Question

Often primary care and primary prevention (intervention) can be confusing and in some cases these words are used together and interchangeably. Refer to this week's chapter and back to chapter 2, and discuss how (give examples) you would explain primary prevention vs. primary care.

Answer 1

Primary prevention is one of the three levels of prevention.

Prevention in relation of health means avoiding disease before it starts.

Primary prevention includes the plans for, and the measures taken, to prevent the onset of illness, injury or other health problem before the disease process begins. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur.

For example

· Immunization against infectious diseases.

· Health education about healthy and safe habits (e.g. eating well, exercising regularly, not smoking)

· Legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos, alcohol) or to mandate safe and healthy practices (e.g. use of seatbelts and bike helmets)

Other two levels of prevention are secondary and tertiary. Secondary prevention includes those preventive measures that are aimed at early diagnosis and prompt treatment of a disease, illness or injury to prevent complications (for example screening for high blood pressure, breast self-examination) and tertiary prevention aimed at rehabilitation of those who have already developed an impairment or disability following significant illness/ injury by retraining, re-educating and rehabilitating people.

Health Education can be applied at all three levels of disease prevention. Examples of health education applied at different levels are-

At the level of primary prevention - education about importance of balanced diet to protect themselves from developing diseases in the future.

At secondary level, educating people to visit health care facility when they experience symptoms of illness example a lump in breast for early diagnosis and treatment for their health problems.

At the tertiary level, you could educate people to take their medication appropriately as advised and on working towards rehabilitation from significant illness or disability.

Primary care is firs point of entry of patient into the health care system.

It includes accessible, comprehensive, coordinated, continuous, and accountable services for health promotion, disease prevention, health maintenance, counselling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, clinic, inpatient, critical care, long-term care, home care, day care, etc.).

It is performed and managed by a physician (in medical specialities of family medicine, general internal medicine, general pediatrics, and obstetrics and gynecology) often collaborating with other health professionals (nurse practitioner, physician assistant and others), and if needed utilizing consultation or referral as appropriate.

Primary care practices are organized to meet the needs of patients with undifferentiated problems, with the vast majority of patient concerns and needs being cared for in the primary care practice itself. Nature of primary care is such that primary care physician serves as the first entry point for medical and health care needs of all patient's - not limited by type of problem, its origin, organ system affected, or diagnosis. Primary care physicians are advocates for the patient in coordinating the use of the entire health care system to benefit the patient.

Primary care practices are generally located in the community (accessible), thereby facilitating access to health care.

Primary care	Primary prevention
Primary care as multidimensional- preventive, promotive, curative, referral and rehabilitation	Only preventive aspect is taken care
Broad scope- wide range of services are offered including preventive, promotive, curative, referral and rehabilitative	Narrow scope- only preventive and promotive
Provided by certain clinician and other health care professional Multidisciplinary team	Can be by any health care professional or non-health care personnel
Formal entry of patient in health care system that includes secondary and tertiary care settings also	No entry in health care system
Oriented to personal (individualized) health care	Community / mass oriented

So both primary care and primary prevention they are usefully distinguished terms and should not be used interchangeably though are certainly related and often overlap