System Global T rend and in KSA OBJECTIVES By the end of this session the Students should be able t o Discuss the global trend in health care system History of health Care system in the Kingdom ID: 734904
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Slide1
Primary Health Care
/
Family Medicine
System
Global
T
rend and
in
K.S.A
. Slide2Slide3
OBJECTIVES:
By
the end of this session the
Students should be able to:
Discuss the global trend in health care system
History of health Care system in the Kingdom
Identify
the
PHC principles, components, types of services,
and requirements
Distinguish
between PHC, PC and Family Medicine
Demonstrates awareness of the general structure of the health care system in Saudi Arabia
Identify the home care services provided to the populationSlide4
Case
Jamila 55 years old
S
audi lady, presented with history of low back pain, irregular uterine bleeding and tiredness of four weeks duration.She was diagnosed earlier to have IBS. She claimed that she has files in many hospitals.She request that to be referred to a specialist for further investigations of her problems.Slide5
Discussion
How we can help this lady?
To which specialty of care, this lady to be referred?Slide6
Global Trend
Health care SystemSlide7
The Shifting Face of Health Care
A
ging of the
population From acute to chronic disease
From institutions to networks of care
From hospital to community
From a single professional, generally a physician, to teams of health care professionals
Expectations/knowledge/involvement of patients, families, communities
7Slide8
A Global Consensus
Primary Care is THE foundation of a sustainable health care system
Evidence that health systems with very strong primary care are effective and
efficientStarfield 2005Kringos 2013
Franks P,
Fiscella
K.
J
Fam
Pract
1998
Macinko
et al, Health
Serv
Res 2003Ramono et al. JAMA Intern Med. Shi et al, J Epidemiol Community Health 2004;
8Slide9
Where are the patients?
9
Green LA et al. N Engl J Med 2001;344:2021-2025.
Results of a Reanalysis of the Monthly Prevalence of Illness in the Community and the Roles of Various Sources of Health Care. Slide10
Family Medicine: A Constant
Evolution
Canadian Prospective
1960-2000-From solo to shared MD practices1990’
s- a specialty; all GPs are family medicine trained in accredited programs
2000- From shared-office MD practices to group interdisciplinary practices
2005-A government and university priority
2016-The Family Medicine Groups (medical home in Quebec) as a Key Integrating Factor
10Slide11
Family Medicine
/ Primary Care
A doctor-patient trusting relationship with
continuity of care
based on each patient having «their» physician and clinical team and each physician having a defined patient population by registering patients to their Family Physician
11Slide12
History:
Health
Care Services
1926 PHC Taif and Makka1928 health and emergency services directorate1931 Ministry of interior (department of health)1950 establishment of ministry of health (MOH) and hospitals Slide13
What is Primary Health Care?
How would you define Primary Health Care?Slide14
Primary health care has been defined by the World Health Organization (WHO, 1978) as:
Essential care
based on
practical, scientifically sound and socially acceptable methods and technology made
universally accessible
to individuals
and families
in the community through their full participation and at a
cost that
the
community and country can afford
to maintain at every
stage of
their development in the spirit of self-reliance and
self determination.
P
rimary Health CareSlide15
الرعاية الصحية الأولية(منظمة الصحة العالمية)
هي إتاحة الرعاية الصحية الأساسية للجميع
بتكلفة يستطيع البلد والمجتمع تحملها
باستخدام وسائل عملية سليمة من الناحية العلمية
ومقبولة من وجهة النظر الاجتماعية
لكل فرد من أفراد المجتمع
وينبغي إشراك المجتمع
وإشراك القطاعات الأخرى ذات العلاقة
Slide16
P
rimary
H
ealth Care:It forms an integral part both of the country’s health system.It is the first level of contact of
individuals, the family, and the community with the national
health system.
Constitutes
the first element of a continuing health
care process
.Slide17
Levels of
Health Care
Primary health care
Secondary health careTertiary health careSlide18
Primary health care
The “first” level of contact between the individual and the health system.
Essential health care (PHC) is provided.
A majority of prevailing health problems can be satisfactorily managed.The closest to the people.Provided by the primary health centers.Slide19
Secondary health care
More
complex problems are dealt with.
Comprises curative servicesProvided by the district hospitalsThe 1st referral levelExample:King Salman HospitalIman HospitalPrince Mohammad Bin Abdulaziz HospitalSlide20
Tertiary health care
Offers
super-specialist care
Provided by regional/central level institution.Provide training programsExample: KKESHKFSHRCSlide21
In accordance with
Alma-ata
(1978) declaration Saudi Arabia decides to adopt PHC approach in 1980
Alm-ata declaration PHC, WORLD HEALTH ORGANIZATION, GENEVA; 1978Primary health care Slide22
Principles for PHC
PHC based on the following
FIVE principles :Social equityNation-wide coverageSelf-reliance
Inter-sectorial
coordination
People’s involvement in the planning and implementation of health programsSlide23
Primary Health Care addresses the main health problems
in the community
through FOUR types of services:Promotive, Preventive,
Curative and
Rehabilitative services Slide24
TEN
components of Primary Health Care
Education: Common health problems and the methods of preventing and controlling themPromotion: food supply and proper nutrition
A
dequate supply of safe water and basic sanitation
Maternal and child health care, including family planning
Immunization against the major infectious diseasesSlide25
Components of Primary Health Care (
cont
)6. Prevention and control of locally endemic diseases7. Appropriate treatment of common diseases and injuries8. Basic laboratory services and provision of essential drugs
9. Training of health guides, health workers and health assistants
10. Referral servicesSlide26
The Basic Requirements for Sound PHC (the 8 A’s and the 3 C’s)
Appropriateness
Availability
AdequacyAccessibilityAcceptabilityAffordability AssessabilityAccountabilityCompletenessComprehensivenessContinuitySlide27
Appropriateness
Whether the service is needed at all in relation to essential human needs, priorities and policies.
