Can General Practitioners Be More Productive? The Impact of Teamwork and Cooperation with Nurses on GP Activities

Abstract

The integration of primary care organizations and interprofessional cooperation is encouraged in many countries to both improve the productive and allocative efficiency of care provision and address the unequal geographical distribution of general practitioners (GPs). In France, a pilot experiment promoted the vertical integration of and teamwork between GPs and nurses. This pilot experiment relied on the staffing and training of nurses; skill mixing, including the authorization to shift tasks from GPs to nurses; and new remuneration schemes. This article evaluates the overall impact of this pilot experiment over the period 2010-2017 on GP activities based on the following indicators: number of working days, patients seen at least once, patients registered, and visits delivered. We control for endogeneity and reduce selection bias by using a case-control design combining coarsened exact matching and difference-indifferences estimates on panel data. We find a small positive impact on the number of GP working days (þ1.2%) following enrollment and a more pronounced effect on the number of patients seen (þ7.55%) or registered (þ6.87%). However, we find no effect on the number of office and home visits. In this context, cooperation and teamwork between GPs and nurses seem to improve access to care for patients.

Sustainable human resource management the mediating role between work engagement and teamwork performance

“…Additionally, individual efforts must be aligned and coordinated by keeping team members together [ 118 ]. Finally, in relation to earnings, incentives can be provided to team members to perform better, and to maintain high levels of performance [ 119 ].…”

The impact of integrated care on health care utilization and costs in a socially deprived urban area in Germany: A difference‐in‐differences approach within an event‐study framework

“…In networks, providers are more strongly connected to one another, and the level of communication and coordination is higher, creating a positive working environment and fostering provider knowledge (Brown et al., 2016), which may result in a lower rate of physicians leaving their jobs or medicine altogether. On a smaller scale, access to primary care services can be improved by integrating providers and fostering teamwork within practices (Loussouarn et al., 2021). Thus, improving provider integration and job satisfaction can help lower the risk of shortages of professionals and ensure timely access to primary care, which in turn can reduce the number of emergency room visits and hospital admissions (Dolton & Pathania, 2016; Lippi Bruni et al., 2016).…”

Primærhelseteam – en mer teambasert fastlegetjeneste

“…Resultatet samsvarer med effektmålene for forsøket, som vektlegger kvalitetsforbedring, og ikke produktivitetsforbedring, på fastlegekontoret. I andre land, som for eksempel Frankrike, har man også observert at PHT bidrar til at legene i legekontor med PHT øker antallet pasienter uten å øke antallet tilbudte helsetjenester samt bidrar til å rekruttere både unge leger og leger til distriktene (Cassou et al, 2020;Loussouarn et al, 2021;Chevillard & Mousquès, 2021).…”