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PATIENT
CENTERED
Dr Hezlin binti Md Zin
M.D USM, Master Fam.Med IIUM
Pakar Perubatan Keluarga UD54
Klinik Kesihatan Rengit
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Principles of care in Primary Health
4C, 4P concepts
“Successful achievement of the four core functions of PC (the
“4Cs”) is linked to improved population health, more
appropriate use of healthcare resources and reduced costs
and more generally to better-functioning health systems”
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The 4Cs of PC are defined as
(Prates et al., 2017):
● First contact – access and use of
health services whenever
necessary;
● Comprehensiveness – promotion,
prevention, treatment and
rehabilitation appropriate to the
PC context;
● Coordination – the integration of all
the care the user receives and
needs with the other health
services;
● Continuity – a professional-
subject-of-care temporal
relationship, leading to the
establishment of strong mutual trust.
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Primary care core functions (4Cs) and suggested operational element
Geronimo Jimenezet al.,2021
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T. Mark Doherty et
al.,2019
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Definition
In recent years, the doctor-patient relationship has evolved
beyond the paternalistic ‘doctor knows best’ model, toward
one where the patients wish to be more actively engaged and
expect a degree of input in their care.
Patient-centered care in healthcare is defined as care provision
that is consistent with the values, needs, and desires of
patients and is achieved when clinicians involve patients in
healthcare discussions and decisions
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Pillars of patient centred care –Picker’s principle
Barrett, M., Boyne, J., Brandts, J. et al.2019
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GETTING TO PATIENT-CENTERED PRACTICE:
WHAT IS NEEDED?
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A patient-centered primary
care practice would have most of the following characteristics :
Superb access to care
Patient engagement in care
Clinical information systems
Care coordination
Integrated, comprehensive care and smooth
information transfer
Ongoing, routine patient feedback to a practice
Publicly available information on practices
A 2020 Vision of Patient-Centered Primary Care
Karen Davis, PhD,1 Stephen C. Schoenbaum, MD,1 Anne-Marie Audet, MD1
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Important elements of patient needs
Barrett, M., Boyne, J., Brandts, J. et al.2019
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Brain storming to a better care
CONTACT COMPREHENSIVENESS
En Ali, 68 years old ,
Retired army.Had traumatic
R eye blindness,with
underlying T2DM, HbA1
10%,stayed alone. Son
stayed nearby. Poor
financial support
COORDINATION
CONTINUITY
Chronic cough x 2 months
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PERSONALIZED PARTICIPATORY
En Ali was
diagnosed with
PTB smear
positive, anti TB
treatment was
started
PREVENTIVE PREDICTIVE
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CONCLUSIONS
Increased patient engagement in their own care has many
potential benefits:
1. Improvement of patient adherence
2. Improvement of patient satisfaction
3. Reduction of direct patient costs (e.g. travel, parking)
4. Reduction of indirect costs (e.g. productivity days missed
for patients and carers)
5. Improvement of patient outcomes and reduction of
healthcare costs.
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Pop Quiz
What are the principles of primary care?
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Thank you!
Do you have any questions?
