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Table 5 Characteristics of included studies (state/national intervention): Access dimension and outcome

From: Organizational interventions improving access to community-based primary health care for vulnerable populations: a scoping review

Study ID Dimensions of access of primary care services Dimensions of ability of consumers Outcomes
Approachability Acceptability Availability and Accommodation Affordability Appropriateness Ability to (1) Perceive; (2) Seek; (3) Reach; (4) Pay; (5) Engage Avoidable hospitalization Avoidable ED admission Unmet health care needs
Clinical multidisciplinary teams
 McDermott, 2004 [62] Implementation of diabetes registers, recall and reminder systems Delivery of services by the local indigenous health workers Delivery of the diabetes health services in the remote indigenous communities.     - 32 % reduction of hospitalization for diabetes-related conditions (p = 0.012);
- Decline of hospitalization from 25 % to 20 % over 3 years (2004).
  
Continuity of care via case management
 Dorr, 2008 [49] Patients referred by PCPs     Individualized care plans were developed according to the needs Ability to engage: patients were actively involved in the development of care plan Decrease (p = 0.55) By 2 years of follow-up: increase (p = 0.02 for all patients, p = 0.37 for patients with diabetes)  
 Gravelle, 2007 [60] Patients identified based on the age and frequency of emergency use    No additional payment Individualized care plans were developed according to the needs Ability to engage: patients were actively involved in the development of care plan   No effect (p = 0.14)  
 Landi, 2001 [63] Patients referred by PCPs   Integration of all the community-based services and services provided by the health agency/municipality into one “single enter” center   Individualized care plans were developed according to the needs Ability to engage: patients were actively involved in the development of care plan Decrease by 18 % (p < 0.001)   
Institution incentives
 Addink, 2011 [58]          No large improvement in
- satisfaction with phone access (2.96 % of increase);
- ability to get appointment within 48 h (1.12 % of increase);
- ability to book an appointment in advance (4.42 % of increase);
- ability to see a particular PCP (1.21 % of increase);
- satisfaction with opening hours (1.25 % of decrease).
 Tan, 2012 [66] The whole population is eligible Services were developed with active partnership of ethnic communities (iwi)   Depending on the income level: very low fees (free to $15 for all ages), low fees ($16–$30), medium ($31–$39), high ($40 or above).   Ability to engage: representatives of local ethnic communities were actively involved in the development of care programs 4 % decrease over five years Enrolled patients contributed to 0.2 % increase in comparison to 1.7 % increase of not enrolled (overall steady increase of 2 % per year).  
Capitation
 Davidoff, 2008 [25]     No payment (Medicaid and State Children’s Health insurance Program)   Ability to pay: no charge as these managed care programs are funded by the State.   Slight reduction (3.8 % points) (p = NS). No effect on unmet medical care needs