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Table 2 Evidence of effects in NSW

From: Improving access to primary health care: a cross-case comparison based on an a priori program theory

Box Impact Evidence Source
10 Consumer ability to perceive need Not measured.  
11 Consumer ability to seek Significant improvement on score on ‘Ability to seek’ (Scale; 1 = Not easy at all to 4 = Very easy) increased from 3.2 to 3.4 p = 0.006. Patient surveys
12 Consumer ability to reach social/ community services There were no significant changes in responses to the question:
In the last 6 months, have you used a health or social service in the community for a specific health problem?
Patient surveys
22 GP knowledge, skills, confidence Significant improvement in scores out of 10 for confidence in providing care to patients with poorly managed diabetes from 7.99 to 9.27 (p = 0.03). Provider surveys
24 Clinic policies 9 of 10 practices reported the intervention changed the way the practice organizes access or care for patients with poorly managed Type 2 diabetes: a little (10%), quite a lot (50%) or a great deal (20%).
Some clinics had instituted recall systems as part of the study to help with recall of patients for health checks.
Practice surveys
31 Appropriate referrals GP self-report provided mixed results.
Significant increase in the frequency of someone from the clinic helping patients to make the appointment for a referral; p = 0.046
No significant changes in frequency of:
• providing information on different referral options
• allowing patients to choose which referral option suits them
• referring patients to self-mgt education.
Provider surveys
32 Appropriate primary care There was no significant improvement in patient reports that the GP provided everything they needed to help them manage their health. However, there was a ceiling effect with a baseline score of 3.8 out of 4 (4 = yes, definitely). Patient surveys
33 Consumer ability to engage Significant improvement in patients’ reports of how easy it was to explain their problems to their health professionals. On a scale of 1 to 4 (1 = Not easy at all; 4 = Very easy), patient scores changed from mean = 3.26 to mean = 3.50 p = 0.007. Patient surveys
   GPs and patients suggested increased engagement of patients, although not universally. Interviews
41 Consumer needs addressed at right location Significantly fewer patients reported spending one or more nights in a hospital after the intervention. Patient surveys
43 Healthcare is perceived /experienced positively Responses to question: “Did you have confidence and trust in the person you saw or spoke to?” did not change – very high at baseline and follow-up (3.9/4) i.e. ceiling effect. Patient follow-up survey