Access systems in general practice: a systematic scoping review.

Autor:	Eccles A; Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry, UK., Bryce C; Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry, UK., Driessen A; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; post-doctoral researcher, Anthropology Department, University of Amsterdam, Amsterdam, the Netherlands., Pope C; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford., MacLellan J; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford., Gronlund T; Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK., Nicholson BD; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford., Ziebland S; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford., Atherton H; Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK.
Jazyk:	angličtina
Zdroj:	The British journal of general practice : the journal of the Royal College of General Practitioners [Br J Gen Pract] 2024 Sep 26; Vol. 74 (747), pp. e674-e682. Date of Electronic Publication: 2024 Sep 26 (Print Publication: 2024).
DOI:	10.3399/BJGP.2023.0149
Abstrakt:	Background: Access to GP appointments is increasingly challenging in many high-income countries, with an overstretched workforce and rising demand. Various access systems have been developed and evaluated internationally. Aim: To systematically consolidate the current international evidence base related to different types of GP access systems. Design and Setting: Scoping review examining international literature. Method: Literature searches were run across relevant databases in May 2022. Title, abstract, and full-text screenings were carried out. Data from included studies were extracted and mapped to synthesise the components and aims within different GP access systems. Results: In total, 49 studies were included in the review. The majority of these were set in the UK. Some access systems featured heavily in the literature, such as Advanced Access, telephone triage, and online consultations, and others less so. There were two key strategies adopted by systems that related to either changing appointment capacity or modifying patient pathways. Components related to these strategies are summarised and illustrated as a schematic representation. Most rationales behind access systems were practice, rather than patient, focused. 'Add-on' systems and aims for efficiency have become more popular in recent years. Conclusion: This synthesis provides a useful tool in understanding access systems' aims, design, and implementation. With focus on alleviating demand, patient-focused outcomes appear to be underinvestigated and potentially overlooked during design and implementation. More recently, digital services have been promoted as offering patient choice and convenience. But a context where demand outweighs resources challenges the premise that extending choice is possible. (© The Authors.)
Databáze:	MEDLINE
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