Effects of Quality on Outcomes in Primary Care: A Review of the Literature

Hsiao, Chun Ju; Boult, Chad

doi:10.1177/1062860608315643

Cited by 43 publications

(29 citation statements)

References 22 publications

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“…Three of the reviews focus on continuity of care and unscheduled secondary care 9 10 13. The reviews by Cabana and Hsiao looked at continuity of primary healthcare and unscheduled secondary care, but the data are over 5 years old.…”

Section: Discussionmentioning

confidence: 99%

Which features of primary care affect unscheduled secondary care use? A systematic review

et al. 2014

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ObjectivesTo conduct a systematic review to identify studies that describe factors and interventions at primary care practice level that impact on levels of utilisation of unscheduled secondary care.SettingObservational studies at primary care practice level.ParticipantsStudies included people of any age of either sex living in Organisation for Economic Co-operation and Development (OECD) countries with any health condition.Primary and secondary outcome measuresThe primary outcome measure was unscheduled secondary care as measured by emergency department attendance and emergency hospital admissions.Results48 papers were identified describing potential influencing features on emergency department visits (n=24 studies) and emergency admissions (n=22 studies). Patient factors associated with both outcomes were increased age, reduced socioeconomic status, lower educational attainment, chronic disease and multimorbidity. Features of primary care affecting unscheduled secondary care were more complex. Being able to see the same healthcare professional reduced unscheduled secondary care. Generally, better access was associated with reduced unscheduled care in the USA. Proximity to healthcare provision influenced patterns of use. Evidence relating to quality of care was limited and mixed.ConclusionsThe majority of research was from different healthcare systems and limited in the extent to which it can inform policy. However, there is evidence that continuity of care is associated with reduced emergency department attendance and emergency hospital admissions.

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Section: Discussionmentioning

confidence: 99%

Which features of primary care affect unscheduled secondary care use? A systematic review

et al. 2014

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“…The following factors may affect the extent to which continuity can be achieved: appointment wait time length, the insurance status of patient, and after-hours care availability [5]. A review of studies conducted in 6 countries regarding primary care quality suggests that better continuity may decrease hospitalizations and ED visits, lowering healthcare costs [121]. …”

Section: Methodsmentioning

confidence: 99%

The Impact of Primary Care: A Focused Review

2012

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Primary care serves as the cornerstone in a strong healthcare system. However, it has long been overlooked in the United States (USA), and an imbalance between specialty and primary care exists. The objective of this focused review paper is to identify research evidence on the value of primary care both in the USA and internationally, focusing on the importance of effective primary care services in delivering quality healthcare, improving health outcomes, and reducing disparities. Literature searches were performed in PubMed as well as “snowballing” based on the bibliographies of the retrieved articles. The areas reviewed included primary care definitions, primary care measurement, primary care practice, primary care and health, primary care and quality, primary care and cost, primary care and equity, primary care and health centers, and primary care and healthcare reform. In both developed and developing countries, primary care has been demonstrated to be associated with enhanced access to healthcare services, better health outcomes, and a decrease in hospitalization and use of emergency department visits. Primary care can also help counteract the negative impact of poor economic conditions on health.

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“…Patients' desire for emotional connection, reassurance, and a healing touch from their caregivers is well documented and longstanding [8,9]. Studies also demonstrate the effectiveness of the "therapeutic touch" of physicians who care and connect emotionally with their patients [10].…”

Section: Will Computers Take Over Medical Practice?mentioning

confidence: 99%

Does Health Information Technology Dehumanize Health Care?

Bailey

2011

AMA Journal of Ethics

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Effects of Quality on Outcomes in Primary Care: A Review of the Literature

Cited by 43 publications

References 22 publications

Which features of primary care affect unscheduled secondary care use? A systematic review

Which features of primary care affect unscheduled secondary care use? A systematic review

The Impact of Primary Care: A Focused Review

Does Health Information Technology Dehumanize Health Care?

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