equipocesca

Socioeconomic status depends on wealth and education. Both have impact on health. In this study there are some comparisons in between two urban district, one rich, one poor. There are differences in health and use of services, but also unexpected differences in the main source of income (pension in the poor district) and the number of generations per household (three in the poor class and two in the upper one).

• Socio-economic status, chronic morbidity and health services utilization by families. Gomez Rodriguez E., Moreno Raymundo, P., Hernandez Monsalve, M., Gérvas, J . Family Practice Vol. 13, No. 4, 1996, 382-385. Download article here.

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Prevention without limits creates monsters. Prevention has week foundations, as diagnostic methods with no scientific base. Good example are the problems with the interpretation of mammography in the screening of breast cancer and with the diagnosis of melanoma.

• Screening for serious illness. Limits to the power of medicine. Gérvas, J. European Journal of General Practice, Volume 8, June 2002, 47-49. Descargar texto completo aquí.

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New health challenges because social, technical and epidemiological changes need new types of medicalinterventions. Old-style prevention is not more justifiedthan old-style treatment. More money spent on preventivecare for the rich people, who are in a better position todemand it, takes time away from the poor people, whohave greater needs for their health problems. We propose more curation less prevention.

• Is clinical prevention better than cure?. Gérvas, J., Starfield, B., Heath, I. Lancet 2008; 372: 1997-99. Download article here.

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Capitation is the way of payment for general practitioners-family physicians in countries where primary care is strong, as Denmark, Holland, Spain, New Zealand, Spain and the UK. Capitation implies the existence of patients’ list and fair distribution of general practitioners over the country.

• Supply and distribution of family physicians. Gérvas, J. Canadian Family Physician/ Le Medecin de famille canadien, VOL 46: JANUARY/JANVIER 2000. Download article here.

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Over time, the definition of prevention has expanded so that its meaning in the context of health services is now unclear. As risk factors are increasingly considered to be the equivalent of ‘‘diseases’’ for purposes of intervention, the concept of pr evention has lost all practical meaning. This paper reviews the inconsistencies in its utility, and suggests principles that it should follow in the future: a population orientation with explicit consideration of attributable risk, the setting of priorities based onreduction in illness and avoidance of adverse effects, and the imperative to reduce inequities in health

• The concept of prevention: a good idea gone astray?. Starfield B., Hyde J., Gérvas J., Heath I. J Epidemiol Community Health 2008; 62: 580-583. Download article here.

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There are doubts about the effectiveness of the HPV vaccines. For that, we can accept the vaccines if (and only if) 1/ Pharmaceutical industries will donate one vaccine to under-developed countries per each vaccination done in developed countries, 2/ In case of need of re-vaccination (because less than 30 years protection) pharmaceutical industries will cover the cost of re-vaccination. And 3/ Pharmaceutical industries will cover the cost of malpractice litigation because cervical cancer in vaccinate females.

• Human papillomavirus vaccines. Three decent proposals. Gérvas, J. CMAJ, 13 June 2008. Download article here.

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We consider countries in Europe with best primary care, as Denmark, Holland, Spain and the UK. There are some common background as having strong associations of general practitioners that help in improving practice.

• Western European best practice in primary healthcare. Gérvas J, Pérez Fernández M. Eur Gen Pract 2006; 12: 30-3. Download article here.

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