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"Perceptions and Expectations of Primary Health Care: a New Form of Identifying Improvements" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "358" "paginaFinal" => "363" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S Redondo Martín, E Bolaños Gallardo, A Almarez Gómez, JA Maderuelo Fernández" "autores" => array:4 [ 0 => array:2 [ "Iniciales" => "S" "apellidos" => "Redondo Martín" ] 1 => array:2 [ "Iniciales" => "E" "apellidos" => "Bolaños Gallardo" ] 2 => array:2 [ "Iniciales" => "A" "apellidos" => "Almarez Gómez" ] 3 => array:2 [ "Iniciales" => "JA" "apellidos" => "Maderuelo Fernández" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:8 [ "pii" => "13080291" "estado" => "S300" 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] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "General Coordinator of the Family and Community Medicine Program of Catalonia, Barcelona, Spain." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "textoCompleto" => "<p class="elsevierStylePara"><img src="27v36n07-13080288tab01.gif"></img></p><p class="elsevierStylePara">The perception which the users have on the quality of the services offered by primary care centres and the health teams varies according to factors which have their origin in the different elements that have a bearing on the care process and in its results: the organisation and staff of the centres and clinics, and the characteristics of the professionals and the users themselves. Satisfaction with the care received is a result of the joint interaction of this group of factors and, for this reason, it used to be very difficult to analyse, under the perspective of cause and effect, the role of any one of them in isolation.<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">Of the group of elements which define the organisation of primary health care, accessibility,<span class="elsevierStyleSup">1</span> time availability<span class="elsevierStyleSup">2</span> and continuity<span class="elsevierStyleSup">3-9</span> are the factors which most influence the perception and satisfaction of the users.</p><p class="elsevierStylePara">In the group of factors related to the characteristics of the professionals, those which help to establish an appropriate relationship with the patient and a pleasant and personalised care are highlighted.<span class="elsevierStyleSup">10,11</span></p><p class="elsevierStylePara">Some characteristics of the patients also appear to play an important role in their perception and expectations on the quality of care received; age, socioeconomic situation, the presence of chronic diseases and the poor health situation, and the frequent use of the health resources are factors which have normally been analysed in this perspective.<span class="elsevierStyleSup">12-19</span></p><p class="elsevierStylePara">In the work by Redondo Martín, et al in this issue of PRIMARY CARE, the perceptions and expectations of the patients are qualitatively analysed (discussion groups), translated in terms of satisfaction, on the different aspects of the care received in health centres and, from them, possible improvement initiatives are deduced. To homogenise the characteristics of the participating patients, 6 discussion groups composed of 5-7 people were established. This group compartmentalisation could be considered excessive for the objective of the study. The conclusions corroborate the role of the principle factors that influence satisfaction and which have frequently been analysed in the scientific literature, and they add some more, such as the references to the relevance of prevention activities and the deficiencies observed in the assistance for mental health in the context of primary care, which has received little attention in previous studies.<span class="elsevierStyleSup">20-24</span></p><p class="elsevierStylePara">As pointed out at the beginning, the satisfaction of the user/patient has its origin in many factors, but there is wide agreement in the scientific literature on considering that continuity and the accessibility to care and, in relation to these, the establishment of a patient/doctor relationship based on confidence and in the bilateral participation in decision making,<span class="elsevierStyleSup">25-27</span> and placed in a context of availability of sufficient time, are central factors in determining not only the satisfaction of the user, but also the results in terms of effectiveness and efficiency of the care rendered. In this framework, the nursing professionals are called upon to fulfil an increasingly leading role.