Are Primary Healthcare Organizational Attributes Associated with Patient Self-Efficacy for Managing Chronic Disease?

Lemieux, Valérie; Lévesque, Jean‐Frédéric; Ehrmann-Feldman, Debbie

doi:10.12927/hcpol.2011.22350

Cited by 9 publications

(9 citation statements)

References 28 publications

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“…Few authors have reported on the magnitude of organizational contribution to quality of care. 7,[36][37][38] Our observations about practice size agree with previous reports. 6,11,16 The observed associations with visit duration and physician remuneration should, however, be viewed with caution.…”

Section: Discussionsupporting

confidence: 92%

Characteristics of primary care practices associated with high quality of care

Beaulieu

Haggerty

Tousignant

et al. 2013

CMAJ

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A health care system is only as strong as its primary care sector, 1 which provides "entry into the system for all new needs and problems, provides person-focused (not disease-oriented) care over time, provides care for all but very uncommon or unusual conditions …" 2 Patient enrolment, team-based care, information technology, and funding and remuneration schemes that foster comprehensiveness and collaboration are key characteristics of effective primary care systems.3 None can be singled out as the most determining, but how they are clustered defines a limited set of organizational models that have been associated with a variety of outcomes. 4 Canadian provinces have implemented different primary care models with different scopes of changes.5 Research has not yet identified a "winning" model. For example, in Ontario, community health centres deliver better chronic illness care 6 but have less accessibility than feefor-service enrolment models, 7 and no model provided more comprehensive preventive care. Walk-in clinics achieved better quality scores than did family medicine clinics for treatment of a set of acute problems.9 How the work is organized may be as important, if not more important, than what the model is called.These observations suggest that the challenges associated with providing high-quality services differ depending on the nature of care considered.9-11 Even if chronic illness is a major challenge, the quality of care must not be improved at the expense of accessibility, preventive or good episodic care, which are all essential components of primary care.In this study, we report the results of the quantitative component of a multimethod observational study conducted in Quebec to determine which organizational characteristics of primary care practices are associated with high-quality care. We sought to find a quality measure of care that would encompass the comprehensive nature of primary care (episodic, chronic and preventive care), and we explored how the contribution of organizational characteristics varied based on the type of care provided.

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Section: Discussionsupporting

confidence: 92%

Characteristics of primary care practices associated with high quality of care

Beaulieu

Haggerty

Tousignant

et al. 2013

CMAJ

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“…Since relevant and available competence is imperative to gain positive effects from implementation [ 42 ], discrepancies put strains especially on health care and its providers to bridge the gap. Our results were similar to studies on self-management support that emphasized inter-professional cooperation, [ 11 , 43 ] and strategies to improve user-involvement [ 44 ] as core skills for health professionals engaged in self-management support. In line with Liaw and colleagues [ 45 ], knowledge and skills in adjustments to cultural and social norms would be important to enhance in support programme development and running.…”

Section: Discussionsupporting

confidence: 87%

Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users’ and health professionals’ perceptions

Solberg

Steinsbekk

Solbjør

et al. 2014

BMC Health Serv Res

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BackgroundDevelopment of more self-management support programmes in primary health care has been one option used to enhance positive outcomes in chronic disease management. At present, research results provide no consensus on what would be the best way to develop support programmes into new settings. The aim of the present study was therefore to explore users’ and health professionals’ perceptions of what would be the vital elements in a self - management support programme applicable in primary health care, how to account for them, and why.MethodsFour qualitative, semi-structured focus group interviews were conducted in Central Norway. The informants possessed experience in development, provision, or participation in a self-management support programme. Data was analysed by the Systematic Text Condensation method.ResultsThe results showed an overall positive expectation to the potential benefits of development of a self-management support programme in primary health care. Despite somewhat different arguments and perspectives, the users and the health professionals had a joint agreement on core characteristics; a self-management support programme in primary health care should therefore be generic, not disease specific, and delivered in a group- based format. A special focus should be on the everyday- life of the participants. The most challenging aspect was a present lack of competence and experience among health professionals to moderate self-management support programmes.ConclusionsThe development and design of a relevant and applicable self-management support programme in primary health care should balance the interests of the users with the possibilities and constraints within each municipality. It would be vital to benefit from the closeness of the patients’ every-day life situations. The user informants’ perception of a self-management support programme as a supplement to regular medical treatment represented an expanded understanding of the self-management support concept. An exploring approach should be applied in the development of the health professionals’ competence in practice. The effect of a self-management support programme based on the core characteristics found in this study needs to be evaluated.

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“…Within Canada, eight primary care organizational attribute data collection tools were identified (Table ). Seven of these tools collected primary care organizational attribute information at a jurisdictional level within the provinces of Alberta [42,43], Ontario [11–13,44–47], Québec [48–54] and Nova Scotia [55].…”

Section: Resultsmentioning

confidence: 99%

Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings

Lukewich

Corbin

VanDenKerkhof

et al. 2014

Evaluation Clinical Practice

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Rationale, aims and objectives Given the increasing emphasis being placed on managing patients with chronic diseases within primary care, there is a need to better understand which primary care organizational attributes affect the quality of care that patients with chronic diseases receive. This study aimed to identify, summarize and compare data collection tools that describe and measure organizational attributes used within the primary care setting worldwide. Methods Systematic search and review methodology consisting of a comprehensive and exhaustive search that is based on a broad question to identify the best available evidence was employed. Results A total of 30 organizational attribute data collection tools that have been used within the primary care setting were identified. The tools varied with respect to overall focus and level of organizational detail captured, theoretical foundations, administration and completion methods, types of questions asked, and the extent to which psychometric property testing had been performed. The tools utilized within the Quality and Costs of Primary Care in Europe study and the Canadian Primary Health Care Practice-Based Surveys were the most recently developed tools. Furthermore, of the 30 tools reviewed, the Canadian Primary Health Care Practice-Based Surveys collected the most information on organizational attributes. Conclusions There is a need to collect primary care organizational attribute information at a national level to better understand factors affecting the quality of chronic disease prevention and management across a given country.

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Are Primary Healthcare Organizational Attributes Associated with Patient Self-Efficacy for Managing Chronic Disease?

Cited by 9 publications

References 28 publications

Characteristics of primary care practices associated with high quality of care

Characteristics of primary care practices associated with high quality of care

Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users’ and health professionals’ perceptions

Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings

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