After -hours primary healthcare delivery: A systematic review

Introduction: Universal access of all segments of society to Primary Health Care (PHC) services when needed and at an appropriate time and location is their undeniable right. Access to these services after working hours (evenings and nights) is one of the challenges that people face. This study was conducted to examine the provision of Primary Health Care (PHC) services after working hours (evenings and nights) in different countries. Search Strategy: The present study is a systematic review conducted using the PRISMA writing guide. Studies published in English from ۲۰۰۰ to the present in databases such as PubMed, Scopus, and Google Scholar were systematically searched. The keywords and phrases used included combinations of primary health care, primary care services, emergency services, community-based centers, primary health care provider facilities, and non-official hours (after working hours). Boolean operators (AND, OR) and MeSH terms were used to combine search terms. The inclusion criteria consisted of studies focusing on the provision of primary health care services after working hours (evenings and nights), excluding other studies. Data extraction and quality assessment were conducted independently by two individuals. Any disagreements were resolved through discussion or consultation with a third specialized researcher. Quality assessment was performed using the JBI tool. Data extraction included study details (author, year, location) and the manner of providing services after working hours. Results: ۳۲ studies had entry criteria. These studies focused on examining services and care in countries such as Brazil, France, Italy, Japan, New Zealand, and Singapore. In some countries, after-hours care is provided by health centers, while in others it is offered in hospital outpatient departments. In all countries, hospitals and clinics were allocated extra costs by the government or a separate government subsidy for providing services outside of regular hours. Among selected countries, only Japan and France had remote and telephone consultations for after-hours care. In some rural areas of New Zealand, nurses provided primary care with additional rights. After-hours care units in Singapore are closed on Mondays, whereas in Italy, these units operate during nights and weekends as well. Conclusion and Discussion: To enhance and improve people's access to necessary services, various strategies and methods such as allocating additional budget, strengthening healthcare centers, providing telephone guidance and counseling, and improving coordination between healthcare centers and hospitals emphasizing the organization of the referral system can be employed.

کلیدواژه ها:

primary health care ، after-hours care ، healthcare delivery ، systematic review