Acessibility Enhancing Urban Primary Care Service Systems: Systematic Review and Narrative Synthesis
Keywords:
urban areas, primary care service system, accessibilityAbstract
Accessibility to primary care services in urban areas remained an important public health problem in Thailand. Main factor contributing to this problem was fast growing urbanization, resulting in inadequate infrastructure and public services. This study aimed to systematically review research studies and projects relating to provision of primary care services in urban areas which successfully increased people’s accessibility; to analyze promoting methods used in these studies and projects; and to make recommendations on improving urban primary care service systems in Thailand. Nine officially evaluated research articles and projects in both developed and developing countries, published during 2005 – 2018 were included in the study. Systematic review and narrative analysis were used for data analysis. The results revealed five classified diverse methods used to increase the accessibility and utilization of primary care services in the urban areas; these were facilitating the accessibility, motivating the utilization, promoting methods, reducing needs for treatment, and quality control and cost containment. The most important element that was an integral part of all methods was the participation of all sectors: public, private, NGOs, community, and family, and at all levels. It was found that the methods used in these studies depended on social, cultural and political contexts and the levels of economic and education advancement of each area.
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