Empanelment: A foundational component of primary health care

Abstract

Empanelment is a foundational strategy for building or improving primary health care systems and a critical pathway for achieving effective universal health coverage. However, there is little international guidance for defining empanelment or understanding how to implement empanelment systems in low- and middle-income countries. To fill this gap, a multi-country collaborative within the Joint Learning Network for Universal Health Coverage developed this empanelment overview, proposing a people-centered definition of empanelment that reflects the responsibility to proactively deliver primary care services to all individuals in a target population. This document, building on existing literature on empanelment and representing input from 10 countries, establishes standard concepts of empanelment and describes why and how empanelment is used. Finally, it identifies key domains that may influence effective empanelment and that must be considered in deciding how empanelment can be implemented. This document is designed to be a useful resource for health policymakers, planners and decision-makers in ministries of health, as well as front line providers of primary care service delivery who are working to ensure quality people-centered primary care to everyone everywhere.

Early Implementation of a Patient-centered Medical Home in Singapore: a Qualitative Study Using Theories on Diffusion of Innovations

“…ComSA-PCMH practices empanelment, which enables the provision of rst-contact access, as well as continuous, coordinated and comprehensive care (39). However, empanelment was a novelty in the PC sector in Singapore, thus was not commonly understood.…”

“…ComSA-PCMH was established to serve a target population of Whampoa residents aged 40 or above identi ed to have complex medical and psychosocial needs. Such targeted service is called "empanelment", which is de ned as "a continuous, iterative set of processes that identi es and assigns populations to facilities, care teams, or providers who have a responsibility to know their assigned population and to proactively deliver coordinated primary health care towards achieving universal health coverage" (39). It has two distinct but integrated care components, comprising a PC clinic and home-based care management (CM) service.…”

Early Implementation of a Patient-Centered Medical Home in Singapore: A Qualitative Study Using Theory on Diffusion of Innovations

“…ComSA-PCMH was established to serve a target population of Whampoa residents aged 40 or above identified to have complex medical and psychosocial needs. Such targeted service is called “empanelment”, which is defined as “a continuous, iterative set of processes that identifies and assigns populations to facilities, care teams, or providers who have a responsibility to know their assigned population and to proactively deliver coordinated primary health care towards achieving universal health coverage” [ 41 ]. It has two distinct but integrated care components, i.e., a PC clinic and home-based care management (CM) service.…”

A Comparative Case Study: Does the Organization of Primary Health Care in Brazil and Turkey Contribute to Reducing Disparities in Access to Care?

“…13,38 Policymakers can also consider using different patient impanelment strategies (the process by which individuals are identified and assigned to health care providers). 39,40 By enabling providers to actively monitor and manage the health care needs of patients in their care, 41 patient impanelment offers an important means for improving continuity of care and the use of PHC services, while promoting accountability, especially in communities where certain population groups lack access to a regular source of care. 39 Patient impanelment has been linked to improvements in the effectiveness of service delivery 13 by reducing the need for hospitalizations for ambulatory care-sensitive conditions and emergency department visits.…”

“…39,40 By enabling providers to actively monitor and manage the health care needs of patients in their care, 41 patient impanelment offers an important means for improving continuity of care and the use of PHC services, while promoting accountability, especially in communities where certain population groups lack access to a regular source of care. 39 Patient impanelment has been linked to improvements in the effectiveness of service delivery 13 by reducing the need for hospitalizations for ambulatory care-sensitive conditions and emergency department visits. 42 Changing the organization of PHC systems does not always yield observable improvements in health system performance.…”