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Article
Publication date: 12 June 2009

Brian C. Martin, Leiyu Shi and Ryan D. Ward

The purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care.

Abstract

Purpose

The purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care.

Design/methodology/approach

The 2003 Medical Expenditure Panel Survey Household Component (MEPS) was used. Four distinguishing primary care attributes and selected measures were operationalized primarily from a sample subset that identified a usual source of care (USC): accessibility to USC; interface between primary care and specialist services; treatment decisions; and preventive services received from the USC. Bivariate and multivariate results are reported.

Findings

Adjusting for covariates, the following items remained statistically significant: race – choosing primary care physician as USC, USC having office hours, and going to USC for new health problems; gender – choosing primary care physician as USC and USC having office hours; and language – lack of difficulty contacting the USC after hours. However, these items appear to be isolated cases rather than indicators that concordance plays a key role in determining primary care quality. Language barriers/communication issues are the only areas where improvement appears warranted.

Research limitations/implications

While the study has strong accessibility and interpersonal relationship measures, service coordination and comprehensiveness indicators are limited. The analyses' cross‐sectional nature also poses a problem in drawing causal relationships and conclusive findings. Finally, sample size limitations preclude stratified analyses across racial/ethnic groups, an important consideration as the relationships between concordance and quality may vary across groups.

Practical implications

This study indicates that more research is needed in this area to determine future resource allocation and policy direction.

Originality/value

The unique contribution of the study is to suggest that race and gender concordance may not accurately predict primary health care quality.

Details

International Journal of Health Care Quality Assurance, vol. 22 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 January 2006

Debbie Wall, Clare Gerada, Maurice Conlon, Sharon Ombler‐Spain and Lucy Warner

To report on the clinical governance work of the NHS Clinical Governance Support Team's, Primary Care Team.

Abstract

Purpose

To report on the clinical governance work of the NHS Clinical Governance Support Team's, Primary Care Team.

Design/methodology/approach

The review describes the formation of the NHS Clinical Governance Support Team's Primary Care Team and the development of a range of national clinical governance activities, drawing on a case study example.

Findings

The Team have been developing appraisal, and revalidation for general practitioners across the UK, supporting front‐line staff in primary care to improve patient experience by embedding principles of clinical governance into day‐to‐day practice, and are providing an online education and training programme to develop primary care managers. It has established links, and worked collaboratively with a range of partners in its activities.

Originality/value

The article provides a summary of the activities of the Primary Care Team and its activities to date. An example of supporting clinical governance in primary care is given in a case study of facilitating an influenza vaccination campaign.

Details

Clinical Governance: An International Journal, vol. 11 no. 1
Type: Research Article
ISSN: 1477-7274

Keywords

Content available
Book part
Publication date: 6 May 2019

Mitch Blair, Mariana Miranda Autran Sampaio, Michael Rigby and Denise Alexander

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might…

Abstract

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

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Article
Publication date: 1 December 2003

Mary Nettleman and Leanne Yanni

In the USA, primary care is usually defined as comprehensive or coordinated care that is delivered by physicians practicing general internal medicine, family practice, or…

Abstract

In the USA, primary care is usually defined as comprehensive or coordinated care that is delivered by physicians practicing general internal medicine, family practice, or pediatrics. Obstetrics and gynecology is sometimes included under the auspices of primary care since many women, particularly during the childbearing years, rely on these physicians for preventive services. Over the last 50 years, the funding models for primary care in the USA have been inconsistent and fragmented, resulting in a complex and inadequate funding system. Although many countries have developed government‐sponsored, universal health care plans, the USA did not choose this route. Rather, significant change in US medicine has been the intended or unintended result of legislation and market‐forces.

Details

Clinical Governance: An International Journal, vol. 8 no. 4
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 1 March 2006

Brenda Leese, Phil Heywood, Victoria Allgar, Reg Walker, Aamra Darr and Ikhlaq Din

Primary care cancer lead clinicians (PCCLs) act strategically in primary care trusts (PCTs) in England to improve communication and understanding of cancer across primary

Abstract

Purpose

Primary care cancer lead clinicians (PCCLs) act strategically in primary care trusts (PCTs) in England to improve communication and understanding of cancer across primary and secondary care and provide a link between Cancer Networks and primary care. The aim is to evaluate the first three years of the initiative.

Design/methodology/approach

A postal questionnaire was sent to all PCT chief executives in all PCTs in England and some were passed on to other PCT managers for completion. The response rate was 61 per cent. PCT directors of public health were the largest group of respondents (29 per cent). Most (74 per cent) PCCLs were GPs and 22 per cent were nurses.

