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Open Access Research article

Performance evaluation of the essential dimensions of the primary health care services in six localities of Bogota–Colombia: a cross-sectional study

Paola A Mosquera12*, Jinneth Hernández2, Román Vega2, Jorge Martínez2 and Miguel San Sebastián1

Author Affiliations

1 Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, 901 87 Umeå, Sweden

2 Postgraduate programs in Health Administration and Public Health, Pontificia Universidad Javeriana, Cr. 40 6-23 P.8 Bogota, Colombia

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BMC Health Services Research 2013, 13:315  doi:10.1186/1472-6963-13-315

Published: 15 August 2013

Abstract

Background

The high segmentation and fragmentation in the provision of services are some of the main problems of the Colombian health system. In 2004 the district government of Bogota decided to implement a Primary Health Care (PHC) strategy through the Home Health program. PHC was conceived as a model for transforming health care delivery within the network of the first-level public health care facilities. This study aims to evaluate the performance of the essential dimensions of the PHC strategy in six localities geographically distributed throughout Bogotá city.

Methods

The rapid assessment tool to measure PHC performance, validated in Brazil, was applied. The perception of participants (users, professionals, health managers) in public health facilities where the Home Health program was implemented was compared with the perception of participants in private health facilities not implementing the program. A global performance index and specific indices for each primary care dimension were calculated. A multivariate logistic regression analysis was conducted to determine possible associations between the performance of the PHC dimensions and the self-perceived health status of users.

Results

The global performance index was rated as good for all participants interviewed. In general, with the exception of professionals, the differences in most of the essential dimensions seemed to favor public health care facilities where the Home Health program was implemented. The weakest dimensions were the family focus and community orientation—rated as critical by users; the distribution of financial resources—rated as critical by health managers; and, accessibility—rated as intermediate by users.

Conclusions

The overall findings suggest that the Home Health program could be improving the performance of the network of the first-level public health care facilities in some PHC essential dimensions, but significant efforts to achieve its objectives and raise its visibility in the community are required.

Keywords:
Primary health care; Health services evaluation; Bogota