Special Issue "Primary Healthcare"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: 31 December 2021.

Special Issue Editors

Dr. Belchin Kostov
E-Mail Website
Guest Editor
Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Primary Care Centre Les Corts, Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
Interests: primary healthcare; biostatistics; questionnaire validation; data visualization; multivariate analysis
Dr. Luis González-de Paz
E-Mail Website
Guest Editor
Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Primary Care Centre Les Corts, Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
Interests: primary healthcare; nursing; nursing interventions; scale development; ethics; public health
Prof. Dr. Antoni Sisó-Almirall
E-Mail Website
Guest Editor
CAP Les Corts, Consorci d'Atenció Primària de Salut Barcelona Esquerre (CAPSBE), 08028 Barcelona, Catalonia, Spain
Interests: Clinic Research; COVID-19; autoimmune diseases
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues, 

We are organizing a Special Issue titled “Primary Healthcare” in the International Journal of Environmental Research and Public Health, a peer-reviewed scientific journal, indexed in the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) with an impact factor of 2.849 (IF 2019), that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph

According to the World Health Organization, primary healthcare (PHC) can meet 90% of a person’s health needs throughout their lifetime. In recent decades, PHC has been neglected in many countries in favor of a disease-specific approach. However, all research that has been carried out in primary healthcare has shown that healthcare systems with a PHC structure result in improved patient clinical outcomes, increased healthcare efficiency, better quality of care, reduced healthcare inequities and enhanced patient satisfaction. In 2018, world leaders committed to advancing PHC. We know very well that this will only be possible thanks to innovation and research in PHC. For these various reasons, this Special Issue welcomes original research articles presenting quantitative and/or qualitative data that highlight core values of primary healthcare: health-promoting, disease-preventing, community-oriented, patient-centered and continuous healthcare. 

Dr. Belchin Kostov
Dr. Luis González-de Paz
Dr. Antoni Sisó-Almirall

Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • primary healthcare
  • comorbidity
  • eHealth
  • chronic diseases
  • home care
  • risk factors
  • family health
  • geriatrics
  • health promotion
  • disease prevention
  • long-term care

Published Papers (7 papers)

