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Contents tagged: family medicine

Nov. 25, 2019 Western Pacific Publication

Families as Partners: Co-design of a localised model of care for children with medical complexity living in rural Australia and evaluation using the Paediatric Integrated Care Survey (PICS)

The number of children with medical complexity (CMC) residing in regional Australia is growing, challenging the health system to provide equitable care. Families of CMC experience problems in accessing appropriate care locally and they have high out-of-pocket costs and family disruptions because of long travel distances to access care in metropolitan paediatric hospitals.  The Murrumbidgee Local Health District (MLHD) in collaboration with the Sydney Children’s Hospitals Network (SCHN) partnered with families and local services to co-design a Model of Care (MoC) which better reflects the needs of CMC, their families and local services. The MoC was co-designed with families, local healthcare providers and the tertiary paediatric network.

Oct. 12, 2019 Global Publication

Patient- and Family-Centered Care Coordination: A Framework for Integrating Care for Children and Youth Across Multiple Systems

Understanding a care coordination framework, its functions, and its effects on children and families is critical for patients and families themselves, as well as for pediatricians, pediatric medical subspecialists/surgical specialists, and anyone providing services to children and families. Care coordination is an essential element of a transformed American health care delivery system that emphasizes optimal quality and cost outcomes, addresses family-centered care, and calls for partnership across various settings and communities. High-quality, cost-effective health care requires that the delivery system include elements for the provision of services supporting the coordination of care across settings and professionals

July 18, 2019 Global Publication

Clinical leadership and integrated primary care: A systematic literature review

As numbers of chronically ill patients with complex healthcare needs are increasing, primary care professionals will be challenged to deliver integrated care. Integrated care is about ‘delivering seamless care for patients with complex long-term problems cutting across multiple services, providers and settings.
Leaders are needed to address healthcare changes essential for implementation of integrated primary care. What kind of leadership this needs, which professionals should fulfil this role and how these leaders can be supported remains unclear.

April 25, 2018 Africa Publication

The Influence of Family Physicians Within the South African District Health System: A Cross-Sectional Study

Evidence of the influence of family physicians on health care is required to assist managers and policy makers with human resource planning in Africa. The International argument for family physicians derives mainly from research in high-income countries, so this study aimed to evaluate the influence of family physicians on the South African district health system. 

Nov. 11, 2016 Europe Publication

Rethinking primary care’s gatekeeper role

Gatekeeping is the term used to describe the role of primary care physicians or general practitioners (GPs) in authorizing access to specialty care, and diagnostic tests. Gatekeeping has crucial influences on service utilisation, health outcomes, healthcare costs, and patient satisfaction. 
It was developed as a response to a shortage of specialists and a desire to control healthcare spending and has been an accepted practice in lot of countries. Yet direct access could help reduce GP workload and facilitate greater patient choice. They look in this study at the pros and cons of gatekeeping policies in various countries, and highlight the need for more evidence to devise policy. 

June 21, 2016 Europe, Global Publication

Can hospital services work in primary care settings?

In this post, the author analyzes how recent changes in primary care in the National Health Services could face the purpose of moving some services from hospital to primary care settings.

The author bases her discussion on a report published by RAND corporation (“Outpatient Services and Primary Care”) that identifies five main areas to be considered when moving services from hospital to primary care:

  1. Transfer: The substitution of services delivered by specialists for services delivered by primary care clinicians.
  2. Relocation: Shifting the venue of specialist care from hospitals to primary care settings.
  3. Liaison: Joint working between specialists and primary care clinicians to provide care to individual patients.
  4. Professional behaviour change: Changing the way GPs refer patients to specialists.
  5. Patient behaviour change: Helping patients make informed decisions about their care.

There is not a unique way of moving these services; many studies suggest that patients’ satisfaction usually grows when services are ...

May 26, 2016 Global Publication

Understanding pressures in general practice

“General practice is in crisis”; that is how this King’s Fund report start its analysis, pointing to funding and workforce as two of the main problems in general practice situation. Increasing needs and complexity, trends of moving patients from hospital to communities and rising expectations in population act as factors that increase pressures in general practice.

This report identifies some immediate priorities and some future challenges in order to protect general practice and to make it can face future needs.

Immediate priorities would be: (I) providing practical support to practices, (II) accelerating the uptake of technologies that can help practice deal with growing pressures more effectively, (III) encouraging reshaping of workforce in primary care, (IV) reducing bureaucratic burdens, (V) placing primary care at the heart of sustainability and transformation plans, (VI) supporting patients to use health services appropriately.
Long-term challenges pointed by this report are: (I) solving deficiencies in ...

May 26, 2016 Europe Publication

Reshaping the workforce to deliver the care patients need

Workforce structure is one of the most difficult things to modulate in health systems. Current transition to new models of care could be a good opportunity to make workforce structure match actual needs of systems and populations. In this report, published by the Nuffield Trust, it is analyzed how organizations could reshape their current workforce and what the benefits would be:

There is a need to evolve from an illness-based system to a patient-centred system.
Workforce should meet future needs by incorporating professionals with a vision aligned with future models of care.
There are opportunities to develop the current workforce at all grades: from redeploying support staff, extending the skills of registered professionals and training advanced practitioners.
There is good evidence that support workers can provide good-quality, patient-focused care as well as reduce the workload of more highly qualified staff. Investment here could provide a cost-effective and rapid solution to ...

May 12, 2016 Global Publication

New primary care model yielding early results

Several ways of shaping primary care are being developed all around the world. Improving the role of nurses or giving general practitioners new competences are just a couple of ways of moving primary care towards a more comprehensive way of working.

In this post in the NHS Confederation Blog, some of the initiatives performed to change primary care are explained and some of the challenges that future primary care will face are listed.


One of the main points outstanded is the need of integrating care and workforce from different levels of health care. As it is said in this post “Patients will benefit from easy access to a single integrated, multidisciplinary team drawn from a wide range of health and social care professionals”