scholarly journals Impact of a well-developed primary care system on the length of stay in emergency departments in the Netherlands: a multicenter study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Wendy A. M. H. Thijssen ◽  
Nicole Kraaijvanger ◽  
Dennis G. Barten ◽  
Marleen L. M. Boerma ◽  
Paul Giesen ◽  
...  
Keyword(s):  
Primary Care ◽  
Length Of Stay ◽  
The Netherlands ◽  
Multicenter Study ◽  
Emergency Departments ◽  
Primary Care System ◽  
Care System

scholarly journals Estimating the Costs of Implementing Comprehensive Primary Care: A Narrative Review

2019 ◽  
Vol 6 ◽  
pp. 233339281984248
Author(s):  
Grant R. Martsolf ◽  
Ryan Kandrack ◽  
Mark W. Friedberg ◽  
Brian Briscombe ◽  
Peter S. Hussey ◽  
...  
Keyword(s):  
Primary Care ◽  
Narrative Review ◽  
Fee For Service ◽  
Primary Care System ◽  
High Functioning ◽  
Illness Burden ◽  
Care Practices ◽  
Primary Care Practices ◽  
Limited Generalizability ◽  
Care System

The performance of the any health-care system relies on a high-functioning primary care system. Increasing primary care practices’ adoption of “comprehensive primary care” capabilities might yield meaningful improvements in the quality and efficiency of primary care. However, many comprehensive primary care capabilities, such as care management and coordination, are not compensated via traditional fee-for-service payment. To calculate new payments for these capabilities, policymakers would need estimates of the costs that practices incur when adopting, maintaining, and using the capabilities. We performed a narrative review of the existing literature on the costs of adopting and implementing comprehensive primary care capabilities. These studies have found that practices incur significant costs when adopting and implementing comprehensive primary care capabilities. However, the studies had significant limitations that prevent extensive use of their estimates for payment policy. Particularly, the strongest studies focused on a small numbers of practices in specific geographic areas and the concepts and methods used to assess costs varied greatly across the studies. Furthermore, none of the studies in our review attempted to estimate differences in costs across practices with patients at varying levels of complexity and illness burden which is important for risk-adjusting payments to practices. Therefore, due to the heterogeneous designs and limited generalizability of published studies highlight the need for additional research, especially if payers wish to link their financial support for comprehensive primary care capabilities to the costs of these capabilities for primary care practices.

Do We Need More Pediatricians? Effect of Group Practice

PEDIATRICS ◽  
1973 ◽  
Vol 51 (4) ◽  
pp. 754-755
Author(s):  
Harvey Klevit
Keyword(s):  
Primary Care ◽  
Health Plan ◽  
Statistical Data ◽  
Group Practice ◽  
Primary Care System ◽  
Manpower Shortage ◽  
Care System

We appreciate being cited as a model efficient primary care system by D. Haggerty1 in his commentary which questions the existence of a pediatric manpower shortage. Readers might be interested in some of our statistical data. Our group of 20 pediatricians (18 when corrected for research and administrative activities), has provided primary services to a known Kaiser Health Plan (Oregon Region) population of 55,000 children under age 17 in 1972. We have been able to function at a ratio of one pediatrician per 2,800 to 3,200 patients since 1965, when we began "keeping score."

The Education of Pediatricians for Primary Care: The Score After Two Score Years

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 270-272
Author(s):  
Evan Charney
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care System ◽  
Medical Profession ◽  
Primary Care System ◽  
Educational Structure ◽  
Task Forces ◽  
Do So ◽  
Care System

In a 1973 monograph on the education of physicians for primary care, Joel Alpert and I wrote, "There are two interrelated and serious problems in our present educational structure—not enough physicians enter primary care and those who do so are not adequately prepared for the job."1 Twenty years and many task forces and exhortatory editorials later, much the same could be said. But that conclusion would not be entirely fair: changes have indeed occurred in the subsequent two score years. There is now clear consensus that a strong primary care system should be the linchpin of our nation's health care system, with 50 to 60% of physicians as generalists, 2,3 and the medical profession has at least professed to agree with that strategy.4

scholarly journals Provider perspectives on general practice in Henan, China: a mixed-methods study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e036240
Author(s):  
Jiming Zhu ◽  
Proochista Ariana
Keyword(s):  
Public Health ◽  
Primary Care ◽  
General Practice ◽  
Mixed Methods ◽  
Central Government ◽  
Point Of Care ◽  
Primary Care System ◽  
Common People ◽  
Provider Perspectives ◽  
Care System

ObjectiveSince 2011 China’s central government has committed to establishing a new ‘general practitioner’ (GP)-centred primary care system. To this end there have been great efforts to train an additional 300 000 GPs by 2020. This paper examines the perspective of practitioners in Henan, China, regarding general practice.DesignA mixed-methods approach using focus group discussions (FGD), and structured questionnaires.Setting/participantsSeven FGDs and responses to 1887 questionnaires included medical students, primary care doctors and GP residents in Henan.ResultsThe three surveyed medical groups have some awareness of the attributes of general practice (eg, comprehensiveness, first contact and coordination), but often misinterpret what being a GP entails. Five themes were identified through the FGDs and tested quantitatively for their prevalence with structured questionnaires. First, the GPs’ role as a comprehensive care provider was (mis)interpreted as an ‘all-round doctor’. Second, the GP’s responsibility as the first point of care was understood in two conflicting ways: private personal doctors of the rich and the powerful or village doctors for common people. Third, referral was understood as simply guiding patients to appropriate departments within the hospital while the gatekeeping role was interpreted to involve GPs being peoples’ health protectors rather than being also gatekeepers of specialty services. Traditional Chinese medicine now further complicates the understanding of GPs. And lastly, the GPs’ main responsibility was considered to be public health work.ConclusionThe misunderstandings of the roles and responsibilities of GPs render problematic the policy foundation of China’s GP-centred primary care system. Pursuing the quantity of GPs on its own is meaningless, since the number needed depends on the delineated role of GPs. Top priority is to establish clarity about the GP role, which requires reforming the health delivery system to address issues with fragmented care, strategically taking into account the development of GPs with work delegation and substitution and providing more clarity on the distinction between general practice and public health.

Sign in / Sign up

Export Citation Format

Share Document