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Research

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Article
The Risk of Hospitalization in COVID-19 Patients Can Be Predicted by Lung Ultrasound in Primary Care
Int. J. Environ. Res. Public Health 2021, 18(11), 6083; https://doi.org/10.3390/ijerph18116083 - 04 Jun 2021
Viewed by 1034
Abstract
Background: The usefulness of Lung Ultrasound (LUS) for the diagnosis of interstitial syndrome caused by COVID-19 has been broadly described. The aim of this study was to evaluate if LUS may predict the complications (hospital admission) of COVID-19 pneumonia in primary care patients. [...] Read more.
Background: The usefulness of Lung Ultrasound (LUS) for the diagnosis of interstitial syndrome caused by COVID-19 has been broadly described. The aim of this study was to evaluate if LUS may predict the complications (hospital admission) of COVID-19 pneumonia in primary care patients. Methods: This observational study collects data from a cohort of 279 patients with clinical symptoms of COVID-19 pneumonia who attended the Balaguer Primary Health Care Area between 16 March 2020 and 30 September 2020. We collected the results of LUS scans reported by one general practitioner. We created a database and analysed the absolute and relative frequencies of LUS findings and their association with hospital admission. We found that different LUS patterns (diffuse, attenuated diffuse, and predominantly unilateral) were risk factors for hospital admission (p < 0.05). Additionally, an evolutionary pattern during the acute phase represented a risk factor (p = 0.0019). On the contrary, a normal ultrasound pattern was a protective factor (p = 0.0037). Finally, the presence of focal interstitial pattern was not associated with hospital admission (p = 0.4918). Conclusion: The lung ultrasound was useful to predict complications in COVID-19 pneumonia and to diagnose other lung diseases such as cancer, tuberculosis, pulmonary embolism, chronic interstitial pneumopathy, pleuropericarditis, pneumonia or heart failure. Full article
(This article belongs to the Special Issue Primary Healthcare)
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Article
Adjusting Client-Level Risks Impacts on Home Care Organization Ranking
Int. J. Environ. Res. Public Health 2021, 18(11), 5502; https://doi.org/10.3390/ijerph18115502 - 21 May 2021
Viewed by 529
Abstract
Quality indicators (QIs) based on the Resident Assessment Instrument-Home Care (RAI-HC) offer the opportunity to assess home care quality and compare home care organizations’ (HCOs) performance. For fair comparisons, providers’ QI rates must be risk-adjusted to control for different case-mix. The study’s objectives [...] Read more.
Quality indicators (QIs) based on the Resident Assessment Instrument-Home Care (RAI-HC) offer the opportunity to assess home care quality and compare home care organizations’ (HCOs) performance. For fair comparisons, providers’ QI rates must be risk-adjusted to control for different case-mix. The study’s objectives were to develop a risk adjustment model for worsening or onset of urinary incontinence (UI), measured with the RAI-HC QI bladder incontinence, using the database HomeCareData and to assess the impact of risk adjustment on quality rankings of HCOs. Risk factors of UI were identified in the scientific literature, and multivariable logistic regression was used to develop the risk adjustment model. The observed and risk-adjusted QI rates were calculated on organization level, uncertainty addressed by nonparametric bootstrapping. The differences between observed and risk-adjusted QI rates were graphically assessed with a Bland-Altman plot and the impact of risk adjustment examined by HCOs tertile ranking changes. 12,652 clients from 76 Swiss HCOs aged 18 years and older receiving home care between 1 January 2017, and 31 December 2018, were included. Eight risk factors were significantly associated with worsening or onset of UI: older age, female sex, obesity, impairment in cognition, impairment in hygiene, impairment in bathing, unsteady gait, and hospitalization. The adjustment model showed fair discrimination power and had a considerable effect on tertile ranking: 14 (20%) of 70 HCOs shifted to another tertile after risk adjustment. The study showed the importance of risk adjustment for fair comparisons of the quality of UI care between HCOs in Switzerland. Full article
(This article belongs to the Special Issue Primary Healthcare)
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Article
Missing Diagnoses during the COVID-19 Pandemic: A Year in Review
Int. J. Environ. Res. Public Health 2021, 18(10), 5335; https://doi.org/10.3390/ijerph18105335 - 17 May 2021
Viewed by 1141
Abstract
The COVID-19 pandemic has had major impacts on population health not only through COVID-positive cases, but also via the disruption of healthcare services, which in turn has impacted the diagnosis and treatment of all other diseases during this time. We study changes in [...] Read more.
The COVID-19 pandemic has had major impacts on population health not only through COVID-positive cases, but also via the disruption of healthcare services, which in turn has impacted the diagnosis and treatment of all other diseases during this time. We study changes in all new registered diagnoses in ICD-10 groups during 2020 with respect to a 2019 baseline. We compare new diagnoses in 2019 and 2020 based on administrative records of the public primary health system in Central Catalonia, Spain, which cover over 400,000 patients and 3 million patient visits. We study the ratio of new diagnoses between 2019 and 2020 and find an average decline of 31.1% in new diagnoses, with substantial drops in April (61.1%), May (55.6%), and November (52%). Neoplasms experience the largest decline (49.7%), with heterogeneity in the magnitudes of the declines across different types of cancer diagnoses. While we find evidence of temporal variation in new diagnoses, reductions in diagnoses early in the year are not recouped by the year end. The observed decline in new diagnoses across all diagnosis groups suggest a large number of untreated and undetected cases across conditions. Our findings provide a year-end summary of the impact of the pandemic on healthcare activities and can help guide health authorities to design evidence-based plans to target under-diagnosed conditions in 2021. Full article
(This article belongs to the Special Issue Primary Healthcare)
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Article
Self-Perception and Self-Acceptance Are Related to Unhealthy Weight Control Behaviors in Catalan Adolescents: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(9), 4976; https://doi.org/10.3390/ijerph18094976 - 07 May 2021
Viewed by 787
Abstract