Findings

PCCLs were most likely to focus on palliative care and preventive services. Key achievements were identified as raising awareness of cancer, developing relationships and promoting primary care. The personal skills of the PCCLs were important as was support of colleagues at all levels. Lack of time was a major barrier to achievement, as was a lack of understanding of the role from others. Links with the Cancer Networks were being developed. About 85 per cent of managers wanted the role to continue.

Originality/value

The paper illustrates that PCCLs are at the forefront of improving cancer services in primary care. They are particularly important in view of the priority of reducing premature deaths and promotion of healthy lifestyles.

Details

Journal of Health Organization and Management, vol. 20 no. 2
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 1 June 1998

Ian Carruthers

THIS ARTICLE APPRAISES the Government's White Paper, The New NHS: Modern, Dependable, from the perspective of a health authority chief executive, outlining the context for…

Abstract

THIS ARTICLE APPRAISES the Government's White Paper, The New NHS: Modern, Dependable, from the perspective of a health authority chief executive, outlining the context for developing health care, the joint challenges of the White Paper and the Green Paper, Our Healthier Nation, the role and potential of primary care groups (in detail), the developing role of the health authority, and the agenda for shaping and improving the delivery of health and health services. It ends with an appraisal of particular implications for community care.

Details

Journal of Integrated Care, vol. 6 no. 3
Type: Research Article
ISSN: 1476-9018

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Abstract

Details

Mental Health Review Journal, vol. 9 no. 4
Type: Research Article
ISSN: 1361-9322

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Article
Publication date: 19 September 2016

Paul Lamarche and Lara Maillet

Improving the performance of health care organizations is now perceived as essential in order to better address the needs of the populations and respect their ability to…

Abstract

Purpose

Improving the performance of health care organizations is now perceived as essential in order to better address the needs of the populations and respect their ability to pay for the services. There is no consensus on what is performance. It is increasingly considered as the optimal execution of four functions that every organization must achieve in order to survive and develop: reach goals; adapt to its environment; produce goods or services and maintain values; and a satisfying organizational climate. There is also no consensus on strategies to improve this performance. The paper aims to discuss these issues.

Design/methodology/approach

This paper intends to analyze the performance of primary health care organizations from the perspective of Kauffman’s model. It mainly aims to understand the often contradictory, paradoxical and unexpected results that emerge from studies on this topic.

Findings

To do so, the first section briefly presents Kauffman’s model and lays forward its principal components. The second section presents three studies on the performance of primary organizations and brings out the contradictory, paradoxical and unexpected results they obtained. The third section explains these results in the light of Kauffman’s model.

Originality/value

Kauffman’s model helps give meaning to the results of researches on performance of primary health care organizations that were qualified as paradoxical or unexpected. The performance of primary health care organizations then cannot be understood by only taking into account the characteristics of these organizations. The complexity of the environments in which they operate must simultaneously be taken into account. This paper brings original development of an integrated view of the performance of organizations, their own characteristics and those of the local environment in which they operated.

Details

Journal of Health Organization and Management, vol. 30 no. 6
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 1 May 1993

Laurann Yen

Outlines the key issues which determine primary care services asappropriate to meet the needs of women users. These issues includetaking a particular interest in women and…

Abstract

Outlines the key issues which determine primary care services as appropriate to meet the needs of women users. These issues include taking a particular interest in women and their health; recognizing the importance of talking through health issues; not making their decisions for them; working with women to improve their health and recognizing the role of women as carers. Ends by noting the importance of primary care providing a diverse range of professional services, not just those identified as medical, and stresses again the importance of finding out what women want as the key prerequisite in the provision of an appropriate and relevant service.

Details

Journal of Management in Medicine, vol. 7 no. 5
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 1 October 2001

Anna Wood

Alcohol Concern decided to develop the service for several reasons. Primary care is the main contact people have with the health service ‐ in any year 70% of the…

Abstract

Alcohol Concern decided to develop the service for several reasons. Primary care is the main contact people have with the health service ‐ in any year 70% of the population will visit their general practitioner (GP). This makes primary care an ideal setting in which to detect and identify hazardous and dependent drinkers. While people experiencing difficulties or ill health because of their drinking will not necessarily attend a specialist alcohol service, they will probably visit their GP. Problem drinkers are known to consult their GPs twice as often as the average patient, the most common complaints are gastrointestinal, psychiatric and accidents (Heather & Kaner, in press).

Details

Drugs and Alcohol Today, vol. 1 no. 1
Type: Research Article
ISSN: 1745-9265

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