The Post–COVID-19 Case for Primary Care

Much has been written and discussed about challenges faced by the US health care system, with most of it justifiably concerning the payment system for medical services, and how that leaves an unconscionably large proportion of US residents uninsured or underinsured for quality care. Although payment systems are undoubtedly a challenge and merit substantial conversation, the structure of US health care delivery also leaves much to be desired.

Central to that problem is the paucity of primary care physicians in the US. The approximately 200 000 active primary care physicians in the US represent about 30% of all active ...

Health Networks in Action: The experiences of Argentina, Brazil, Colombia and Mexico

Dioselina is a 54-year-old divorcée who has no children and lives alone in a large city. She has been unemployed for a year and just started receiving welfare six months ago. As for her health, she has long-term obesity, chronic obstructive pulmonary disease, and diabetes. In recent months, she began to develop foot ulcers because her blood sugar was not being monitored properly, which is attributable in part to difficulty accessing healthcare services and getting medications and lab tests. If she does not receive rapid treatment and more specialized care for the ulcers, they could worsen and require hospitalization ...

COVID-19: General recommendations for the care of older persons from a human rights perspective

Older people may be more likely to experience complications during the COVID-19 pandemic, so this paper provides recommendations for the care of this social group from a human rights perspective, which can be applied in the home, community and long-term care facilities. These recommendations were drawn up on the basis of good practices in countries in the Latin American and Caribbean region and beyond.

After COVID-19—Thinking Differently About Running the Health Care System

The US response to the COVID-19 pandemic highlights several strategies that should be emphasized more in the management of the health care system. These strategies include using waivers to boost federalism, reconsidering the role of hospitals and other institutions as hubs for care, expanding the use of telehealth, and bringing together funds from multiple programs to improve the delivery of health care and health-related services. The urgent steps that have been taken to make the health care system more flexible and innovative during the COVID-19 pandemic should not be forgotten once the crisis is over. Many of these steps need ...

Building a Thriving Primary Health Care System: The story of Costa Rica

Situated in Central America, Costa Rica’s 4.9 million citizens have access to one of the most effective primary health care systems in the world. The country’s unique, team-based model of primary care service delivery successfully combines preventive and curative care to provide comprehensive primary health care to nearly all Costa Rican citizens. This case study examines the process by which Costa Rica developed its laudable primary health care system, fully describes the functioning of the system through both clinical and patient perspectives, and elucidates key lessons about primary health care delivery that can be learned from the ...

Will Disruptive Innovation in Health Care Improve the Health of Populations?

Health care in the United States is long overdue for an upheaval. The mismatch between costs, by far the highest in the world, and health outcomes, among the worst in the high-income world, has long been glaring. Perhaps the good news is that the time for such an upheaval has come. At least 4 forces have been gathering steam, each promising to change the nature of health care and, in so doing, influence population health.

The creative potential of health work to develop an integrated care model in Brazilian primary health care  

In November 2015, at the 3rd World Congress on Integrated Care and 8th National Congress of Integrated Medicine, “Co-producing High Quality People-Centered Integrated Care for ALL”, Debora Santos presented her PhD research on primary health care teams in Alagoas, the most unequal state in Brazil. According to Debora Santos, while Brazil's Unified Health System (SUS) is headed by principles of integrated care, in practice a biomedical conception of health typically prevails instead of one focused on integrated care. Therefore, the objective of her research was to identify potential ways to develop an integrated care model of primary health care ...

Experiencing Integrated Health: Ontarians’ views of health care coordination and communication

Health Quality Ontario (HQO) has published an analysis using data from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults in order to identify, from a patient perspective, how well different parts of health system are working together.

The HQO extracted a sample with the population from Ontario; Ontarians reported similar results as top-ranking countries in some indicators related to coordination of care; about 80% of Ontarians said they received help from their regular physicians to coordinate their care with other providers.

The sample from Ontario population made able to identify some key points where Canadian Health System ...

The Patient-Centered Medical Home’s Impact on Cost and Quality: Annual Review of Evidence, 2014-15

The Patient-Centered Medical Home (PCMH) is a model of primary care that is patient-centred, comprehensive, coordinated, accessible and committed to quality and safety. In the PCMH, the primary care team coordinates care for patients and guides them in their journeys across the health care system.  In February 2016, the Patient-Centered Primary Care Collaborative, a not-for-profit membership organization, published a review titled "The Patient-Centered Medical Home's Impact on Cost and Quality", which provides a summary of PCMH cost and utilisation outcomes in the United States. The review includes peer-reviewed studies, state government evaluations, industry reports and independent federal program evaluations ...