Implications of interprofessional primary care team characteristics for health services and patient health outcomes: A systematic review with narrative synthesis.

Autor: Wranik WD; School of Public Administration, Faculty of Management, Dalhousie University, Canada; Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Canada. Electronic address: dwl@dal.ca., Price S; School of Nursing, Faculty of Health Professions, Dalhousie University, Canada., Haydt SM; School of Public Administration, Faculty of Management, Dalhousie University, Canada., Edwards J; Shared Health Manitoba, Canada., Hatfield K; School of Journalism and Communication, Carleton University, Canada., Weir J; Halifax Partnership, Dalhousie University, Canada., Doria N; Maritime SPOR Support Unit, Dalhousie University, Canada.
Jazyk: angličtina
Zdroj: Health policy (Amsterdam, Netherlands) [Health Policy] 2019 Jun; Vol. 123 (6), pp. 550-563. Date of Electronic Publication: 2019 Apr 01.
DOI: 10.1016/j.healthpol.2019.03.015
Abstrakt: Interprofessional primary care (IPPC) teams are promoted as an alternative to single profession physician practices in primary care with focus on preventive care and chronic disease management. Characteristics of teams can have an impact on their performance. We synthesized quantitative, qualitative or mixed-methods evidence addressing the design of IPPC teams. We searched Ovid MEDLINE, Embase, CINAHL, and PAIS using search terms focused on IPPC teams. Studies were included if they discussed the influence of team structure, organization, financial arrangements, or policies and procedures, or either health care processes or outputs, health outcomes, or costs, and were conducted in Australia, Canada, the United Kingdom or New Zealand between 2003 and 2016. We screened 11,707 titles, 5366 abstracts, and selected 77 full text articles (38 qualitative, 31 quantitative and 8 mixed-methods). Literature focused on the implications of team characteristics on team processes, such as teamwork, collaboration, or satisfaction of patients or providers. Despite heterogeneity of contexts, some trends are observable: shared space, common vision and goals, clear definitions of roles, and leadership as important to good teamwork. The impacts of these on health care outputs or patient health are not clear. To move the state of knowledge beyond perception of what works well for IPPC teams, researchers should focus on quantitative causal inference about the linkages between team characteristics and patient health.
(Copyright © 2019 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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