Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review

BMC Health Services Research

Research

Amy Wang¹  Sarah E. Neil-Sztramko²  Nancy Carter³  Abbira Nadarajah³  Janet Adams³  Kamal Jain³  Penelope Petrie³  Rebecca Ganann³  Kylie Teggart³  Caroline Moore³  Aref Alshaikhahmed³  Shreya Yugendranag³ 

[1] Department of Family Medicine, University of Alberta, 5-16 University Terrace, T6G 2T4, Edmonton, AB, Canada;Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 175 Longwood Rd S, Suite 210a, L8P 0A1, Hamilton, ON, Canada;School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, HSC 3N25L8S 4K1, Hamilton, ON, Canada;

关键词: Health services research;    Patient and public involvement;    Patient navigation;    Primary care;    Social prescribing;    Social services;    System navigation;    Systematic review;   

DOI  :  10.1186/s12913-023-09424-5

 received in 2022-12-02, accepted in 2023-04-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundFragmented delivery of health and social services can impact access to high-quality, person-centred care. The goal of system navigation is to reduce barriers to healthcare access and improve the quality of care. However, the effectiveness of system navigation remains largely unknown. This systematic review aims to identify the effectiveness of system navigation programs linking primary care with community-based health and social services to improve patient, caregiver, and health system outcomes.MethodsBuilding on a previous scoping review, PsychInfo, EMBASE, CINAHL, MEDLINE, and Cochrane Clinical Trials Registry were searched for intervention studies published between January 2013 and August 2020. Eligible studies included system navigation or social prescription programs for adults, based in primary care settings. Two independent reviewers completed study selection, critical appraisal, and data extraction.ResultsTwenty-one studies were included; studies had generally low to moderate risk of bias. System navigation models were lay person-led (n = 10), health professional-led (n = 4), team-based (n = 6), or self-navigation with lay support as needed (n = 1). Evidence from three studies (low risk of bias) suggests that team-based system navigation may result in slightly more appropriate health service utilization compared to baseline or usual care. Evidence from four studies (moderate risk of bias) suggests that either lay person-led or health professional-led system navigation models may improve patient experiences with quality of care compared to usual care. It is unclear whether system navigation models may improve patient-related outcomes (e.g., health-related quality of life, health behaviours). The evidence is very uncertain about the effect of system navigation programs on caregiver, cost-related, or social care outcomes.ConclusionsThere is variation in findings across system navigation models linking primary care with community-based health and social services. Team-based system navigation may result in slight improvements in health service utilization. Further research is needed to determine the effects on caregiver and cost-related outcomes.

【 授权许可】

CC BY   
© The Author(s) 2023

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