Is the co-location of GPs in primary care centres associated with a higher patient satisfaction? Evidence from a population survey in Italy

Bonciani, Manila; Barsanti, Sara; Murante, Anna Maria

doi:10.1186/s12913-017-2187-2

Cited by 21 publications

(30 citation statements)

References 55 publications

(58 reference statements)

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“…An alternative interpretation is that the observed differences in GP outcomes due to co-location may not yet have led to effective teamwork, due to the challenges related to inter-professional collaboration, such as difficulties in overcoming barriers and conflicts or defining roles and common objectives [ 34 , 41 , 45 ]. In fact, another study underlined the importance of a multidisciplinary team combined with GP co-location in increasing patient satisfaction [ 6 ]. Both interpretations are in line with the discrepancy of perspectives between providers and users that Lloyd and Wait highlighted [ 38 ] in providing a definition of integrated care.…”

Section: Discussionmentioning

confidence: 99%

“…This co-location may also minimize fragmentation among the various providers involved in the patient care pathway, by reducing duplication and ensuring more responsiveness to users [ 9 , 24 , 40 ]. This is particularly important for patients with chronic conditions or multi-morbidity [ 6 , 55 ], who require a comprehensive approach and the involvement of different professionals in the provision of integrated care [ 20 , 54 ]. The co-location of services and professionals in primary care can facilitate integration in the delivery of healthcare, prevention and rehabilitation services [ 48 ].…”

Section: Introductionmentioning

confidence: 99%

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The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries

Bonciani

Schäfer

Barsanti

et al. 2018

BMC Health Serv Res

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BackgroundThere is no clear evidence as to whether the co-location of primary care professionals in the same facility positively influences their way of working and the quality of healthcare as perceived by patients. The aim of this study was to identify the relationships between general practitioner (GP) co-location with other GPs and/or other professionals and the GP outcomes and patients’ experiences.MethodsWe wanted to test whether GP co-location is related to a broader range of services provided, the use of clinical governance tools and inter-professional collaboration, and whether the patients of co-located GPs perceive a better quality of care in terms of accessibility, comprehensiveness and continuity of care with their GPs. The source of data was the QUALICOPC study (Quality and Costs of Primary Care in Europe), which involved surveys of GPs and their patients in 34 countries, mostly in Europe. In order to study the relationships between GP co-location and both GPs’ outcomes and patients’ experience, multilevel linear regression analysis was carried out.ResultsThe GP questionnaire was filled in by 7183 GPs and the patient experience questionnaire by 61,931 patients. Being co-located with at least one other professional is the most common situation of the GPs involved in the study. Compared with single-handed GP practices, GP co-location are positively associated with the GP outcomes. Considering the patients’ perspective, comprehensiveness of care has the strongest negative relationship of GP co-location of all the dimensions of patient experiences analysed.ConclusionsThe paper highlights that GP mono- and multi-disciplinary co-location is related to positive outcomes at a GP level, such as a broader provision of technical procedures, increased collaboration among different providers and wider coordination with secondary care. However, GP co-location, particularly in a multidisciplinary setting, is related to less positive patient experiences, especially in countries with health systems characterised by a weak primary care structure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries

Bonciani

Schäfer

Barsanti

et al. 2018

BMC Health Serv Res

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“…Co-location of professionals may facilitate improved care for frequent users and patients with complex needs [6364]. The study by Graue described HCNs who received diverging advice from different physicians located in general practices and hospitals that left nurses feeling unsupported in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

A Scoping Review of Facilitators of Multi-Professional Collaboration in Primary Care

