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unding Primary Health Care in the Baltic Sea Area - Joint Transnational Synthesis Report for ImPrim countries

There are substantial health differences between the countries of the Baltic Sea region. While the gap between Scandinavian and Baltic countries among basic health status indicators is slowly closing in, some crucial differences remain. These are notably the health status in Russia, which has not significantly improved like the economy after the socio-economic stress in the early 90´s, but also the differences between men and women, which still prevails also in the Baltic countries.

This report concludes that the last two decades of efforts in reforms of our health systems, on both sides of the Baltic Sea, to increase efficiency and promote preventive services, have not generally created equity problems. With specific exceptions, all residents of the Baltic Sea region countries are still generally enjoying publically funded services. However, we still lack some evidence about how the last years´ reforms have affected equity in access and utility of PHC specifically. The report also concludes that the differences in financial resources between countries in our region do not necessarily mean anything for the differences in providing services. Countries with more limited resources, or countries prioritising health less than other, still seem to have good accessibility to services. Instead reforms to strengthen PHC are about needed prioritisation of PHC, and development of the content and increase of the scope of services in PHC.

Nurses´workload, Klaipeda Region, Lithuania

- A tool developed for quality improvement from a bottom-up perspective

ImPrim EU-BSR flagship project focus on primary health care development and especially on the role of nurses in basic health care. In Work Package 4 one of the deliverables are to develop tools for quality improvement from a bottom-up perspective. To have such a tool web-based has been tried several times in primary health care in Scandinavia, but has not been considered realistic. Not least due to the demand for confidentiality from the individual participants.

Nurses taking part in the ImPrim courses in Turku University, Finland and Blekinge, Sweden have all carried out pilot audit project in the field "Nurses' work load" to describe their work up to structure, process and results. Two groups of nurses in Klaipeda region continued in a full size audit registering in family doctors clinics — group A and in policlinics - Group B. In group A 15 nurses registered 2733 and in group B 20 nurses registered 4396 consultations. In all 7129 consultations were registered during one week in march 2011.

Diabetes care — an APO-audit by family nurses in Kaliningrad region

A subproject associated to the EUBSR-NDPHS flagship project ImPrim

This report is part of the APO-audit process for Primary Health Care (PHC)qualitydevelopment. The first step is an initial professional discussion and decision-making on topic to choose and variables to measure in clinical practice. The registration takes place during a specific time parallel by a number of colleagues. After that the data are processed and analyzed. A report on the group results is produced for the participants.

The report will be the basis for an internal discussion as well as a follow-up for the whole group where even resource persons like subspecialists are invited. Each participant will also get their personal results, which are strict confidential. Supported by the Minister of Health and due to an earlier decision among family nurses and family doctors in Kaliningrad region the topic “Diabetes care in PHC in Kaliningrad region" was chosen. Both family doctors and family nurses carried out specific audit registrations on this topic during spring 2011.

Diabetes care — an APO-audit by family doctors in Kaliningrad region

A subproject associated to the EUBSR-NDPHS flagship project ImPrim

The first step is an initial professional discussion and decision-making on topic to choose and variables to measure in clinical practice. The registration takes place during a specific time parallel by a number of colleagues. After that the data are processed and analyzed. A report on the group results is produced for the participants.
The report will be the basis for an internal discussion as well as a follow-up for the whole group where even resource persons like subspecialists are invited. Each participant will also get her/his personal results, which are strict confidential. Supported by the Minister of Health and due to an earlier decision among family doctors in Kaliningrad region the topic “Diabetes care in PHC in Kaliningrad region" was chosen. Both family doctors and family nurses carried out specific audit registrations on this topic during spring 2011.

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