Primary health care systems (PHCS) can be highly effective at meeting the healthcare needs of people with chronic or multiple morbidity. Under the right conditions it is also the best setting to ...assess health more generally and to intervene when health risks are identified. For people with an established chronic disease, primary care is also the natural setting to coordinate care and to ensure that patients receive the right balance of specialist vs. generalist input - care that is effectively coordinated can improve the overall quality of care by minimising the need for unnecessary and costly acute care, and by improving patient satisfaction. But how is it possible to measure the configuration of a health system and how do the essential features of health systems relate to quality of care? This paper provides an overview of how this might be approached and discusses the challenges therein.
Sistemi primarnega zdravstvenega varstva so lahko zelo učinkoviti pri zadovoljevanju zdravstvenih potreb ljudi s kroničnimi ali več sočasnimi boleznimi. Pod pravimi pogoji so tudi najboljše okolje za splošno oceno zdravja ter za izvajanje ukrepov, ko prepoznamo tveganja za zdravje. Za ljudi s kroničnimi boleznimi je primarno zdravstvo tudi naravno okolje za usklajevanje nege in zagotavljanje ravnovesja med specialistično in splošno oskrbo. Zdravstvena nega, ki je učinkovito usklajena, lahko izboljša splošno kakovost tako, da stremi k zmanjševanju potreb po nepotrebni in dragi akutni negi ter k izboljšanju zadovoljstva bolnikov. Toda, kako izmeriti konfiguracijo zdravstvenega sistema in ugotoviti, na kakšen način bistvene značilnosti zdravstvenih sistemov odražajo v kakovosti zdravstvene nege? V prispevku predstavljamo možne pristope in razpravljamo o izzivih, ki se nanašajo nanje.
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