A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care
<p>Abstract</p> <p>Background</p> <p>Although primary health care (PHC) is a key component of all health care systems, services are not always readily available, accessible or affordable. This systematic review examines effective strategies to enhance access to best pra...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-11-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1472-6963/12/415 |
| _version_ | 1818755578492616704 |
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| author | Comino Elizabeth Davies Gawaine Krastev Yordanka Haas Marion Christl Bettina Furler John Raymont Anthony Harris Mark F |
| author_facet | Comino Elizabeth Davies Gawaine Krastev Yordanka Haas Marion Christl Bettina Furler John Raymont Anthony Harris Mark F |
| author_sort | Comino Elizabeth |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Although primary health care (PHC) is a key component of all health care systems, services are not always readily available, accessible or affordable. This systematic review examines effective strategies to enhance access to best practice processes of PHC in three domains: chronic disease management, prevention and episodic care.</p> <p>Methods</p> <p>An extensive search of bibliographic data bases to identify peer and non-peer reviewed literature was undertaken. Identified papers were screened to identify and classify intervention studies that measured the impact of strategies (singly or in combination) on change in use or the reach of services in defined population groups (evaluated interventions).</p> <p>Results</p> <p>The search identified 3,148 citations of which 121 were intervention studies and 75 were evaluated interventions. Evaluated interventions were found in all three domains: prevention (n = 45), episodic care (n = 19), and chronic disease management (n = 11). They were undertaken in a number of countries including Australia (n = 25), USA (n = 25), and UK (n = 15). Study quality was ranked as high (31% of studies), medium (61%) and low (8%). The 75 evaluated interventions tested a range of strategies either singly (n = 46 studies) or as a combination of two (n = 20) or more strategies (n = 9). Strategies targeted both health providers and patients and were categorised to five groups: practice re-organisation (n = 43 studies), patient support (n = 29), provision of new services (n = 19), workforce development (n = 11), and financial incentives (n = 9). Strategies varied by domain, reflecting the complexity of care needs and processes. Of the 75 evaluated interventions, 55 reported positive findings with interventions using a combination of strategies more likely to report positive results.</p> <p>Conclusions</p> <p>This review suggests that multiple, linked strategies targeting different levels of the health care system are most likely to improve access to best practice PHC. The proposed changes in the structure of PHC in Australia may provide opportunities to investigate the factors that influence access to best practice PHC and to develop and implement effective, evidence based strategies to address these.</p> |
| first_indexed | 2024-12-18T05:41:23Z |
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| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-18T05:41:23Z |
| publishDate | 2012-11-01 |
| publisher | BMC |
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| series | BMC Health Services Research |
| spelling | doaj.art-9efde1817b28441fa65cdfdc95fa35582022-12-21T21:19:10ZengBMCBMC Health Services Research1472-69632012-11-0112141510.1186/1472-6963-12-415A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic careComino ElizabethDavies GawaineKrastev YordankaHaas MarionChristl BettinaFurler JohnRaymont AnthonyHarris Mark F<p>Abstract</p> <p>Background</p> <p>Although primary health care (PHC) is a key component of all health care systems, services are not always readily available, accessible or affordable. This systematic review examines effective strategies to enhance access to best practice processes of PHC in three domains: chronic disease management, prevention and episodic care.</p> <p>Methods</p> <p>An extensive search of bibliographic data bases to identify peer and non-peer reviewed literature was undertaken. Identified papers were screened to identify and classify intervention studies that measured the impact of strategies (singly or in combination) on change in use or the reach of services in defined population groups (evaluated interventions).</p> <p>Results</p> <p>The search identified 3,148 citations of which 121 were intervention studies and 75 were evaluated interventions. Evaluated interventions were found in all three domains: prevention (n = 45), episodic care (n = 19), and chronic disease management (n = 11). They were undertaken in a number of countries including Australia (n = 25), USA (n = 25), and UK (n = 15). Study quality was ranked as high (31% of studies), medium (61%) and low (8%). The 75 evaluated interventions tested a range of strategies either singly (n = 46 studies) or as a combination of two (n = 20) or more strategies (n = 9). Strategies targeted both health providers and patients and were categorised to five groups: practice re-organisation (n = 43 studies), patient support (n = 29), provision of new services (n = 19), workforce development (n = 11), and financial incentives (n = 9). Strategies varied by domain, reflecting the complexity of care needs and processes. Of the 75 evaluated interventions, 55 reported positive findings with interventions using a combination of strategies more likely to report positive results.</p> <p>Conclusions</p> <p>This review suggests that multiple, linked strategies targeting different levels of the health care system are most likely to improve access to best practice PHC. The proposed changes in the structure of PHC in Australia may provide opportunities to investigate the factors that influence access to best practice PHC and to develop and implement effective, evidence based strategies to address these.</p>http://www.biomedcentral.com/1472-6963/12/415Primary health careFamily practiceHealth services needs and demandHealth services accessibilityDiabetes mellitusPapanicolaou testAfter-hours careAppointments and schedulesContinuity of patient careEnglish language |
| spellingShingle | Comino Elizabeth Davies Gawaine Krastev Yordanka Haas Marion Christl Bettina Furler John Raymont Anthony Harris Mark F A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care BMC Health Services Research Primary health care Family practice Health services needs and demand Health services accessibility Diabetes mellitus Papanicolaou test After-hours care Appointments and schedules Continuity of patient care English language |
| title | A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care |
| title_full | A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care |
| title_fullStr | A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care |
| title_full_unstemmed | A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care |
| title_short | A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care |
| title_sort | systematic review of interventions to enhance access to best practice primary health care for chronic disease management prevention and episodic care |
| topic | Primary health care Family practice Health services needs and demand Health services accessibility Diabetes mellitus Papanicolaou test After-hours care Appointments and schedules Continuity of patient care English language |
| url | http://www.biomedcentral.com/1472-6963/12/415 |
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