Table 2 Examples of the need to modify or develop PHC indicators: Inputs, Activities, Outputs
From: Enhancing measurement of primary health care indicators using an equity lens: An ethnographic study
PHC Logic Model | Examples from Pan-Canadian PHC Indicators (CIHI) | Study recommendations |
|---|---|---|
Input-Fiscal Resources | Objective: Provider payment methods that align with primary health care goals -PHC provider remuneration method -Average PHC provider income by funding model | Recommended Areas for Development of New Indicators -source(s) of funding -stability of funding |
Activity-Management level | Objective: To increase the number of PHC organizations who are responsible for providing planned services to a defined population: - PHC outreach services for vulnerable/special needs populations - Specialized programs for PHC vulnerable/special needs populations - Support for PHC vulnerable/special needs populations | Suggested Modification of Monitoring and Performance Indicators -Increase operability of currently available indicators to elucidate how PHC organizations can successfully deliver PHC services to vulnerable/special needs populations: -weekly team meetings of all clinic staff -collaboration and input from all clinic staff on care plan and management -number and type of places where care is delivered (e.g., clinic, home, street) -supportive environment where management rewards respectful interactions between all staff -supportive environment where patients feel comfortable |
Activity-Clinic level | Objective: To facilitate integration and coordination between health care institutions and health care providers to achieve informational and management continuity of patient care -Use of standardized tools for coordinating PHC -Collaborative care with other health care organizations -intersectoral collaboration -PHC team effectiveness | -number of patients receiving assistance for housing, food stamps, obtaining welfare -number of patients who have charts with trauma history recorded -Use of appropriate skill mix (e.g., physician, nurse, social worker, drug and alcohol counselor, elder) to provide complex PHC -Support for individual staff to develop and enhance respectful communication amongst staff and patients (e.g. time for critical self-reflection, opportunities for providing/receiving support feedback) |
Output-quality: Whole Person Care | Objective: To enhance the provision of whole-person comprehensive PHC services, including episodic and ongoing care with increased emphasis on health promotion, disease and injury prevention and management of common mental health conditions and chronic diseases: - Scope of PHC services - Health risk screening - Smoking cessation advice in PHC - Alcohol consumption advice in PHC - PHC initiatives for reducing health risks - Smoking rate - Fruit and vegetable consumption rate - Overweight rate - Heavy drinking rate - PHC resources for self-management of chronic conditions - Time with PHC provider - Client/patient participation in PHC treatment planning | Recommended Areas for Development of New Indicators - Assessment of individual's social environment -Assessment of individual's emotional health -Treating individual as a person (not a case or a disease) |