Composition of general practices in western countries and associations with their perceived ability to manage patients with chronic conditions.

IF 2 Q2 PRIMARY HEALTH CARE

BJGP Open Pub Date : 2025-10-03 DOI:10.3399/BJGPO.2024.0200

Adeline Cachou de Camaret, Pascal Wild, Nicolas Senn, Christine Cohidon

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Abstract

Background: Primary care teams (PCTs) are recognized to improve the quality of care. However, few studies have examined which PCT composition best meets patients' primary care (PC) needs.

Aim: The present study aimed to describe the composition of PCTs in eleven Western countries and investigate potential associations with general practitioners' (GPs) opinions about their practice's ability to manage patients with chronic conditions and communicate with caregivers.

Design & setting: We conducted a secondary analysis of the data from 11 Western countries that participated in the 2019 Commonwealth Fund International Health Policy Survey of Primary Care Physicians (N=13,200).

Method: We used a hierarchical clustering algorithm to characterise different types of PCT according to the composition of the health care professionals (HCPs) making them up, in addition to GPs. We subsequently assessed associations between practice types and two GP-reported indicators: their practice's coordination with social services (SS) and other community providers (CPs) and ability to manage patients with chronic conditions.

Results: We characterised five types of PCT (Traditional, Multidisciplinary, Nurse-centred, Psychologist-centred and Physiotherapist-centred). The Traditional type represented 51.6% of all PCTs; they were mainly composed of moderate percentages of all the HCPs: The Multidisciplinary (11.9%) were composed of high percentages of the different HCPs. After controlling for country, the Multidisciplinariy type reported better coordination with SS and CPs than did Traditional ones (OR 0.39, 95%CI [0.29-0.53]).

Conclusion: Multidisciplinary PCTs reported better outcomes than Traditional ones regarding their coordination with SS and CPs and perceived ability to manage patients with chronic conditions. These results should encourage governmental efforts to promote PC that uses multidisciplinary PCTs.

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西方国家全科医生的组成及其与慢性疾病患者管理能力的关系。

背景：初级保健团队（PCTs）被认为是提高护理质量的重要手段。然而，很少有研究调查哪种PCT组合最能满足患者的初级保健（PC）需求。目的：本研究旨在描述11个西方国家pct的组成，并调查其与全科医生（gp）对其实践管理慢性病患者和与护理人员沟通能力的看法的潜在关联。设计与设置：我们对参加2019年英联邦基金初级保健医生国际卫生政策调查的11个西方国家（N=13,200）的数据进行了二次分析。方法：除了全科医生外，我们还根据构成PCT的卫生保健专业人员（HCPs）的组成，使用分层聚类算法来表征不同类型的PCT。我们随后评估了实践类型与两个gdp报告指标之间的关联：他们的实践与社会服务（SS）和其他社区提供者（CPs）的协调以及管理慢性病患者的能力。结果：我们描述了五种类型的PCT（传统、多学科、以护士为中心、以心理学家为中心和以物理治疗师为中心）。传统类型占所有pct的51.6%；多学科（11.9%）由不同类型的HCPs组成，比例较高。在对国家进行控制后，多学科类型报告与SS和cp的协调优于传统类型（OR 0.39, 95%CI[0.29-0.53]）。结论：多学科PCTs在与SS和CPs的协调以及管理慢性疾病患者的感知能力方面比传统PCTs报告了更好的结果。这些结果应鼓励政府努力促进使用多学科pct的pct。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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