How far does family physician supply correlate with district health system performance?

Robert Mash,Tracey Naledi,Robin E. Dyers

doi:10.4102/phcfm.v7i1.796

Abstract

BackgroundSince 2011, a new cadre of family physicians, with 4 years of postgraduate training, was deployed in the district health services of the Western Cape, and tasked with a considerable range of duties aimed at a general improvement in care and health outcomes. There is a need to evaluate the contribution of these family physicians to the district health system.AimTo develop a methodology for describing the correlation between family physician supply and district health system performance, clinical processes and outcomes, and to measure this correlation at baseline.MethodA cross-sectional study was undertaken that analysed data at an ecological level for the period of 01 April 2011 to 31 March 2012. This was a pilot project analysing data from the first year of a 4-year project. The correlations between family physician supply and 18 health system indicators were assessed within a logic model. The supplies of other categories of staff were also measured.ResultsAlthough most of the correlations with family physicians were positive, the study was unable to demonstrate any strong or statistically significant correlations at baseline. There were significant correlations with other categories of staff.ConclusionsThis study developed a methodology for monitoring the relationship between family physician supply using routinely collected indicators of health system performance, clinical processes and outcomes over time. Additional research will also be needed to investigate the impact of family physicians and triangulate findings as this methodology has many limitations and potential confounding factors.

Highlights

Since 2011, a new cadre of family physicians, with 4 years of postgraduate training, was deployed in the district health services of the Western Cape, and tasked with a considerable range of duties aimed at a general improvement in care and health outcomes
In South Africa, family medicine was recognised as a new area of specialisation in 2007 and training of family physicians as expert generalists began in 2008, with the first graduates in 2011
The six roles of these new family physicians in the district health services (DHS) have been defined as providing clinical care, consulting on patients referred by other members of the health care team, mentoring and training other clinical staff, taking responsibility for clinical governance within the facility or subdistrict, supervising interns and registrars and contributing to a more community-oriented approach.[7]

Summary

Introduction

Since 2011, a new cadre of family physicians, with 4 years of postgraduate training, was deployed in the district health services of the Western Cape, and tasked with a considerable range of duties aimed at a general improvement in care and health outcomes. The six roles of these new family physicians in the district health services (DHS) have been defined as providing clinical care, consulting on patients referred by other members of the health care team, mentoring and training other clinical staff, taking responsibility for clinical governance within the facility or subdistrict, supervising interns and registrars and contributing to a more community-oriented approach.[7] In general terms family physicians differ from medical officers in that they have 4 years of postgraduate training, have broader roles beyond clinical care and have greater length of experience

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