weak primary care systems are distinguished. First a number of social health insurance systems in Western Europe. In these systems we identified policies to strengthen primary care by small steps, characterized by weak incentives and a voluntary basis for primary care providers and patients. Secondly, transitional countries in Central and Eastern Europe (CCEE) that transformed their state-run, polyclinic based systems to general practice based systems to a varying extent. In this policy review article we describe the policies to strengthen primary care. For Western Europe, Germany, Belgium and France are described. The CCEE transformed their systems in a completely different context and urgency of problems. For this group, we describe the situation in Estonia and Lithuania, as former states of the Soviet Union that are now members of the EU, and Belarus which is not. We discuss the usefulness of voluntary approaches in the context of acceptability of such policies and in the context of (absence of) European policies.

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Primary care in a post-communist country 10 years later

Cited by 14 publications

References 7 publications

Nutrition and physical activity counselling by general practitioners in Lithuania, 2000–2014

Nutrition and physical activity counselling by general practitioners in Lithuania, 2000–2014

Primary Health Care: Our Experience From an Urban Primary Health Care Center in Greece

Strengthening weak primary care systems: Steps towards stronger primary care in selected Western and Eastern European countries

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