Please use this identifier to cite or link to this item: https://doi.org/10.3399/bjgp20X714199
Title: Multicomponent interventions for enhancing primary care: a systematic review
Authors: Jimenez, Geronimo
Matchar, David 
Koh, Gerald Choon-Huat 
Car, Josip
Keywords: Science & Technology
Life Sciences & Biomedicine
Primary Health Care
Medicine, General & Internal
General & Internal Medicine
chronic disease
health services research
healthcare reform
primary health care
systematic review
PRIMARY-HEALTH-CARE
QUALITY-OF-CARE
HOSPITAL USE
GUIDED CARE
PROGRAM
IMPACT
OUTCOMES
ACCESS
MODEL
INCENTIVES
Issue Date: 1-Jan-2021
Publisher: ROYAL COLL GENERAL PRACTITIONERS
Citation: Jimenez, Geronimo, Matchar, David, Koh, Gerald Choon-Huat, Car, Josip (2021-01-01). Multicomponent interventions for enhancing primary care: a systematic review. BRITISH JOURNAL OF GENERAL PRACTICE 71 (702) : E10-E21. ScholarBank@NUS Repository. https://doi.org/10.3399/bjgp20X714199
Abstract: Background Many countries have implemented interventions to enhance primary care to strengthen their health systems. These programmes vary widely in features included and their impact on outcomes. Aim To identify multiple-feature interventions aimed at enhancing primary care and their effects on measures of system success — that is, population health, healthcare costs and utilisation, patient satisfaction, and provider satisfaction (quadruple-aim outcomes). Design and setting Systematic review and narrative synthesis. Method Electronic, manual, and grey-literature searches were performed for articles describing multicomponent primary care interventions, providing details of their innovation features, relationship to the ‘4Cs’ (first contact, comprehensiveness, coordination, and continuity), and impact on quadruple-aim outcomes. After abstract and full-text screening, articles were selected and their quality appraised. Results were synthesised in a narrative form. Results From 37 included articles, most interventions aimed to improve access, enhance incentives for providers, provide team-based care, and introduce technologies. The most consistent improvements related to increased primary care visits and screening/preventive services, and improved patient and provider satisfaction; mixed results were found for hospital admissions, emergency department visits, and expenditures. The available data were not sufficient to link interventions, achievement of the 4Cs, and outcomes. Conclusion Most analysed interventions improved some aspects of primary care while, simultaneously, producing non-statistically significant impacts, depending on the features of the interventions, the measured outcome(s), and the populations being studied. A critical research gap was revealed, namely, in terms of which intervention features to enhance primary care (alone or in combination) produce the most consistent benefits.
Source Title: BRITISH JOURNAL OF GENERAL PRACTICE
URI: https://scholarbank.nus.edu.sg/handle/10635/228140
ISSN: 0960-1643
1478-5242
DOI: 10.3399/bjgp20X714199
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