To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The Alma-Ata Declaration was a big step in the development of primary care, defining the main tasks and populations’ expectation. Celebrating the 40th year’s anniversary is a good opportunity to make an analysis. Development of primary care was not parallel in the Eastern and Western part of Europe.
To provide an overview on the societal and economic situation, structural and financial changes of healthcare systems in the former ‘Soviet bloc’ countries, to present an analysis of the primary healthcare (PHC) provision and to find relationships between economic development and epidemiological changes of the respective countries.
Epidemiological data, healthcare expenditures and structure, and financing schemes were compared; systematic literature search was performed.
Visible improvements in population health, in the national economic condition, structural changes in healthcare and more focus to primary care were experienced everywhere. Higher life expectancies with high inter-country variation were observed in the former ‘Soviet bloc’ countries, although it could not be clearly linked to the development of healthcare system. PHC provision improved while structural changes were rarely initiated, often only as a project or model initiation. Single-handed practices are yet predominant. The gate-keeping system is usually weak; there were no effective initiatives to improve the education of nurses and to widen their competences. Migrations of workforce to Western countries become a real threat for the Central-East European countries.
Lack of coordination between practices and interdisciplinary cooperation were recognized as the main barriers for further improvement in the structure.
In Hungary, since 1990, each government has tried to transform and rationalize the structure of health care. One of the reforms was the Care Managing Organization (CMO) programme introduced in 1999.
The aim of this paper is to describe the regional, environmental, structural and preliminary health related outcomes of the CMO in Bács-Kiskun County (Central-Eastern Hungary).
First, cardiovascular screening programmes were organized for pre-screened and randomly selected populations of a total of 4462 persons. Seven years after completing the programmes, regional mortality data were analysed and compared. Second, nutritional and lifestyle counselling programmes with increased physical activity were organized for 2489 overweight or obese patients from the participating primary care practices. Anthropometric and laboratory data were examined after one and two years.
First, for persons with higher cardiovascular risk, appropriate medical treatment was introduced, and after seven years, their mortality rates proved better than the regional and national data. Second, almost all measured anthropometric parameters improved (body mass index, body weight decrease) after the first year and this trend lasted till the end of the second year.
According to the data of the National Health Insurance Fund, the average savings rate for all CMOs for the fiscal years 1999–2007 was 4.94%. The highest rates of savings were realized in chronic and acute inpatient care and medical devices. In the end of 2008, by which time 14 CMOs had already covered 2.1million people, the programme was discontinued by the government, without a comprehensive evaluation of the experience and outcomes.
To describe the design of the Feel4Diabetes-intervention and the baseline characteristics of the study sample.
School- and community-based intervention with cluster-randomized design, aiming to promote healthy lifestyle and tackle obesity and obesity-related metabolic risk factors for the prevention of type 2 diabetes among families from vulnerable population groups. The intervention was implemented in 2016–2018 and included: (i) the ‘all-families’ component, provided to all children and their families via a school- and community-based intervention; and (ii) an additional component, the ‘high-risk families’ component, provided to high-risk families for diabetes as identified with a discrete manner by the FINDRISC questionnaire, which comprised seven counselling sessions (2016–2017) and a text-messaging intervention (2017–2018) delivered by trained health professionals in out-of-school settings. Although the intervention was adjusted to local needs and contextual circumstances, standardized protocols and procedures were used across all countries for the process, impact, outcome and cost-effectiveness evaluation of the intervention.
Primary schools and municipalities in six European countries.
Families (primary-school children, their parents and grandparents) were recruited from the overall population in low/middle-income countries (Bulgaria, Hungary), from low socio-economic areas in high-income countries (Belgium, Finland) and from countries under austerity measures (Greece, Spain).
The Feel4Diabetes-intervention reached 30 309 families from 236 primary schools. In total, 20 442 families were screened and 12 193 ‘all families’ and 2230 ‘high-risk families’ were measured at baseline.
The Feel4Diabetes-intervention is expected to provide evidence-based results and key learnings that could guide the design and scaling-up of affordable and potentially cost-effective population-based interventions for the prevention of type 2 diabetes.
Email your librarian or administrator to recommend adding this to your organisation's collection.