Primary Health Care System Strengthening Project in Sri Lanka: Status and Challenges with Human Resources, Information Systems, Drugs and Laboratory Services

A Primary Healthcare-System-Strengthening Project (PSSP) is implemented by the Ministry of Health, Sri Lanka, with funding support from the World Bank for providing quality care through primary medical care institutions (PMCIs). We used an explanatory mixed-methods study to assess progress and challenges in human resources, drug availability, laboratory services and the health management information system (HMIS) at PMCIs. We used an explanatory mixed-methods study to assess progress and challenges in human resources, drug availability, laboratory services and the health management information system (HMIS) at PMCIs. We conducted a checklist-based assessment followed by in-depth interviews of healthcare workers in one PMCI ...

Data-driven integrated care pathways: Standardization of delivering patient-centered care

Health care delivery in China is in transition from reactive and doctor-centered to preventative and patient-centered. The challenge for the reform is to account for the needs of unique individuals and local communities while ensuring efficiency and equity. This Viewpoint presents data-driven integrated care pathways as a potential solution to standardize patient-centered care delivery, highlighting five core aspects of the entire care journey for personalization by using real-time data and digital technology, and identifying three capabilities to support the uptake of data-driven design.

The Post–COVID-19 Case for Primary Care

Much has been written and discussed about challenges faced by the US health care system, with most of it justifiably concerning the payment system for medical services, and how that leaves an unconscionably large proportion of US residents uninsured or underinsured for quality care. Although payment systems are undoubtedly a challenge and merit substantial conversation, the structure of US health care delivery also leaves much to be desired.

Central to that problem is the paucity of primary care physicians in the US. The approximately 200 000 active primary care physicians in the US represent about 30% of all active ...

Fit for the Future: a new plan for GPs and their patients

General practice is the cornerstone of the NHS, helping around 50 million people in England every year, carrying out 370 million consultations last year. So, when GPs and their patients tell us that general practice is in crisis, we should all be concerned.

In 2022, the RCGP launched Fit for the Future: a new plan for GPs & their patients to put pressure on politicians and decision makers with responsibility for the NHS in England to commit to a bold new plan to provide GPs and patients with the support that they need.

This campaign follows our 2019 Fit for the ...

Reimagining Primary Health Care Workforce in Rural and Underserved Settings

This Discussion Paper starts at the local level and reimagines primary health care (PHC) and the PHC workforce from the perspective of people living in rural and underserved urban areas of low- and middle-income countries (LMICs). Drawing on research evidence and successful examples, it presents a “start local” health service delivery model, health system design framework, and financing models intended to ensure high-quality local comprehensive PHC is available and accessible to all. Core PHC team members (community health workers, registered nurses, specialist family physicians, and administrators) and other health practitioners are generalists in their disciplines, working together in collaborative practice ...

A proposal to reform general practice and enable digital healthcare at scale

General practice has always been the foundation and gateway to the NHS. However the problems are mounting up: a stretched and increasingly burnt-out workforce, no systematic reporting or analysis of activity and demand, fragmentation with secondary care, and confusing and dated contracting and reimbursement mechanisms. The status quo is increasingly unacceptable to both patients and GPs. There is now a consensus that changes are needed, including to the small-scale independent contractor model, to ensure that primary care can thrive in the future.

Policy Exchange has set out a pragmatic proposal for reform. Addressing issues around integration, workforce, digital transformation and ...

Patients’ preferences for telemedicine versus in-clinic consultation in primary care during the COVID-19 pandemic

The Hybrid Patient Care system integrates telehealth and in-clinic consultation. While COVID-19 increased telehealth use, healthcare providers are still seeking the best combination of virtual and in-clinic consultation. Understanding patients’ tele-consultation-related preferences is vital for achieving optimal implementation. The discrete choice experiment (DCE) is the stated preference technique for eliciting individual preferences and is increasingly being used in health-related applications. The study purpose was to evaluate attributes and levels of the DCE regarding patients’ preferences for telemedicine versus traditional, in-clinic consultation in primary care during the COVID-19 pandemic, in order to facilitate successful implementation.

Perceptions of people living with dementia regarding patient-centred aspects of their care and caregiver support

This study examined the perceptions of a sample of Australian people living with dementia regarding the person-centred care and support they received from health professionals and family.

Decision-Making Dilemmas within Integrated Care Service Networks: A Systematic Literature Review

The diverse nature of people’s care needs requires collaboration between different organisations and sectors. One way of achieving such collaboration is through integrated care service networks. Decision-making is considered an important aspect of network governance and key to achieve further integration of care services. As integrated care scholars only implicitly seem to touch upon the issue of decision-making, we aimed to identify multiple decision-making dilemmas.

Prioritization of implementation barriers related to integrated care models in Central and Eastern European countries

The importance of integrated care will increase in future health systems due to aging populations and patients with chronic multimorbidity, however, such complex healthcare interventions are often developed and implemented in higher income countries. For Central and Eastern European (CEE) countries it is important to investigate which integrated care models are transferable to their setting and facilitate the implementation of relevant models by identifying barriers to their implementation. This study investigates the relative importance of integrated care models and the most critical barriers for their implementation in CEE countries. Experts from Croatia, Hungary, Poland, Romania and Serbia were invited to ...