Determinants of the choice of the first level of care in medicine as a field of training and work: A qualitative study

Ariel Franco, Juan Victor; Granero, Mariano; Silvina Musarella, Nadia; Andrea Fernandez, Carina; Victoria Weisbrot, Maria; Dolores Arceo, Maria

Abstract

Objective: To explore the determinants of eligibility and the choice of the first level of care as a workplace and training environment for health professionals. Design: Qualitative study. Setting: Four universities in the Metropolitan Area of Buenos Aires, Argentina. Participants: Recently graduated doctors and medical students. Method: Based on the grounded constructivist theory, semi-structured interviews and focus groups were conducted for data collection and subsequent analysis. Results: 31 interviews and three focus groups were conducted during 2019-2020. Emerging concepts were organized in main axes for analysis. Positive and negative experiences were identified in relation to primary health care (PHC) in curricular spaces and practical rotations, and a significant lack of knowledge of its scope. For the choice of medical specialties, personal interests, future projections, social prestige, economic income and knowledge of a specific area of medicine are important. There is a devaluation in terms of the role and resolution capacity of PHC, and it is also associated with the assistance of populations with low socioeconomic resources. Conclusions: Little knowledge of PHC, its lack of prestige, and insufficient remuneration for first-level care professionals were identified as the main barriers to choosing PHC as a place of work and training. In contrast, social commitment, the possibility of having a better lifestyle, and the type of doctor -patient relationship appear as the main facilitators. (c) 2021 The Authors. Published by Elsevier Espana, S.L.U.

Más información

Título según WOS: ID WOS:000753062900010 Not found in local WOS DB
Título de la Revista: ATENCION PRIMARIA
Volumen: 54
Número: 2
Editorial: Ediciones Doyma S.A.
Fecha de publicación: 2022
DOI:

10.1016/j.aprim.2021.102192

Notas: ISI