Performance evaluation of the essential dimensions of the primary health care services in six localities of Bogota–Colombia: a cross-sectional studyReportar como inadecuado




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BMC Health Services Research

, 13:315

Health systems and services in low and middle income settings

Abstract

BackgroundThe high segmentation and fragmentation in the provision of services are some of the main problems of the Colombian health system. In 2004 the district government of Bogota decided to implement a Primary Health Care PHC strategy through the Home Health program. PHC was conceived as a model for transforming health care delivery within the network of the first-level public health care facilities. This study aims to evaluate the performance of the essential dimensions of the PHC strategy in six localities geographically distributed throughout Bogotá city.

MethodsThe rapid assessment tool to measure PHC performance, validated in Brazil, was applied. The perception of participants users, professionals, health managers in public health facilities where the Home Health program was implemented was compared with the perception of participants in private health facilities not implementing the program. A global performance index and specific indices for each primary care dimension were calculated. A multivariate logistic regression analysis was conducted to determine possible associations between the performance of the PHC dimensions and the self-perceived health status of users.

ResultsThe global performance index was rated as good for all participants interviewed. In general, with the exception of professionals, the differences in most of the essential dimensions seemed to favor public health care facilities where the Home Health program was implemented. The weakest dimensions were the family focus and community orientation—rated as critical by users; the distribution of financial resources—rated as critical by health managers; and, accessibility—rated as intermediate by users.

ConclusionsThe overall findings suggest that the Home Health program could be improving the performance of the network of the first-level public health care facilities in some PHC essential dimensions, but significant efforts to achieve its objectives and raise its visibility in the community are required.

KeywordsPrimary health care Health services evaluation Bogota Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-13-315 contains supplementary material, which is available to authorized users.

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Autor: Paola A Mosquera - Jinneth Hernández - Román Vega - Jorge Martínez - Miguel San Sebastián

Fuente: https://link.springer.com/







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