Reflexiones sobre la atención primaria del siglo xxi

Primary care must face the new challenges of the XXI century that have already started with the Covid-19 pandemic. These challenges have to do with a new sociosanitary reality characterized by a rise of the prevalence of the comorbidity and fragility linked to the eldering and the impact of the determinants of the health. Changes in the population, one with more informed patients who demand participating in the decisions that affect their health in a society that is increasingly digitalized. In this context the primary care must solve its challenges such as changing its way of functioning in more cohesive teams that can incorporate new profiles that are really needed and that bring value and where a compromise with teaching and investigation exists. The management of these challenges requires that the professionals working in primary care in the XXI century deepen in their competences looking further than the limits of their health centres. Competences such as the selection and use of the best knowledge, the critical thought, the use of communication to approach to the values and preferences of their patients, the shared decision making and social conscience. In order to these changes to pursue, an institutional impulse is necessary, one with the, many times insistently claimed by the professionals, measures. Among which is, firstly, a bigger inversion in personnel and equipment as well as the commitment with evidently proved models intended to obtain a more coordinated and integrated attention between the primary care, the hospital, the mental health, the public health and the social services, the judicious use of the e-health solutions or the incorporation of a knowledge area of primary care in the University.