The Contribution of Hospitals to the Improvement of Primary Healthcare

Nasser Fardousi^*
*Correspondence: Nasser Fardousi, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK, Email:

Keywords

Primary healthcare • Medical technology • Healthcare system

Introduction

Referral services

Hospitals are often the referral points for primary healthcare services. Primary healthcare providers refer patients to hospitals when they require specialized medical care or advanced diagnostic and treatment procedures. Hospitals, in turn, refer patients back to primary healthcare providers when they no longer require specialized care or when they need on-going care and follow-up. This referral system ensures that patients receive the appropriate level of care at the right time and in the right place. It also helps to prevent unnecessary hospital admissions and reduces the burden on hospitals, which can focus on providing specialized care to patients who need it most [1].

Training and education

Hospitals play a critical role in the training and education of primary healthcare providers. Many hospitals have affiliations with medical schools and nursing programs, providing opportunities for students to gain hands-on experience in a hospital setting. Through these partnerships, hospitals can help to ensure that primary healthcare providers receive the necessary training and education to deliver high-quality healthcare services. They can also provide on-going training and continuing education to help primary healthcare providers keep up-to-date with the latest advances in medical technology and treatment [2].

Literature Review

Coordination of care

Hospitals can also play a key role in coordinating care for patients with complex healthcare needs. Many patients require on-going care from multiple healthcare providers, including primary healthcare providers, specialists, and hospitals. Hospitals can help to coordinate care between these providers, ensuring that patients receive seamless, integrated care that is tailored to their specific needs. This can help to prevent gaps in care, reduce the risk of medical errors, and improve patient outcomes [3].

Community outreach

Hospitals can also play an important role in community outreach and health promotion. They can partner with community organizations, schools, and other stakeholders to promote healthy lifestyles, prevent disease, and improve access to healthcare services. Hospitals can provide health education programs, free health screenings, and other community-based services to help people stay healthy and prevent disease. They can also work to identify and address health disparities and other social determinants of health that affect the health of their communities [4].

Data collection and analysis

Hospitals can also contribute to the improvement of primary healthcare services by collecting and analysing data on patient outcomes, healthcare utilization, and other key performance indicators. By tracking these metrics, hospitals can identify areas of improvement and develop strategies to address them. For example, hospitals can analyse data on hospital readmissions to identify the underlying causes and develop strategies to reduce them. They can also use data on patient outcomes to evaluate the effectiveness of different treatment approaches and make evidence-based decisions about patient care [5].

Technology and innovation

Hospitals are often at the forefront of medical technology and innovation. They invest in the latest medical equipment and technology to provide patients with the most advanced diagnostic and treatment options available. These advances in technology can also benefit primary healthcare providers and their patients. For example, hospitals can provide primary healthcare providers with access to electronic health records (EHRs) that allow them to easily share patient information and coordinate care. They can also provide telehealth services that allow patients to receive healthcare services remotely, reducing the need for in-person visits and improving access to care [6].

The World Health Organization (WHO) warned more than ten years ago that an overreliance on specialised, hospital-centric curative care and commercialization were harming fairness, quality, and effectiveness in healthcare by fragmenting service delivery. It came to the conclusion that health systems won't inevitably lean towards the objectives of universal health care if left to their own devices (UHC). The WHO report also emphasised the need for policymakers to alter their approach in order to increase access to primary health care (PHC) that is of high quality and meets peoples' needs, integrate public-health interventions with frontline primary care services, and address the complexity of the health systems through effective government leadership.

Discussion

Despite significant efforts to improve the availability of primary care in settings with adequate resources (such as family medicine or general practice),2,3, policymakers have been all too happy to accept a modest array of primary-care services that concentrate on priority illnesses in low- and middle-income settings. Spending on hospital-based services can reach up to 40% in high-income countries due to new medical technologies' increased dependence on specialised knowledge, rising costs, and focus on hospitals (HICs). 4 A more comprehensive strategy that incorporates family health, community health, illness prevention and early detection, qualified staff, and necessary funding is required in contrast to this constrained form of PHC, which is frequently characterised by stand-alone institutions.

What function may be identified for hospitals as well as primary care practitioners to promote PHC? There is an increasing push to reconsider hospitals' contributions to enhancing PHC and achieving UHC, including the operationalization of novel ideas in various health system settings. 5 With reference to both the literature and country case studies, we address the role of hospitals in enhancing PHC in this study, which is informed by these changes. We refer to a frontline service delivery function inside the larger health system as "primary care," as opposed to the more inclusive idea of "primary health care," which has a history dating back to Alma Ata. Unleashing hospitals' potential to improve PHC could result in gains through better care delivery both prior to and following hospitalisation to reduce needless readmissions and enhance health outcomes. Innovative strategies show the various roles hospitals can play in bolstering PHC in both HICs and LMICs; this research attempts to explore these roles.

Together with a University of Melbourne expert librarian, a search strategy was created to find pertinent literature. A significant obstacle was the absence of common nomenclature and conceptual clarity on the subject. A lack of relevant literature on the subject was revealed by searches of the electronic database Embase using terms to link hospitals and primary care/primary health care, such as integration, network, continuity, continuum, strengthening, support, involvement, management, and governance. Research on the hospital’s participation in primary care was typically limited to programme reviews of integrated care model implementations. Given the dearth of studies examining additional potential roles, our approach revealed a sizable vacuum in the literature.

Conclusion

By combining the aforementioned search terms, we also used Google to research the grey literature. With two notable exceptions from WHO5 and the King's Fund in the UK7 that expressly focused on the junction between the role of hospitals in bolstering PHC and the notions of integrated care and population health, this search also revealed the dearth of literature devoted to this subject. Additional research into the literature on health systems indicates that, depending on the environment, hospitals also contribute to integration and population health through enhancing supply and demand for primary care. These four themes, which were found in the literature, served as organising ideas for the many functions that hospitals perform to support PHC.

Acknowledgement

None.

Conflict of Interest

None.

References

1. Lehman, Wayne EK. "Evaluation of WaySafe: a disease-risk reduction curriculum for substance-abusing offenders." J Subst Abuse Treat 58 (2015): 25-32.

Google Scholar, Crossref, Indexed at

2. Peele, Stanton. "Can alcoholism and other drug addiction problems be treated away or is the current treatment binge doing more harm than good?." J Psych Drugs 20 (1988): 375-383.

Google Scholar, Crossref, Indexed at

3. Ross, Joanne, Maree Teesson, Shane Darke and Michael Lynskey, et al. "The characteristics of heroin users entering treatment: findings from the Australian treatment outcome study (ATOS)." Drug Alcohol Rev 24 (2005): 411-418.

Google Scholar, Crossref, Indexed at

4. Ryan, Richard M., Robert W. Plant and Stephanie O'Malley. "Initial motivations for alcohol treatment: Relations with patient characteristics, treatment involvement, and dropout." Addictive Behav 20 (1995): 279-297.

Google Scholar, Crossref, Indexed at

5. Simpson, D. Dwayne. "A conceptual framework for drug treatment process and outcomes." J Subst Abuse Treat 27 (2004): 99-121.

Google Scholar, Crossref, Indexed at

6. Simpson, D. Dwayne and George W. Joe. "A longitudinal evaluation of treatment engagement and recovery stages." J Subst Abuse Treat 27 (2004): 89-97.

Google Scholar, Crossref, Indexed at