Primary Healthcare

Biography

Biography: Gustavo H. Marin

Abstract

Primary Health Care (PHC) has been an excellent theoretical strategy however, in practice, after more than 30 years from the proposal, health’s results and indicators are not the one expected. From Alma Ata to our days, the epidemiological approach of diseases has changed. Chronic illnesses such as hypertension and diabetes mellitus have replaced the infectious diseases as the major causes of morbidity and mortality worldwide. Our group has focused the absence of nominal responsibility and customization of the practices by the health team as one of the major drawbacks of the lack of success with PHC strategy. To demonstrate this point, we examined the impact of nominal and customized health care model in patients with diabetes and hypertension. 2,400 patients were included in a randomized study. Patients were assigned to a control group or to an intervention. Both groups received medication prescribed by health professional for free, but “control” group received the treatment on demand; while in the "intervention" group, a weekly regular contact by one of the member of the health team. A nominal responsibility of the patient was being then assigned to that team’s member. After 24 months of running this health care model, results showed 46% reduction in cardiovascular events and 62% decrease in hospital admissions due to events related to these diseases. We conclude that PHC strategy showed a substantial improvement of the goals when a nominal responsibility is assigned to a member of the health team in order to provide this care practices.