Formal Professional Relationships Between General Practitioners and Specialists in Shared Care: Possible Associations with Patient Health and Pharmacy Costs

Lublóy, Ágnes; Keresztúri, Judit Lilla; Benedek, Gábor

doi:10.1007/s40258-015-0206-1

Cited by 12 publications

(13 citation statements)

References 35 publications

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“…The studies included in this review spanned the USA, Canada, Europe (UK and Netherlands), Asia (China), and the Middle East (Oman). Methodologically, these studies were principally qualitative ( 7 , 35 – 38 , 40 , 41 , 44 , 47 , 49 , 51 , 54 – 56 ), with a few using mixed methods ( 6 , 39 , 42 , 45 , 48 , 50 , 53 ) and two randomized control trials ( 28 , 46 ). Furthermore, two reviews ( 24 , 52 ) were included about diabetes that provided some insights into the organizational context necessary for team-based care, although they were not specifically about organizational conditions.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the research focused on identifying the factors that were present in practices which resulted in TBC for diabetes ( 24 ). Therefore, there is practically no empirical data on the effect of the organizational factors cited on TBC for diabetes ( 6 , 7 , 26 , 35 – 37 , 39 , 43 – 46 , 48 , 51 , 53 , 57 , 58 ). It is important to note that the three studies that did not see improved outcomes had a focus on Structure and Processes (the only unifying factor) and none focused on Governance ( 28 , 47 , 54 ).…”

Section: Resultsmentioning

confidence: 99%

“…Potential team members cited in the literature include Specialists, Registered Nurses, Nurse Practitioners, Nutritionist, Physical Therapist, Mental Health Providers, Diabetologists, Pharmacists, Community Health Workers, Care Managers, Health Coaches, Health Managers, Diabetes Nurses, and Medical Assistants ( 40 , 47 , 49 , 51 , 54 , 55 ). At the micro-level, the human resource availability and stability were cited as important factors ( 36 , 37 , 39 , 45 , 48 ).…”

Section: Resultsmentioning

confidence: 99%

“…At a meso level WC factors include leadership, power dynamics, and morale (40,44,47,49). Workplace culture is represented at the micro level through a broad spectrum of factors in addition to those cited above, including trust, team climate, strength of relationships, motivation/will, role perception, perceived benefit, flexibility for implementation, and shared between team members (36,39,46,48).…”

Section: Workplace Culture (Wc)mentioning

confidence: 99%

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Organizational Conditions That Impact the Implementation of Effective Team-Based Models for the Treatment of Diabetes for Low Income Patients—A Scoping Review

et al. 2020

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Background: Team-based care models (TBC) have demonstrated effectiveness to improve health outcomes for vulnerable diabetes patients but have proven difficult to implement in low income settings. Organizational conditions have been identified as influential on the implementation of TBC. This scoping review aims to answer the question: What is known from the scientific literature about how organizational conditions enable or inhibit TBC for diabetic patients in primary care settings, particularly settings that serve low-income patients? Methods: A scoping review study design was selected to identify key concepts and research gaps in the literature related to the impact of organizational conditions on TBC. Twenty-six articles were finally selected and included in this review. This scoping review was carried out following a directed content analysis approach. Results: While it is assumed that trained health professionals from diverse disciplines working in a common setting will sort it out and work as a team, co-location, and health professions education alone do not improve patient outcomes for diabetic patients. Health system, organization, and/or team level factors affect the way in which members of a care team, including patients and caregivers, collaborate to improve health outcomes. Organizational factors span across seven categories: governance and policies, structure and process, workplace culture, resources, team skills and knowledge, financial implications, and technology. These organizational factors are cited throughout the literature as important to TBC, however, research on the organizational conditions that enable and inhibit TBC for diabetic patients is extremely limited. Dispersed organizational factors are cited throughout the literature, but only one study specifically assesses the effect of organizational factors on TBC. Thematic analysis was used to categorize organizational factors in the literature about TBC and diabetes and a framework for analysis and definitions for key terms is presented. Conclusions: The review identified significant gaps in the literature relating to the study of organizational conditions that enable or inhibit TBC for low-income patients with diabetes. Efforts need to be carried out to establish unifying terminology and frameworks across the field to help explain the relationship between organizational conditions and TBC for diabetes. Gaps in the literature include research be based on organizational theories, research carried out in low-income settings and low and middle income countries, research explaining the difference between the organizational conditions that impact the implementation of TBC vs. maintaining or sustaining TBC and the interaction between organizational factors at the micro, meso and macro level and their impact on TBC. Few studies include information on patient outcomes, and fewer include information on low income settings. Further research is necessary on th...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Workplace Culture (Wc)mentioning

