Continuity and care coordination of primary health care: a scoping review

Abstract

Background Healthcare coordination and continuity of care conceptualize all care providers and organizations involved in health care to ensure the right care at the right time. However, systematic evidence synthesis is lacking in the care coordination of health services. This scoping review synthesizes evidence on different levels of care coordination of primary health care (PHC) and primary care. Methods We conducted a scoping review of published evidence on healthcare coordination. PubMed, Scopus, Embase, CINAHL, Cochrane, PsycINFO, Web of Science and Google Scholar were searched until 30 November 2022 for studies that describe care coordination/continuity of care in PHC and primary care. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines to select studies. We analysed data using a thematic analysis approach and explained themes adopting a multilevel (individual, organizational, and system) analytical framework. Results A total of 56 studies were included in the review. Most studies were from upper-middle-income or high-income countries, primarily focusing on continuity/care coordination in primary care. Ten themes were identified in care coordination in PHC/primary care. Four themes under care coordination at the individual level were the continuity of services, linkage at different stages of health conditions (from health promotion to rehabilitation), health care from a life-course (conception to elderly), and care coordination of health services at places (family to hospitals). Five themes under organizational level care coordination included interprofessional, multidisciplinary services, community collaboration, integrated care, and information in care coordination. Finally, a theme under system-level care coordination was related to service management involving multisectoral coordination within and beyond health systems. Conclusions Continuity and coordination of care involve healthcare provisions from family to health facility throughout the life-course to provide a range of services. Several issues could influence multilevel care coordination, including at the individual (services or users), organizational (providers), and system (departments and sectors) levels. Health systems should focus on care coordination, ensuring types of care per the healthcare needs at different stages of health conditions by a multidisciplinary team. Coordinating multiple technical and supporting stakeholders and sectors within and beyond health sector is also vital for the continuity of care especially in resource-limited health systems and settings.

Deprescribing medications among patients with multiple prescribers: A socioecological model

“…This may be more likely in healthcare systems that have not adopted electronic health records or strategies to facilitate the transfer of relevant health information between providers at different locations. An international scoping review of continuity of care and care coordination found numerous barriers to effective care coordination between hospitals and primary care, including difficulty planning timely follow‐up appointments, lack of awareness of patient hospitalizations by PCPs, not having hospital records or discharge summaries at follow‐up appointments, and low levels of information continuity between healthcare settings which can be hampered by barriers related to data ownership and confidentiality 39 . Notably, despite the mandated adoption of electronic health records in the US, there is often minimal communication and coordination about medication changes between health systems, settings with different acuity of care (e.g., inpatient and outpatient), different clinical specialties (including primary care), and community pharmacies 40 …”