Abstract
BackgroundThe implementation of evidence-based approaches by general practitioners (GPs) is new in the primary care setting, and few quantitative studies have evaluated the impact of contextual factors on the attendance of these approaches.MethodsIn total, 892 GPs from 75 community healthcare centers (CHCs) in Shanghai completed our survey. We used logistic regression to analyze factors affecting the number of evidence-based chronic disease programs attended by GPs and whether they had held the lead position in such a program.ResultsA total of 346 (38.8%) of the practitioners had never participated in any evidence-based chronic disease prevention (EBCDP) program. The EBCDP interventions in which the GPs had participated were predominantly related to hypertension, diabetes, and cardiovascular disease. However, the proportion of GPs in the lead role was relatively low, between 0.8% (programs involving prevention and control of asthma) and 5.0% (diabetes). Organizational factors and areas were significantly associated with evidence-based practices (EBPs) of the GP, while monthly income and department were the most significantly related to GPs who have the lead role in a program. The results indicated that GPs who had taken the lead position had higher scores for policy and economic impeding factors. GPs who were men, had a higher income, and worked in prevention and healthcare departments and urban areas were more likely to take the lead position.ConclusionEvidence-based programs for chronic diseases should be extended to different types of diseases. Personal, organizational, political, and economic factors and the factors of female sex, lower income, department type, and suburban area environment should be considered to facilitate the translation of evidence to practice.
Highlights
The implementation of evidence-based approaches by general practitioners (GPs) is new in the primary care setting, and few quantitative studies have evaluated the impact of contextual factors on the attendance of these approaches
We found that 38.8% of the GPs had not participated in any evidence-based practices (EBPs) program for chronic disease prevention
Evidence-based programs for chronic diseases should be extended to address the types of diseases encountered by GPs
Summary
The implementation of evidence-based approaches by general practitioners (GPs) is new in the primary care setting, and few quantitative studies have evaluated the impact of contextual factors on the attendance of these approaches. After China’s New Health Reform of 2009, the government accelerated the construction of primary healthcare institutions and expanded the team of general practitioners (GPs) facing the pressure of an aging population, replacing the situation of secondary and tertiary hospitals taking the main role of both medical and prevention service provision [2,3,4]. In China, primary healthcare institutions consisted of community healthcare centers (CHCs) in cities, township health centers in countries, and village clinics in villages, which covered 55% of outpatient care (4.4 billion visits) in 2016 [3]. CHCs take the responsibility of preventative healthcare instead of larger hospitals, as the New Health Policy requires [4, 5]. The efficiency of preventative healthcare is still not optimal among CHCs and other primary care institutions in China [3]
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