Disentangling the Linkage of Primary Care Features to Patient Outcomes: A Review of Current Literature, Data Sources, and Measurement Needs

Abstract

Primary care plays a central role in the provision of health care, and is an organizing feature for health care delivery systems in most Western industrialized democracies. For a variety of reasons, however, the practice of primary care has been in decline in the U.S. This paper reviews key primary care concepts and their definitions, notes the increasingly complex interplay between primary care and the broader health care system, and offers research priorities to support future measurement, delivery and understanding of the role of primary care features on health care costs and quality.

Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study

“…Continuity of care with the same primary care clinician or practice over time has been associated with improved outcomes, including increased use of preventive services, better adherence to clinician recommendations, and lower total costs, although it has not been well studied in the context of maternal and child care delivery. 17 Evidence also suggests that mothers regularly attend their child's health care visits even if they do not seek care for themselves between pregnancies. 18,19 Previous studies have found that most mothers accept inquiry about health behaviors and referral for services at well-child visits.…”

Barriers to Choosing Wisely® in Primary Care: It’s Not Just About “the Money”

“…Patients considering CW recommendations emphasize the importance of a trusting relationship with the clinician, 7 and past studies of primary care demonstrate greater patient adherence to evidence-based recommendations when clinicians have a continuity relationship with patients. 8 However, such interpersonal continuity can vary considerably across primary care settings and encounters, which may alter the resources required to support patient acceptance of clinician recommendations in circumstances like these. A practice environment characterized by direct patient access to heavily marketed specialized centers may also be perceived by primary care clinicians to create patient expectations for certain services (like early advanced imaging for back pain).…”

Primary health care and universal health coverage: Achieving health for all

“…According to the World Health Report 2008: Primary Health Care (Now More Than Ever), primary health care can provide such a framework [6]. Patientcenteredness, comprehensiveness, integration and continuity of care are among primary health care's core features that have been repeatedly associated with better health outcomes, cost-effectiveness and higher user satisfaction [7,8]. However, it is recognised that primary care can offer much more than reduction of costs.…”