The service has to be properly selected and carried out by trained personnel in the proper way.Slide28
Adequacy
The service proportionate to requirement.
Sufficient volume of care to meet the need and demand of a communitySlide29
Affordability
The cost should be within the means and resources of the individual and the country.Slide30
Accessibility
Reachable, convenient services
Geographic, economic, cultural accessibility Slide31
Acceptability
Acceptability of care depends on a variety of factors, including satisfactory communication between health care providers and the patients, whether the patients trust this care, and whether the patients believe in the confidentiality and privacy of information shared with the providers.Slide32
Availability
Availability of medical care means that care can be obtained whenever people need it.Slide33
Assessability
Assessebility means that medical care can be readily evaluated.Slide34
Accountability
Accountability implies the feasibility of regular review of financial records by certified public accountants.Slide35
Completeness
Completeness of care requires adequate attention to all aspects of a medical problem, including prevention, early detection, diagnosis, treatment, follow up measures, and rehabilitation.Slide36
Comprehensiveness
Comprehensiveness of care means that care is provided for all types of health problems.Slide37
Continuity
Continuity of care requires that the management of a patient’s care over time be coordinated among providers.Slide38
The current Status of PHC as per Saudi Ministry of Health:
33% of PHC centers are equipped with X rays.
72% of PHC centers are equipped with labs. CBC, ESR, INR, HbA1c, Lipid. TSH.
27 patients/physician/day, 3155 GPs, 1729 with FM training. Board certified FM (<1%). Slide39
Think, Pair
&
ShareSlide40
Primary care?
Primary
health
care?
Family
medicine?Slide41
L.K. Muldoon, W.E. Hogg, M. Levitt ; Primary care (PC) and primary health are (PHC): What is the difference?
Canadian Journal of Public Health , September/October 2006, Vol.97, No.5,
409-11
Primary Care: is “that level of a health service system that provides entry into the system for all new needs and problems, provides person-focused (not disease-oriented)care over time, provides care for all but very uncommon or unusual conditions, and coordinates or integrates care provided elsewhere by others.”Slide42
L.K. Muldoon, W.E. Hogg, M. Levitt ; Primary care (PC) and primary health are (PHC): What is the difference?
Canadian Journal of Public Health , September/October 2006, Vol.97, No.5,
409-11
Primary health care refers to an approach to health and a spectrum of services beyond the traditional health care system. It includes all services that play a part in health, such as income, housing, education, and environment. Primary care is the element within primary health care that focuses on health care services, including health promotion, illness and injury prevention, and the diagnosis and treatment of illness and injury.Slide43
Family
medicine
is
just one of the primary care specialties, the others being general internal medicine, general pediatrics and, in some cases, ob-gyn (obstetrics/gynecology). Family medicine training
, however, is the only primary care specialty to offer care for the whole family, irrespective of
age or
gender. Family medicine also includes broader training in areas such as obstetrics, gynecology
, orthopedics
, surgery and psychiatry, which is not included in most of the other primary care specialties.Slide44
Health care system in Saudi ArabiaSlide45Slide46
Kingdom of
Saudia
Arabia National e-Health Strategy:
The New PHC Systems The Ministry of Health (MOH) aims to improve health care in the Kingdom of Saudi Arabia by improving its equability,
standards
,
availability and quality
all over the Kingdom.
To realize this vision, the MOH has developed a business strategy and 5 year plan, and has positioned e-Health as a primary transformation agent and enabler.
MOH worked with national and international advisors and IBM, and has developed an e-Health Strategy and 5 years Roadmap to enable the vision.
http://www.moh.gov.sa/en/Ministry/nehs/Pages/default.aspxSlide47
Home Health care (HHC)
Definition:
It is an important
service to help aging patients get their medical treatment at home without the hassles of traveling to hospitals or clinics.Prior to 2010, there were five well-established government-sponsored HHC programs at:
King
Faisal Specialist Hospital in
Alqassim
,
King
Fahad
National Guard Hospital in Riyadh,
Military
hospital in Riyadh, and
King
Khalid National Guards Hospital in Jeddah.Slide48
The Ministry of Health mobilized a new fleet of 189 vehicles for this program
There are more than 700 health officials who are divided into 246 teams working in the field in all parts of the Kingdom,” they are linked to 169 hospitals to attend to the health needs of patients confined to their homes
Each medical team comprises a doctor, a nurse, technicians, physiotherapists and social workers to offer counseling to patients and their relatives
Home Health careNews and views "Saudi Arabia - Home care program benefits over 15,000 patients", International Journal of Health Care Quality Assurance, (2012) Vol. 25 Iss
: 7, Slide49
To Summarize
Primary care is an approach that:
Focuses on the person not the disease, considers all determinants of health
Integrates care when there is more than one problemForms the basis for other levels of health systemsAddresses most important problems in the community by promotive, preventive, curative, and rehabilitative servicesOrganizes deployment of resources aiming at promoting and maintaining health. Slide50
Thank you