Sørensen¹,

Stenberg²,

Garnweidner-Holme

2018

Int J Integr Care

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Introduction:Multi-professional collaboration (MPC) is essential for the delivery of effective and comprehensive care services. As in other European countries, primary care in Norway is challenged by altered patient values and the increased expectations of health administrations to participate in team-based care. This scoping review reports on the organisational, processual, relational and contextual facilitators of collaboration between general practitioners (GP) and other healthcare professionals (HCPs) in primary care.Methods:A systematic search in specialist and Scandinavian databases retrieved 707 citations. Following the inclusion criteria, nineteen studies were considered eligible and examined according to Arksey and O’Malley’s methodological framework for scoping reviews. The retrieved literature was analysed employing a content analysis approach. A group of stakeholders commented on study findings to enhance study validity.Results:Primary care research into MPC is immature and emerging in Norway. Our analysis showed that introducing common procedures for documentation and handling of patient data, knowledge sharing, and establishing local specialised multi-professional teams, facilitates MPC. The results indicate that advancements in work practices benefit from an initial system-level foundation with focus on local management and MPC leadership. Further, our results show that it is preferable to enhance collaborative skills before introducing new professional teams, roles and responsibilities. Investing in professional relations could build trust, respect and continuity. In this respect, sufficient time must be allocated during the working day for professionals to share reflections and engage in mutual learning.Conclusion:There is a paucity of research concerning the application and management of MPC in Norwegian primary care. The work practices and relations between professionals, primary care institutions and stakeholders on a macro level is inadequate. Health care is a complex system in which HCPs need managerial support to harvest the untapped benefits of MPC in primary care. As international research demonstrates, local managers must be supported with infrastructure on a macro level to understand the embedding of practice and look at what professionals actually do and how they work.

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“…The adoption of the CCM strategies has never been mandatory for GPs, who have voluntary joined the new model of care. GPs receive an incentive if they enrol patients in the CCM and meet related targets [ 36 , 37 ].…”

Section: Methodsmentioning

confidence: 99%

Reported experience of patients with single or multiple chronic diseases: empirical evidence from Italy

Vainieri

Quercioli

Maccari

et al. 2018

BMC Health Serv Res

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BackgroundMore and more countries have been implementing chronic care programs, such as the Chronic Care Model (CCM) to manage non-acute conditions of diseases in a more effective and less expensive way. Often, these programs aim to provide care for single conditions instead of the sum of diseases. This paper analyzes the satisfaction and better management of single and multiple chronic patients with the core elements of chronic care programs in Siena, Italy. In addition, the paper also considers whether the CCM introduced in Siena has any influence on satisfaction and better self-management.MethodsSurvey data from patients with single chronic (N = 500) and multiple chronic diseases (N = 454), assisted by the Local Health Authority in Siena (Tuscany, Italy), were considered for the analysis. Variables on education, monitoring system, proactivity, relational continuity, model of care (CCM versus no CCM) and patient demographics were used to detect which strategies are associated with a higher patient-reported ability to better self-manage the disease and overall patient satisfaction. Logistic and ordinary logistic models were executed on data related to patients with both single and multiple chronic diseases.ResultsThe results showed that monitoring was the sole strategy associated with overall satisfaction and better self-management for both single and multiple chronic patients. Relational continuity also showed a significant positive association with better self-management perception for both patient groups, but had a positive association with patient satisfaction only for single chronic patients. Enrolment in the CCM was not associated with both overall satisfaction and better management for the two patient groups.ConclusionsStrategies that are significantly associated with satisfaction and perception of better disease self-management were the same for both single and multiple chronic patients. The delivery of care based on the Siena CCM does not seem to make a difference in the perception of better self-management and overall satisfaction for all the patients. Other concurrent strategies implemented by the regional government in Tuscany on primary care monitoring and health promotion could partially explain why CCM does not have a significant influence.

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Is the co-location of GPs in primary care centres associated with a higher patient satisfaction? Evidence from a population survey in Italy

Cited by 21 publications

References 55 publications

The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries

The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries

A Scoping Review of Facilitators of Multi-Professional Collaboration in Primary Care

Reported experience of patients with single or multiple chronic diseases: empirical evidence from Italy

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