From: Improving access to primary health care: a cross-case comparison based on an a priori program theory
Box | Impact | Evidence | Source |
---|---|---|---|
10 | Consumer perceives need | All patients appreciated the telephone outreach, and several patients indicated that they did not realize until after receiving the call that they needed the information that was provided. | Qualitative interviews |
11 | Consumer ability to seek | Significant increase in score on ‘Ability to seek’ scale (1 = Not easy at all to 4 = Very easy) from 2.8 to 3.3, p = 0.000. | Patient survey |
12 | Consumer gets to social/ community service relative to need | Reported use of community health services not significantly increased from 6% (3/51) at baseline to 17% (n = 8/48) at follow-up (p = 0.13). Helpfulness of services received not significantly increased from an average of 1.6 (n = 14) to 3.3 (n = 44) (p = 0.020) where 1 = “no, not at all” and 4 = “yes, absolutely”. | Patient Survey |
13 | Consumer gets to GP/FP | Among patients who tried to contact their provider by telephone: At baseline, 37% reported it was ‘very easy’ compared to 73% post-intervention. | Patient Survey |
31 | Appropriate referrals | Referral to community health and social services by the usual physician increased significantly from 5% at baseline (1/19 with a usual place of care) to 14% (6/42 reporting on new physician) at follow-up (p = 0.06). (NB – providers were different). | Patient survey |
32 | Appropriate PMC is provided | Patients reported the extent to which their doctor or nurse provided everything needed to manage their health on a 4-point scale from 1 = not at all to 4 = yes, definitely. Mean scores increased from 3.4 at baseline (n = 24, referring to usual source of care) to 3.8 at follow-up (n = 54, referring to new FP), p = 0.08. | Patient survey |
33 | Consumer engages with care | Patients’ abilities to explain their problems to health professionals increased from 3.4 at base line (mostly easy) to 3.8 at follow-up (mostly very easy), p = 0.002. At follow-up interviews, patients reported that the visit preparation tools had helped them have more effective visits and to better understand their own needs. | Patient survey Qualitative interview |
41 | Consumer needs addressed at right location | The rate of forgone care because of access difficulties dropped from 41% at baseline to 12% at follow-up. The rate of emergency-room use fell from 20% (12/60) at baseline to 11% at follow-up (6/54, 4 were repeat users). | Patient survey |
42 | Enduring relationship with GP/FP | Reported attachment to a specific responsible professional increased from 15% (6/60) at baseline to 89% (48/54) at follow-up, p < 0.000. | Patient survey |
43 | Healthcare is perceived /experienced positively | Reports of patient-centered care increased between baseline and follow up: • 26 to 48% reported their provider explored patient concerns about health • 48 to 68% gave importance to patient’s ideas about health • 48 to 85% put patients at ease to discuss issues. | Patient survey |