<span class="elsevierStyleSup">28</span></p><p class="elsevierStylePara">This nuclear conglomerate which should characterise the increasingly important activity of primary care, as it increases the level of dependency of the patient in relation to the health and social services (chronic diseases, the physically and mentally handicapped, etc). In short, we are talking about a primary care built with the basic mission of giving personalised clinical attention and in which the resources of mental and social health have to be increasingly integrated. This subsystem of personal clinical care is different (although not separate) form technological clinical care centred in acute hospitals. This new primary care should leave its almost exclusive image of gatekeeper and patient distribution point to the technology subsystem behind completely and assume a greater capacity for resolving. As described in a recent editorial of the American edition of the <span class="elsevierStyleItalic"> British Medical Journal</span>,<span class="elsevierStyleSup">29</span> it is necessary to redefine primary care and include in this redefinition, a new perspective of evaluating its activity which must not be centred on number of clinical visits made, but on the quality and satisfaction generated.</p><p class="elsevierStylePara"> The full incorporation of the new information and communication technologies into the daily clinical activity will introduce profound changes in the workloads. In the previously mentioned editorial, it is pointed out that assistance via the Internet (e-mail and website) could take on an increasing percentage of care and prevention activity. It also talks of the need of new formulas of care, such as group visits of patients with chronic diseases, and of promoting the access and possibility that patients may be able to add relevant information into their clinical history, computerised and situated in the website of the centre or the professional. It is in these contexts that we have to place the new primary care and, with this, professionals capable of providing health services with an optimum level of quality and perceived as satisfactory and effective by the people, politicians and managers responsible for the health system.</p>" "pdfFichero" => "27v36n07a13080288pdf001.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "tbl1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "27v36n07-13080288tab01.gif" "imagenAlto" => 333 "imagenAncho" => 318 "imagenTamanyo" => 9929 ] ] ] ] ] ] 1 => array:5 [ "identificador" => "tbl2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Las expectativas de los pacientes. ¿Qué aspectos valoran en un centro de salud?: un estudio cualicuantitativo." 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Original language: English
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2024 October | 10 | 12 | 22 |
2024 September | 14 | 6 | 20 |
2024 August | 15 | 4 | 19 |
2024 July | 21 | 3 | 24 |
2024 June | 13 | 2 | 15 |
2024 May | 6 | 0 | 6 |
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2024 February | 14 | 5 | 19 |
2024 January | 21 | 8 | 29 |
2023 December | 19 | 9 | 28 |
2023 November | 17 | 8 | 25 |
2023 October | 32 | 6 | 38 |
2023 September | 25 | 6 | 31 |
2023 August | 15 | 7 | 22 |
2023 July | 20 | 5 | 25 |
2023 June | 29 | 11 | 40 |
2023 May | 30 | 6 | 36 |
2023 April | 29 | 5 | 34 |
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2020 December | 8 | 10 | 18 |
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2019 September | 7 | 3 | 10 |
2019 August | 11 | 3 | 14 |
2019 July | 7 | 5 | 12 |
2019 June | 27 | 15 | 42 |
2019 May | 71 | 25 | 96 |
2019 April | 26 | 16 | 42 |
2019 March | 8 | 5 | 13 |
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2019 January | 6 | 3 | 9 |
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2018 October | 13 | 10 | 23 |
2018 September | 12 | 27 | 39 |
2018 August | 2 | 0 | 2 |
2018 July | 4 | 1 | 5 |
2018 June | 3 | 0 | 3 |
2018 May | 2 | 4 | 6 |
2018 April | 3 | 7 | 10 |
2018 March | 6 | 0 | 6 |
2018 February | 2 | 1 | 3 |
2018 January | 2 | 0 | 2 |
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2017 November | 3 | 0 | 3 |
2017 October | 8 | 0 | 8 |
2017 September | 8 | 2 | 10 |
2017 August | 7 | 7 | 14 |
2017 July | 10 | 1 | 11 |
2017 June | 7 | 2 | 9 |
2017 May | 8 | 2 | 10 |
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2017 March | 19 | 1 | 20 |
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2016 August | 19 | 2 | 21 |
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2016 March | 61 | 5 | 66 |
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2016 January | 34 | 5 | 39 |
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2015 November | 47 | 4 | 51 |
2015 October | 56 | 7 | 63 |
2015 September | 48 | 14 | 62 |
2015 August | 60 | 8 | 68 |
2015 July | 31 | 5 | 36 |
2015 June | 19 | 5 | 24 |
2015 May | 47 | 4 | 51 |
2015 April | 21 | 9 | 30 |
2015 March | 38 | 9 | 47 |
2015 February | 51 | 3 | 54 |
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2014 October | 161 | 4 | 165 |
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2013 August | 46 | 2 | 48 |
2013 July | 51 | 4 | 55 |
2013 June | 0 | 1 | 1 |
2005 October | 1026 | 0 | 1026 |