Does bureaucracy in primary care dehumanize the provision of healthcare services?

La burocracia en la atención primaria: ¿deshumaniza la prestación de servicios en salud?

Primary healthcare plays a fundamental role in the proper functioning of health systems, as this level of care must guarantee equitable access to essential health services for the entire population.1 Therefore, at this level of care, essential health services must be provided in a comprehensive manner and health professionals must be able to meet most of the health needs and demands of the population.

El primer nivel de atención de los servicios de salud juega un papel fundamental para el adecuado funcionamiento del sistema de salud, ya que en dicho nivel se debe garantizar el acceso equitativo a servicios esenciales en salud para toda la población.¹ De esta forma, en este nivel de atención se deben brindar los cuidados esenciales en salud de manera integral y los profesionales de la salud deben ser capaces de resolver la mayoría de las necesidades y demandas en salud de la población.

Letter to the editor

Aldo Medina-Gamero1 Mónica Regalado-Chamorro2

1 Universidad Tecnológica del Perú - Faculty of Humanities - Lima - Peru.

² Universidad Científica del Sur Department of Humanities - Lima - Peru.

Open access

Received: 03/05/2022

Accepted: 30/06/2022

Corresponding author: Aldo Medina Gamero. Facultad de Humanidades, Universidad Tecnológica del Perú. Lima. Perú. Email: medrafa222@gmail.com.

Keywords: Primary Health Care; Health Services; Health Policy (MeSH).

Palabras clave: Atención primaria de salud; Servicios de salud; Política de salud (DeCS).

How to cite: Medina-Gamero A, Regalado-Chamorro M. Does bureaucracy in primary care dehumanize the provision of healthcare services? Rev. Fac. Med. 2023;71(3):e102482. English. doi: https://doi.org/10.15446/revfacmed.v71n3.102482.

Cómo citar: Medina-Gamero A, Regalado-Chamorro M. [La burocracia en la atención primaria: ¿deshumaniza la prestación de servicios en salud?]. Rev. Fac. Med. 2023;71(3):e102482. English. doi: https://doi.org/10.15446/revfacmed.v71n3.102482.

Copyright: Copyright: ©2023 Universidad Nacional de Colombia. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, as long as the original author and source are credited.

Dear editor:

Primary healthcare plays a fundamental role in the proper functioning of health systems, as this level of care must guarantee equitable access to essential health services for the entire population.1 Therefore, at this level of care, essential health services must be provided in a comprehensive manner and health professionals must be able to meet most of the health needs and demands of the population.1

At this level of care, at least in Latin America, health services are provided in health posts classified into different categories and organized structurally in networks. In addition, these health centers carry out health promotion activities and undertake actions aimed at achieving early diagnosis and timely treatment of the most common health problems.2 However, despite their importance, they lack infrastructure, human resources, budget, organization, and local management.2

One of the problems in the management of primary healthcare institutions in the region is the shortage of administrative workers, which is why their functions must be covered by healthcare professionals.3 It is also known that primary care physicians have to use part of the already scarce time available for consultations in activities outside their professional practice, such as writing prescriptions that should be ordered by other specialists and requesting complementary tests (laboratory, imaging, histological, etc.), among others.4

One of the measures that all health institutions agree on in order to achieve better management of primary healthcare is the debureaucratization of consultations with the aim of eliminating unnecessary tasks, as well as those that are performed inefficiently or by inappropriate delegation to other healthcare levels.5 In this context, bureaucracy refers to the processes or set of administrative tasks related to patient care in primary healthcare centers that, in some cases, result in deficiencies in the provision of healthcare services due to the high administrative burden and/or activities that cannot be carried out in a timely manner.

Furthermore, the current imbalance between the high demand and limited supply of health services in the context of primary care is increasingly worsening due to the phenomenon known as “hyper-frequency” or excessive use of consultations by patients.6 This creates a low level of user satisfaction and a very poor perception of the quality of the health service received.

Consequently, it is imperative to evaluate the health professional team available in primary healthcare institutions, as well as the institutional management documents; to suggest the hiring of a larger number of assistant personnel for administrative tasks related to the operating and management guidelines of these centers; and to release health professionals from unnecessary burdens that are not relevant to their professional practice.7,8

Finally, it should be noted that there is currently a great need to humanize the provision of healthcare services, especially in primary care, in order to offer comprehensive healthcare that responds appropriately to the physical, emotional, social and spiritual needs of patients in a context of healthy relationships between the patient and the health professionals, as well as the administrative and managerial staff of healthcare institutions.9 The reason for this is that any person who visits a center looking for healthcare expects to receive adequate, dignified and humane treatment, and also to feel that they are involved in an interaction in which there is mutual recognition and appreciation.

Conflicts of interest

None stated by the authors.

Funding

None stated by the authors.

Acknowledgments

None stated by the authors.

References

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