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Advancing team-based primary health care: a comparative analysis of policies in western Canada.

Abstract：

BACKGROUND:We analyzed and compared primary health care (PHC) policies in British Columbia, Alberta and Saskatchewan to understand how they inform the design and implementation of team-based primary health care service delivery. The goal was to develop policy imperatives that can advance team-based PHC in Canada. METHODS:We conducted comparative case studies (n = 3). The policy analysis included: Context review: We reviewed relevant information (2007 to 2014) from databases and websites. Policy review and comparative analysis: We compared and contrasted publically available PHC policies. Key informant interviews: Key informants (n = 30) validated narratives prepared from the comparative analysis by offering contextual information on potential policy imperatives. Advisory group and roundtable: An expert advisory group guided this work and a key stakeholder roundtable event guided prioritization of policy imperatives. RESULTS:The concept of team-based PHC varies widely across and within the three provinces. We noted policy gaps related to team configuration, leadership, scope of practice, role clarity and financing of team-based care; few policies speak explicitly to monitoring and evaluation of team-based PHC. We prioritized four policy imperatives: (1) alignment of goals and policies at different system levels; (2) investment of resources for system change; (3) compensation models for all members of the team; and (4) accountability through collaborative practice metrics. CONCLUSIONS:Policies supporting team-based PHC have been slow to emerge, lacking a systematic and coordinated approach. Greater alignment with specific consideration of financing, reimbursement, implementation mechanisms and performance monitoring could accelerate systemic transformation by removing some well-known barriers to team-based care.

journal_name

BMC Health Serv Res

journal_title

BMC health services research

authors

Suter E,Mallinson S,Misfeldt R,Boakye O,Nasmith L,Wong ST

doi

10.1186/s12913-017-2439-1

subject

Has Abstract

pub_date

2017-07-17 00:00:00

pages

493

issue

1

issn

1472-6963

pii

10.1186/s12913-017-2439-1

journal_volume

17

pub_type

杂志文章

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