Detection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine

Abstract Background There is a need for evidence that residency training in family medicine can benefit the care of patients in primary care in low- and middle-income countries. We tested the hypothesis that two years of residency training in family medicine enables doctors to better detect chronic...

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Autores principales:	Adelson Guaraci Jantsch, Bo Burström, Gunnar Nilsson, Antônio Ponce de Leon
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Primary Health Care Family Practice Health Workforce Developing Countries Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/129194df9ca04a68a749f39b3842c117
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spelling	oai:doaj.org-article:129194df9ca04a68a749f39b3842c1172021-11-14T12:32:31ZDetection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine10.1186/s12875-021-01542-51471-2296https://doaj.org/article/129194df9ca04a68a749f39b3842c1172021-11-01T00:00:00Zhttps://doi.org/10.1186/s12875-021-01542-5https://doaj.org/toc/1471-2296Abstract Background There is a need for evidence that residency training in family medicine can benefit the care of patients in primary care in low- and middle-income countries. We tested the hypothesis that two years of residency training in family medicine enables doctors to better detect chronic health conditions while requesting fewer laboratory tests and providing more follow-up visits. Methods We performed a retrospective longitudinal observational analysis of medical consultations from 2013 to 2018 in primary care in Rio de Janeiro, comparing doctors without residency training in family medicine (Generalists) versus family physicians (FPs). Multivariate multilevel binomial regression models estimated the risks of patients being diagnosed for a list of 31 chronic health conditions, having a follow-up visit for these conditions, and having laboratory tests ordered from a list of 30 exams. Results 569.289 patients had 2.908.864 medical consultations performed by 734 generalists and 231 FPs. Patients seen by FPs were at a higher risk of being detected for most of the chronic health conditions, at a lower risk of having any of the 30 laboratory tests requested, and at a higher risk of having a follow-up visit in primary care. Conclusions Residency training in family medicine can make physicians more skilled to work in primary care. Policymakers must prioritize investments in capacity building of healthcare workforce to make primary care truly comprehensive.Adelson Guaraci JantschBo BurströmGunnar NilssonAntônio Ponce de LeonBMCarticlePrimary Health CareFamily PracticeHealth WorkforceDeveloping CountriesMedicine (General)R5-920ENBMC Family Practice, Vol 22, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Primary Health Care Family Practice Health Workforce Developing Countries Medicine (General) R5-920
spellingShingle	Primary Health Care Family Practice Health Workforce Developing Countries Medicine (General) R5-920 Adelson Guaraci Jantsch Bo Burström Gunnar Nilsson Antônio Ponce de Leon Detection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine
description	Abstract Background There is a need for evidence that residency training in family medicine can benefit the care of patients in primary care in low- and middle-income countries. We tested the hypothesis that two years of residency training in family medicine enables doctors to better detect chronic health conditions while requesting fewer laboratory tests and providing more follow-up visits. Methods We performed a retrospective longitudinal observational analysis of medical consultations from 2013 to 2018 in primary care in Rio de Janeiro, comparing doctors without residency training in family medicine (Generalists) versus family physicians (FPs). Multivariate multilevel binomial regression models estimated the risks of patients being diagnosed for a list of 31 chronic health conditions, having a follow-up visit for these conditions, and having laboratory tests ordered from a list of 30 exams. Results 569.289 patients had 2.908.864 medical consultations performed by 734 generalists and 231 FPs. Patients seen by FPs were at a higher risk of being detected for most of the chronic health conditions, at a lower risk of having any of the 30 laboratory tests requested, and at a higher risk of having a follow-up visit in primary care. Conclusions Residency training in family medicine can make physicians more skilled to work in primary care. Policymakers must prioritize investments in capacity building of healthcare workforce to make primary care truly comprehensive.
format	article
author	Adelson Guaraci Jantsch Bo Burström Gunnar Nilsson Antônio Ponce de Leon
author_facet	Adelson Guaraci Jantsch Bo Burström Gunnar Nilsson Antônio Ponce de Leon
author_sort	Adelson Guaraci Jantsch
title	Detection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine
title_short	Detection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine
title_full	Detection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine
title_fullStr	Detection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine
title_full_unstemmed	Detection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine
title_sort	detection and follow-up of chronic health conditions in rio de janeiro – the impact of residency training in family medicine
publisher	BMC
publishDate	2021
url	https://doaj.org/article/129194df9ca04a68a749f39b3842c117
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Detection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine

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