16 Dec
Despite evidence demonstrating the benefits of understanding patients, there is a paucity of information about how physicians address psychological and social concerns of patients. Patients cried in 157 encounters out of a total of 18,627 giving an incidence rate of 8.4 per thousand. More frequent reasons for encounters were: feeling depressed (12.7%), social handicap (mainly [...]
4 Jun
Health systems are social products, and as such they cannot being invented. They are expression of the final election between “freedom” and “equity”. Freedom means that each person may select and pay for the needed health services. Equity means solidarity, to help those in need even at the cost that are fit. Only the USA [...]
4 Jun
Quaternary prevention is the prevention of harms by medical interventions and as such a foundation block of medicine (primum non nocere). All services have adverse effects, all services might produce damage to health. A few services produce more benefits than harms in specific situations. Unnecessary and inappropriate services mainly produce harms, and few benefits if [...]
10 Apr
In this review, we consider empirical studies from the United States and elsewhere, and we focus on how one aspect of health systems, clinical care, contributes to maintaining systematic differences in health across population groups characterized by social disadvantage. We consider inequities in clinical care and the policies that influence them. We develop a framework [...]
13 Oct
All health services have adverse effects, all health services might produce damage to health. A few services produce more benefits than harms in specific situations. Unnecessary and inappropriate services mainly produce harms, and few benefits if any. Quaternary prevention is the prevention of unnecessary and/or inappropriate services and the prevention of over-medicalisation. Quaternary prevention refers mainly to personal services, [...]
21 Sep
Primary health care have a different status across countries. This paper is an exploration of the reasons why. Much can be learned by analysing Spain as a benchmark, and comparing it with other Mediterranean countries (Greece, Italy, and Portugal). Critical steps in Europe to set up PHC under conditions of resource constraint. The case fo the [...]
21 Sep
Primary health care provides services fitted to health needs of the population. To understand the way of working in PHC we need to consider a general framework with focus in the workforce (providers) and the way of payments (and incentives). Considerations around the Duth model helps in this paper to make proposals for improvement. PHC: [...]
