Specialist outreach clinics in primary care and rural hospital settings.

Abstract

This review supports the hypothesis that specialist outreach can improve access, outcomes and service use, especially when delivered as part of a multifaceted intervention. The benefits of simple outreach models in urban non-disadvantaged settings seem small. There is a need for good comparative studies of outreach in rural and disadvantaged settings where outreach may confer most benefit to access and health outcomes.

Clinical Management and Patient Outcomes Among Children and Adolescents Receiving Telemedicine Consultations for Obesity

“…[39][40][41][42][43][44] Behavioral interventions, nutritional counseling, and specialist referrals for pediatric obesity treatment have demonstrated variable short-term as well as long-term success with respect to weight loss or maintenance, depending on the content and intensity of intervention components. [45][46][47][48][49] Patients included in our study did demonstrate significant short-term improvements in diet, activity and weight status while patients were in treatment.…”

Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition

“…34 However, few studies have compared the cost of outreach with that of referral care, especially for rural communities, and we identifi ed no studies from low-income and middle-income countries.…”

“…For example, reviews that considered strategies' eff ects on equity and found promising pro-poor eff ects included those assessing expanded roles for community health workers, 10,11,16 task shifting, 31,32 the expanded use of private service providers, 23,34 strategies to reduce fi nancial barriers to access, 37 and strategies to increase humanresource availability and geographical access. 38,39,43 The other paper in this Series 6 builds on our recommendations and uses data from 15 low-income and middleincome countries to describe how a UNICEF modelling team developed and applied a model that simulates the potential eff ect of implementation of the most promising of these strategies in the context of an equity-based approach to health and nutrition programming.…”

Systematic review of integrated models of health care delivered at the primary–secondary interface: how effective is it and what determines effectiveness?

“…Gruen et al (2004) conducted a Cochrane review of outreach specialist clinics in primary care and rural settings. They showed that specialist outreach clinics in general practice improved access, but not health outcomes, but more in-depth collaboration with primary care did improve health outcomes, and more efficiently.…”