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Primary care

Primary care

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Primary care is the term for the health services
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

 by provider
Health care provider
A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....

s who act as the principal point of consultation for patients within a health care system
Health care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....

. Such a professional can be a primary care physician
Primary care physician
A primary care physician, or PCP, is a physician/medical doctor who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis....

, such as a general practitioner
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...

 or family physician
Family medicine
Family medicine is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body...

, or depending on the locality, health system organization, and patient's discretion, they may see a pharmacist
Pharmacist
Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...

, a physician assistant
Physician assistant
A physician assistant/associate ' is a healthcare professional trained and licensed to practice medicine with limited supervision by a physician.-General description:...

, a nurse practitioner
Nurse practitioner
A Nurse Practitioner is an Advanced practice registered nurse who has completed graduate-level education . Additional APRN roles include the Certified Registered Nurse Anesthetist s, CNMs, and CNSs...

, a nurse (such as in the United Kingdom), a clinical officer
Clinical officer
Clinical officers are health care providers who practice modern medicine. They practice independently but may be supervised by a physician in some settings....

 (such as in parts of Africa), or an Ayurvedic
Ayurveda
Ayurveda or ayurvedic medicine is a system of traditional medicine native to India and a form of alternative medicine. In Sanskrit, words , meaning "longevity", and , meaning "knowledge" or "science". The earliest literature on Indian medical practice appeared during the Vedic period in India,...

 or other traditional medicine professional (such as in parts of Asia). Depending on the nature of the health condition, patients may then be referred
Referral (medicine)
In medicine, referral is the transfer of care for a patient from one clinician to another.Tertiary care is usually done by referral from primary or secondary medical care personnel....

 for secondary or tertiary care.

Background


The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 attributes the provision of essential primary care as an integral component of an inclusive primary health care
Primary health care
Primary health care, often abbreviated as “PHC”, has been defined as "essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost...

 strategy. Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...

, and patients with all manner of acute and chronic physical, mental
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...

 and social health issues, including multiple chronic diseases
Polypharmacy
Polypharmacy is the use of multiple medications by a patient, especially when too many forms of medication are used by a patient, when more drugs are prescribed than is clinically warranted, or even when all prescribed medications are clinically indicated but there are too many pills to take ....

. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care
Preventive medicine
Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms...

, health education
Health education
Health education is the profession of educating people about health. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health...

, and every time they require an initial consultation about a new health problem. Collaboration among providers is a desirable characteristic of primary care.

The International Classification of Primary Care
International Classification of Primary Care
The International Classification of Primary Care is a classification method for primary care encounters. It allows for the classification of the patient’s reason for encounter , the problems/diagnosis managed, primary or general health care interventions, and the ordering of the data of the...

 (ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care by the reason for the patient visit. Common chronic illnesses usually treated in primary care may include, for example: hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...

, angina
Angina
Angina pectoris, commonly known as angina, is chest pain due to ischemia of the heart muscle, generally due to obstruction or spasm of the coronary arteries . Coronary artery disease, the main cause of angina, is due to atherosclerosis of the cardiac arteries...

, diabetes
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...

, asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...

, COPD
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...

, depression and anxiety
Anxiety disorder
Anxiety disorder is a blanket term covering several different forms of abnormal and pathological fear and anxiety. Conditions now considered anxiety disorders only came under the aegis of psychiatry at the end of the 19th century. Gelder, Mayou & Geddes explains that anxiety disorders are...

, back pain
Back pain
Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.The pain can often be divided into neck pain, upper back pain, lower back pain or tailbone pain...

, arthritis
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...

 or thyroid dysfunction
Thyroid disease
-Hyper- and hypofunction:Imbalance in production of thyroid hormones arises from dysfunction of the thyroid gland itself, the pituitary gland, which produces thyroid-stimulating hormone , or the hypothalamus, which regulates the pituitary gland via thyrotropin-releasing hormone . Concentrations of...

. Primary care also includes many basic maternal
Maternal health
Maternal health refers to the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.Preconception care can include...

 and child health care services, such as family planning
Family planning
Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and...

 services and vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

s.

In context of global population ageing
Population ageing
Population ageing or population aging occurs when the median age of a country or region rises. This happens because of rising life expectancy or declining birth rates. Excepting 18 countries termed 'demographic outliers' by the UN) this process is taking place in every country and region across...

