Examining Elements of Health Systems

1. Provide a definition of the terms ‘primary health care’ and ‘primary care.’ What is the difference between these terms?

Gillies (2003) defines primary health care, PHC, as a comprehensive community-based approach of addressing health-related issues in its broadest sense as it ranges over curative, preventive, promotive (health education) and rehabilitative services (Atun, 2004). It also comprises activities such as effective sewage disposal and sufficient supply of consumable food and water (Gillies, 2003) which are believed to ultimately enhance the overall health status.

On the other hand, health care, as a component of PHC, relates to the ‘clinical’ individually-based services provided by caregivers, general practitioners or practitioner nurses in particular (Starfield, 2004). The main priorities of the primary care sector are to serve as approachable care providers and to ensure that visitors receive continuous, comprehensive and integrated care (Bodenheimer & Grumbach, 2009) via diagnostic, pharmaceutical and therapeutic services (French, Old, & Healy, 2001).

Therefore, the distinction to be drawn between the terms is the broadness of the services covered and the consequent difference in goals and people involved in each category in terms of workforce and size of target population.

2.Which elements of disease prevention are handled by primary care practitioners? Which are not?

The “prevention is better than cure” concept is highly valued in primary care by which strategies of health promotion and disease control are implemented. Primary care practitioners, within their range of services, are responsible for various disease prevention initiatives such as promoting a healthy lifestyle and exercise programmes for care-recipients, particularly for those with chronic diseases such as diabetes and asthma. It also includes health education to increase health awareness within a community in addition to family planning services which help people with reproductive and sexual health.

There are, however, more preventive roles that lie within primary health care domain which are implemented on a larger scale such as ensuring effective sanitation and waste disposal, disease control, safety and quality of food (French, Old, & Healy, 2001).

Complementary and collaborative roles are often required for disease prevention. Activities such as immunizations and antismoking efforts could be performed on a small scale within primary care or on a larger scale in the form of national campaign, performed by primary health care.

3. What is ‘gatekeeping.’ Examine the consequences of gatekeeping for patients and for the overall health system.

A key role of primary care is to function as a ‘gatekeeper’ to the health system which significantly impacts on health outcomes.