Unfulfilled potential of primary care in Europe

Allen, Luke; Barkley, Shannon; Maeseneer, Jan De; Weel, Chris van; Kluge, Hans; Wit, Niek de; Greenhalgh, Trisha

doi:10.1136/bmj.k4469

Cited by 22 publications

(14 citation statements)

References 32 publications

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“…Our study reinforces other studies that highlight the key role that discharge planning and primary care systems are essential to support home carers (Hahn‐Goldberg et al, 2018; Scheerens et al, 2018). It also highlights the fact that in many southern European countries, such as Italy, the primary care and community nursing services are not as well developed as other areas of the world (Allen et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Caring for patients at home after acute exacerbation of chronic obstructive pulmonary disease: A phenomenological study of family caregivers’ experiences

Bagnasco

Rosa

Dasso

et al. 2021

Journal of Clinical Nursing

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Aims and objectives To understand the experiences and support needs of informal caregivers of patients with chronic obstructive pulmonary diseases chronic obstructive pulmonary disease who return home following an acute exacerbation. Background The presence of an informal caregiver is important to provide practical and emotional support after an episode of acute exacerbation of chronic obstructive pulmonary disease. However, caregiving in such circumstances can be challenging and stressful. Design Phenomenology. Methods This is a phenomenological study based on semi‐structured interviews with sixteen primary caregivers of chronic obstructive pulmonary disease patients. Interview data were analysed using Colaizzi's descriptive analysis framework, to identify significant themes and sub‐themes. Data were collected between April‐December 2017 in a Teaching Hospital in Italy. The study was designed and reported following the COREQ guidelines and checklist. Results Analysis elicited five themes embracing various aspects of the caregivers’ lived experiences: (a) a home disrupted, (b) living with constant vigilance and anxiety, (c) feeling the need to escape (d) self‐justifications for caregiving role/duty, and (e) feeling abandoned by professionals. Conclusions Our results show that carers experience a range of difficulties when caring for their relative at home with chronic obstructive pulmonary disease. Some of these are linked to the physical disruption of their home but many are linked to feelings of inability to cope and the psycho‐social impact of the caring role. The study also shows how participants felt unsupported by professionals. Focused support for carers is required to enable them to meet these challenges. Relevance to clinical practice Healthcare professionals should be trained to provide technical and psychological support to caregivers especially during the phases of disease that may involve episodes of exacerbation. Home care and continuity of care can work if there is excellent communication and collaboration between healthcare professionals and caregivers. Developing appropriate support for family caregivers is essential to address the problems they can face.

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Section: Discussionmentioning

confidence: 99%

Caring for patients at home after acute exacerbation of chronic obstructive pulmonary disease: A phenomenological study of family caregivers’ experiences

Bagnasco

Rosa

Dasso

et al. 2021

Journal of Clinical Nursing

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“…Increased dissemination of community diagnosis, facilitated by multiprofessional teams, could further enhance health care and health promotion tailored to specific community contexts. Finally, there is a need for integration of public health services and primary care (Allen at al., 2018) to be responsive to today's challenges that require both a person-and population-centred approach.…”

Section: Discussionmentioning

confidence: 99%

Addressing the particular challenges of patients living in rural and remote areas and for disadvantaged groups: skill-mix innovations to improve access and quality of care

Maeseneer¹,

Scarpetti²,

Budde³

et al. 2022

Skill-Mix Innovation, Effectiveness and Implementation

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Addressing the particular challenges of patients living in rural and remote areas and for disadvantaged groups: skill-mix innovations to improve access and quality of care jan de maeseneer, giada scarpetti, hannah budde, claudia b. maier IntroductionThe 2018 Declaration of Astana on Primary Health Care strengthens the importance of access to services (World Health Organization, 2018a). In the EU, the Council of Health Ministers had agreed in 2006 that "Equity relates to equal access according to need, regardless of ethnicity, gender, age, social status or ability to pay" (Council of the European Union, 2006). However, according to the data from the European Union Survey of Income and Living Conditions, in many countries up to 19% of the population report unmet needs for health care (EXPH, 2017).Access can be defined as "the opportunity to reach and obtain appropriate health care services in situations of perceived need for care" (Levesque, Harris & Russel, 2013). There are different dimensions that contribute to access: geographical (distance, accessibility of infrastructure); financial (absence of out-of-pocket payments, especially important to enable access for vulnerable people); administrative (being insured, being registered, access for undocumented people); cultural (ethno-sensitive approaches, availability of translators and cultural mediators) and psychosocial (to what extent the patient experiences services as paying attention to their psychological and social condition). Worldwide, based on data in 174 countries, 56% of populations living in rural areas have shown not to be covered by basic health care, compared with 22% in cities and towns (World Health Organization, 2018b). Tackling gender, cultural, age and geographical issues is paramount to achieving equity of access for rural populations.This chapter focuses on two population groups: those living in rural and remote areas and population groups that are described as vulnerable

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“…Although this model is proposed specifically for Cameroon, it aligns closely with the ‘three pillars’ of primary care; empowered people and communities; multisectoral policy and action; and integrated primary care and public health as the core of health services. 12 This work also resonates with calls for European primary care to engage more deeply with social determinants in Europe, 13 and the new conceptual framework on the levels of engagement with the social determinants in the upcoming WHO Bulletin special issue on primary health care. 14…”

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confidence: 85%

COVID-19 and international primary care systems: Rebuilding a stronger primary care

Allen

Dambha‐Miller²

2020

BJGP Open

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Unfulfilled potential of primary care in Europe

Abstract: The Alma Ata declaration’s compelling vision of health for all will not be realised until we take community level prevention seriously, argue Luke Allen and colleagues

Cited by 22 publications

References 32 publications

Caring for patients at home after acute exacerbation of chronic obstructive pulmonary disease: A phenomenological study of family caregivers’ experiences

Caring for patients at home after acute exacerbation of chronic obstructive pulmonary disease: A phenomenological study of family caregivers’ experiences

Addressing the particular challenges of patients living in rural and remote areas and for disadvantaged groups: skill-mix innovations to improve access and quality of care

COVID-19 and international primary care systems: Rebuilding a stronger primary care

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