, with increasing numbers of older adults at greater risk of chonic non-communicable disease
Non-communicable disease
A non-communicable disease, or NCD, is a medical condition or disease which is non-infectious. NCDs are diseases of long duration and generally slow progression. They include heart disease, stroke, cancer, asthma, diabetes, chronic kidney disease, osteoporosis, Alzheimer's disease, cataracts, and...

s, rapidly increasing demand for primary care services is expected around the world, in both developed and developing countries.

Canada



In Canada, access to primary and other health care services are guaranteed for all citizens through the Canada Health Act
Canada Health Act
The Canada Health Act is a piece of Canadian federal legislation, adopted in 1984, which specifies the conditions and criteria with which the provincial and territorial health insurance programs must conform in order to receive federal transfer payments under the Canada Health Transfer...

.

Nigeria



In Nigeria, health care is a concurrent responsibility of three tiers of government. Local governments focus on the delivery of primary care (e.g. through a system of dispensaries), state governments manage the various general hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....

s (secondary care), while the federal government's role is mostly limited to coordinating the affairs of the Federal Medical Centres
Federal Medical Centres
In Nigeria, primary health care is to be provided by Local Governments, secondary health care by State Governments and tertiary health care by the Federal Government. In operationalizing this policy, the Federal Government decided to establish at least one tertiary health institution in each State...

 and university teaching hospitals (tertiary care).

United States


A 2009 report by the New England Healthcare Institute
New England Healthcare Institute
NEHI is an independent, nonprofit national network and research organization focused on enabling innovation to improve health care quality and lower health care costs. In partnership with members from all across the health care system, NEHI conducts evidence-based research and stimulates policy...

 determined that an increased demand on primary care by older, sicker patients and decreased supply of primary care practitioners has led to a crisis in primary care delivery. The research identified a set of innovations that could enhance the quality, efficiency and effectiveness of primary care in the United States.

See also


  • Health care
    Health care
    Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

    • Direct primary care
      Direct primary care
      In the USA Direct Primary Care is primary care offered direct to the consumer, without insurance intervention. It is an umbrella term which incorporates various health care delivery systems that involve direct financial relationships between patients and health care providers.One niche variant of...

       (United States)
    • Family medicine
      Family medicine
      Family medicine is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body...

       / Family practice
    • General practice
    • Health care provider
      Health care provider
      A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....

    • Nursing shortage
      Nursing shortage
      Nursing shortage refers to a situation where the demand for nursing professionals, such as Registered Nurses , exceeds the supply, either locally , nationally or globally...

    • Physician shortage
    • Primary health care
      Primary health care
      Primary health care, often abbreviated as “PHC”, has been defined as "essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost...

       (PHC)
    • Primary care physician
      Primary care physician
      A primary care physician, or PCP, is a physician/medical doctor who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis....

    • Primary Health Organisation
      Primary Health Organisation
      Primary Health Organisations , in New Zealand, are health care providers that are funded on a capitation basis by the New Zealand Government via District Health Boards...

       (New Zealand)
    • Referral (medicine)
      Referral (medicine)
      In medicine, referral is the transfer of care for a patient from one clinician to another.Tertiary care is usually done by referral from primary or secondary medical care personnel....

  • Medical classification
    Medical classification
    Medical classification, or medical coding, is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers...

    • Anatomical Therapeutic Chemical Classification System
      Anatomical Therapeutic Chemical Classification System
      The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. It is controlled by the WHO Collaborating Centre for Drug Statistics Methodology , and was first published in 1976....

       (ATC classification for drugs)
    • Classification of Pharmaco-Therapeutic Referrals
      Classification of Pharmaco-Therapeutic Referrals
      The Classification of Pharmaco-Therapeutic Referrals is a taxonomy focused to define and group together situations requiring a referral from pharmacists to physicians regarding the pharmacotherapy used by the patients. It has been published in 2008...

       (CPR)
    • International Classification of Diseases (ICD)
    • International Classification of Primary Care
      International Classification of Primary Care
      The International Classification of Primary Care is a classification method for primary care encounters. It allows for the classification of the patient’s reason for encounter , the problems/diagnosis managed, primary or general health care interventions, and the ordering of the data of the...

       (ICPC-2) / ICPC-2 PLUS
      ICPC-2 PLUS
      ICPC-2 PLUS is an extended terminology classified to ICPC-2 International Classification of Primary Care, which aids data entry, retrieval and analysis. ICPC-2 PLUS takes into account the frequency distribution of problems seen in primary health care...


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