confidence: 99%

See 2 more Smart Citations

Organizational Conditions That Impact the Implementation of Effective Team-Based Models for the Treatment of Diabetes for Low Income Patients—A Scoping Review

et al. 2020

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“…Earlier work addressed the associations of patient-sharing relations with health care expenditure, utilization, quality of care [10], interacting drug prescriptions [11], as well as medication costs and patient health status [12]. To our knowledge, patient-sharing networks (PSNs) have not yet been analyzed to gain insights for HIE solutions, except for an earlier study we performed on the use of the Austrian electronic health record system ELGA (acronym for German Elektronische Gesundheitsakte ) [13].…”

Section: Introductionmentioning

confidence: 99%

Patient-Sharing Relations in the Treatment of Diabetes and Their Implications for Health Information Exchange: Claims-Based Analysis

Duftschmid¹,

Rinner²,

Sauter³

et al. 2019

JMIR Med Inform

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Background Health information exchange (HIE) among care providers who cooperate in the treatment of patients with diabetes mellitus (DM) has been rated as an important aspect of successful care. Patient-sharing relations among care providers permit inferences about corresponding information-sharing relations. Objectives This study aimed to obtain information for an effective HIE platform design to be used in DM care by analyzing patient-sharing relations among various types of care providers (ToCPs), such as hospitals, pharmacies, and different outpatient specialists, within a nationwide claims dataset of Austrian DM patients. We focus on 2 parameters derived from patient-sharing networks: (1) the principal HIE partners of the different ToCPs involved in the treatment of DM and (2) the required participation rate of ToCPs in HIE platforms for the purpose of effective communication. Methods The claims data of 7.9 million Austrian patients from 2006 to 2007 served as our data source. DM patients were identified by their medication. We established metrics for the quantification of our 2 parameters of interest. The principal HIE partners were derived from the portions of a care provider’s patient-sharing relations with different ToCPs. For the required participation rate of ToCPs in an HIE platform, we determine the concentration of patient-sharing relations among ToCPs. Our corresponding metrics are derived in analogy from existing work for the quantification of the continuity of care. Results We identified 324,703 DM patients treated by 12,226 care providers; the latter were members of 16 ToCPs. On the basis of their score for 2 of our parameters, we categorized the ToCPs into low , medium , and high . For the most important HIE partner parameter, pharmacies, general practitioners (GPs), and laboratories were the representatives of the top group, that is, our care providers shared the highest numbers of DM patients with these ToCPs. For the required participation rate of type of care provide (ToCP) in HIE platform parameter, the concentration of DM patient-sharing relations with a ToCP tended to be inversely related to the ToCPs member count. Conclusions We conclude that GPs, pharmacies, and laboratories should be core members of any HIE platform that supports DM care, as they are the most important DM patient-sharing partners. We further conclude that, for implementing HIE with ToCPs who have many members (in Austria, particularly GPs and pharmacies), an HIE solution with high participation rates from these ToCPs (ideally a nationwide HIE platform with obligatory participation of the concerned ToCPs) seems essential. This will raise the probability of HIE being achieved with any care provider of these ToCPs. As chronic diseases are rising because of a...

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Socio-economic factors affecting child mortality in hill tracts of chattogram division, Bangladesh

Hossain,

Ara,

Alamgir

et al. 2024

GeoJournal

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Formal Professional Relationships Between General Practitioners and Specialists in Shared Care: Possible Associations with Patient Health and Pharmacy Costs

Abstract: Overall drug expenditure may be reduced by lowering patient care fragmentation through channelling a GP's patients to a small number of SPs.

Cited by 12 publications

References 35 publications

Organizational Conditions That Impact the Implementation of Effective Team-Based Models for the Treatment of Diabetes for Low Income Patients—A Scoping Review

Organizational Conditions That Impact the Implementation of Effective Team-Based Models for the Treatment of Diabetes for Low Income Patients—A Scoping Review

Patient-Sharing Relations in the Treatment of Diabetes and Their Implications for Health Information Exchange: Claims-Based Analysis

Socio-economic factors affecting child mortality in hill tracts of chattogram division, Bangladesh

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