Adolescence is associated with a higher vulnerability that may result in a high dissatisfaction, the practice of unhealthy weight-control behaviors (UWCB) and, eventually, the onset of body image-related mental disorders. These factors are strongly associated with the social context, so it is important [...] Read more.
Adolescence is associated with a higher vulnerability that may result in a high dissatisfaction, the practice of unhealthy weight-control behaviors (UWCB) and, eventually, the onset of body image-related mental disorders. These factors are strongly associated with the social context, so it is important to characterize them in local or regional studies. To assess the relationship between body image and UWCB presence, a cross-sectional study was performed among 2496 schooled adolescents from Lleida (Spain) between 2017 and 2019. Their perceived and desired images were evaluated and compared with the real image in order to obtain the body distortion and the body dissatisfaction and relate them with UWCB. The studied individuals perceived themselves thinner than they actually were, with no differences between males and females. However, differences were found regarding body dissatisfaction, showing that females desired to be thinner, while males desired a more corpulent body image. Furthermore, one out of ten individuals reported UWCB, with higher prevalence among females. UWCB was associated with a desire to be thinner and with distorted body images. It is essential to work on self-perception and self-acceptance in early adolescence from an interdisciplinary perspective at educational, social and health levels to promote health in adolescence. Full article
(This article belongs to the Special Issue Primary Healthcare)
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Article
Effectiveness of an Intervention Aimed at Improving Information for Patients with High Cardiovascular Risk: INFORISK Clinical Trial
Int. J. Environ. Res. Public Health 2021, 18(7), 3621; https://doi.org/10.3390/ijerph18073621 - 31 Mar 2021
Viewed by 653
Abstract
Background: The concept of global cardiovascular risk is not usually well understood by patients in consultation. Methods: This was a multicenter, prospective, randomized, open clinical trial of one-year duration to evaluate the effectiveness in reducing global cardiovascular risk with an intervention aimed at [...] Read more.
Background: The concept of global cardiovascular risk is not usually well understood by patients in consultation. Methods: This was a multicenter, prospective, randomized, open clinical trial of one-year duration to evaluate the effectiveness in reducing global cardiovascular risk with an intervention aimed at high-risk patients to improve information on the cardiovascular risk compared to the usual care. The intervention was focused on providing information about cardiovascular risk in a more understandable way, explaining the best practices to reduce cardiovascular risk, and tailoring information to the individual. Results: Four-hundred and sixty-four subjects participated in the study; 59.3% were men, and the mean age was 61.0 (SD 8.0) years. Significant reductions in systolic blood pressure (SBP) (−3.12 mmHg), body mass index (BMI) (−0.34 kg/m2), abdominal circumference (−1.24 cm), and REGICOR cardiovascular risk (−0.63) were observed in the intervention group. Overall, no differences in cardiovascular risk score were observed between groups at the end of follow-up. Conclusions: Providing an easy-to-understand assessment of the cardiovascular risk motivated high-risk patients to adopt a healthier lifestyle and improved cardiovascular risk after one year in the intervention group. Clinicians should assess a patient’s baseline understanding of their CV risk using tools other than absolute risk before making treatment recommendations. Full article
(This article belongs to the Special Issue Primary Healthcare)
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Article
The Association between Home Healthcare and Burdensome Transitions at the End-of-Life in People with Dementia: A 12-Year Nationwide Population-Based Cohort Study
Int. J. Environ. Res. Public Health 2020, 17(24), 9255; https://doi.org/10.3390/ijerph17249255 - 10 Dec 2020
Cited by 3 | Viewed by 861
Abstract
Background: For people with dementia, burdensome transitions may indicate poorer-quality end-of-life care. Little is known regarding the association between home healthcare (HHC) and these burdensome transitions. We aimed to investigate the impact of HHC on transitions and hospital/intensive care unit (ICU) utilisation nearing [...] Read more.
Background: For people with dementia, burdensome transitions may indicate poorer-quality end-of-life care. Little is known regarding the association between home healthcare (HHC) and these burdensome transitions. We aimed to investigate the impact of HHC on transitions and hospital/intensive care unit (ICU) utilisation nearing the end-of-life for people with dementia at a national level. Methods: A nested case-control analysis was applied in a retrospective cohort study using a nationwide electronic records database. We included people with new dementia diagnoses who died during 2002–2013 in whole population data from the universal healthcare system in Taiwan. Burdensome transitions were defined as multiple hospitalisations in the last 90 days (early transitions, ET) or any hospitalisation or emergency room visit in the last three days of life (late transitions, LT). People with (cases) and without (controls) burdensome transitions were matched on a ratio of 1:2. We performed conditional logistic regression with stratified analyses to estimate the adjusted odds ratio (OR) and 95% confidence interval (CI) of the risks of transitions. Results: Among 150,125 people with new dementia diagnoses, 61,399 died during follow-up, and 31.1% had burdensome transitions (50% were early and 50% late). People with ET had the highest frequency of admissions and longer stays in hospital/ICU during their last year of life, while people with LT had fewer hospital/ICU utilisation than people without end-of-life transitions. Receiving HHC was associated with an increased risk of ET (OR = 1.14, 95 % CI: 1.08–1.21) but a decreased risk of LT (OR = 0.89, 95 % CI 0.83–0.94). In the people receiving HHC, however, those who received longer duration (e.g., OR = 0.50, 95 % CI: 0.42–0.60, >365 versus ≤30 days) or more frequent HHC or HHC delivered closer to the time of death were associated with a remarkably lower risk of ET. Conclusions: HHC has differential effects on early and late transitions. Characteristics of HHC such as better continuity or interdisciplinary coordination may reduce the risk of transitions at the end-of-life. We need further studies to understand the longitudinal effects of HHC and its synergy with palliative care, as well as the key components of HHC that achieve better end-of-life outcomes. Full article
(This article belongs to the Special Issue Primary Healthcare)
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Review

