Resumen

RETAMAL GONZALEZ, A.  y  AGUILAR IDANEZ, Mª J.. A mirror where the Primary Health Care does not want to look itself . Medifam [online]. 2002, vol.12, n.2, pp.115-125. ISSN 1131-5768.

Patients with severe social problems are in many cases poorly served by the health care system. We present the case of a patient with severe biological, psychosocial and social problems ignored by the health care system and, in particular, by the Primary Health Care, since neither her nor her close relatives had requested care. Physical condition, personal background and social and family environment of the patient were assessed and a genogram was elaborated evidencing poor family relationships and a very degraded situation in the aforementioned respects. An intervention strategy was designed aimed not only to the improvement of the physical condition of the patient, but also of her relational and psychological problems. The need to perform a self-criticism regarding the sometimes negative attitude of Primary Health Care professionals towards the proactive identification of this type of cases is highlighted, since those professionals tend to ignore such cases when there is not an explicit demand by the patient or his/her rela-tives, thus jeopardizing the fairness of the National Health System specially for the most needy persons. 

Palabras clave : Health services accesibility; Family APGAR; Social conditions; Family relationship.

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