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On your own or as part of a team – what are the keys to success in Primary Healthcare?
Researchers: Orna Baron-Epel1, Landsberger Daniel2
- University of Haifa
- Maccabi Health Services
Background: Various types of primary care have been developed in order to provide effective ways to tackle the rising burden of chronic illnesses. To date, the various models were not compared, and health outcomes have rarely been examined.
Objectives: To examine the association between the various primary care models and achieving clinical quality, according to the National Program for Quality Indicators.
Method: A quazi-experimental study compared between an Independent Physician Model and multidisciplinary models: Teamwork and Collaboration, implemented by Maccabi Health Services (MHS).
The study consisted of two phases. First, assessment of health professionals (qualitative and quantitative) was performed using questioners and in-depth interviews. Second, statistical multi-leveled analysis of the type of primary care models and their association with health outcomes (vaccinations, check-ups, medical treatment, risk-factors levels and health education) was examined, using data from MHS computerized databases.
The study consisted of two phases. First, assessment of health professionals (qualitative and quantitative) was performed using questioners and in-depth interviews. Second, statistical multi-leveled analysis of the type of primary care models and their association with health outcomes (vaccinations, check-ups, medical treatment, risk-factors levels and health education) was examined, using data from MHS computerized databases.
Findings: Phase 1: The perception of professional's role dictates conduct in the clinics. Training and implementation levels of health education were higher in the multi-disciplinary models.
Phase 2: better health outcomes were identified in the Multi-disciplinary models.
Affiliation with multi-disciplinary clinics canceled the effect of socio-economic status and morbidity on adherence to check-ups, risk factors control and group participation.
In Large and medium sized clinics, levels of adherence to check-ups, risk factors control and group participation were higher.
Group registration was associated with better adherence to check-ups, screening, vaccinations and risk factors control.
Phase 2: better health outcomes were identified in the Multi-disciplinary models.
Affiliation with multi-disciplinary clinics canceled the effect of socio-economic status and morbidity on adherence to check-ups, risk factors control and group participation.
In Large and medium sized clinics, levels of adherence to check-ups, risk factors control and group participation were higher.
Group registration was associated with better adherence to check-ups, screening, vaccinations and risk factors control.
Conclusions: Multi-disciplinary models are associated with better health outcomes compared with the Independent Physician model.
Personal and organizational factors were also influential.
Personal and organizational factors were also influential.
Recommendations: Multi-disciplinary models may improve the populations' health.
Research number: R/24/2015
Research end date: 03/2018