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Review
Long Covid-19: Proposed Primary Care Clinical Guidelines for Diagnosis and Disease Management
Int. J. Environ. Res. Public Health 2021, 18(8), 4350; https://doi.org/10.3390/ijerph18084350 - 20 Apr 2021
Cited by 2 | Viewed by 4088
Abstract
Long COVID-19 may be defined as patients who, four weeks after the diagnosis of SARS-Cov-2 infection, continue to have signs and symptoms not explainable by other causes. The estimated frequency is around 10% and signs and symptoms may last for months. The main [...] Read more.
Long COVID-19 may be defined as patients who, four weeks after the diagnosis of SARS-Cov-2 infection, continue to have signs and symptoms not explainable by other causes. The estimated frequency is around 10% and signs and symptoms may last for months. The main long-term manifestations observed in other coronaviruses (Severe Acute Respiratory Syndrome (SARS), Middle East respiratory syndrome (MERS)) are very similar to and have clear clinical parallels with SARS-CoV-2: mainly respiratory, musculoskeletal, and neuropsychiatric. The growing number of patients worldwide will have an impact on health systems. Therefore, the main objective of these clinical practice guidelines is to identify patients with signs and symptoms of long COVID-19 in primary care through a protocolized diagnostic process that studies possible etiologies and establishes an accurate differential diagnosis. The guidelines have been developed pragmatically by compiling the few studies published so far on long COVID-19, editorials and expert opinions, press releases, and the authors’ clinical experience. Patients with long COVID-19 should be managed using structured primary care visits based on the time from diagnosis of SARS-CoV-2 infection. Based on the current limited evidence, disease management of long COVID-19 signs and symptoms will require a holistic, longitudinal follow up in primary care, multidisciplinary rehabilitation services, and the empowerment of affected patient groups. Full article
(This article belongs to the Special Issue Primary Healthcare)
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