Under the same roof: co-location of practitioners within primary care is associated with specialized chronic care management

BMC Family Practice

Research Article

Tim Kenealy¹  Toni Ashton²  Anna Koné³  Juliet Rumball-Smith³  Jan Barnsley⁴  Walter P Wodchis⁴ 

[1] Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand;Health Systems, School of Population Health, University of Auckland, Auckland, New Zealand;Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Suite 425, M5T 3M6, Toronto, ON, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Suite 425, M5T 3M6, Toronto, ON, Canada;Institute for Clinical Evaluative Sciences, Toronto, ON, Canada;

关键词: Canada;    New Zealand;    Chronic disease;    Patient care team;    Primary care;    Co-location;   

DOI  :  10.1186/1471-2296-15-149

 received in 2014-05-05, accepted in 2014-08-13,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundInternational and national bodies promote interdisciplinary care in the management of people with chronic conditions. We examine one facilitative factor in this team-based approach - the co-location of non-physician disciplines within the primary care practice.MethodsWe used survey data from 330 General Practices in Ontario, Canada and New Zealand, as a part of a multinational study using The Quality and Costs of Primary Care in Europe (QUALICOPC) surveys. Logistic and linear multivariable regression models were employed to examine the association between the number of disciplines working within the practice, and the capacity of the practice to offer specialized and preventive care for patients with chronic conditions.ResultsWe found that as the number of non-physicians increased, so did the availability of special sessions/clinics for patients with diabetes (odds ratio 1.43, 1.25–1.65), hypertension (1.20, 1.03–1.39), and the elderly (1.22, 1.05–1.42). Co-location was also associated with the provision of disease management programs for chronic obstructive pulmonary disease, diabetes, and asthma; the equipment available in the centre; and the extent of nursing services.ConclusionsThe care of people with chronic disease is the ‘challenge of the century’. Co-location of practitioners may improve access to services and equipment that aid chronic disease management.

【 授权许可】

CC BY   
© Rumball-Smith et al.; licensee BioMed Central Ltd. 2014