Abstract
BackgroundInternational and national bodies promote interdisciplinary care in the management of people with chronic conditions. We examine one facilitative factor in this team-based approach - the co-location of non-physician disciplines within the primary care practice.MethodsWe used survey data from 330 General Practices in Ontario, Canada and New Zealand, as a part of a multinational study using The Quality and Costs of Primary Care in Europe (QUALICOPC) surveys. Logistic and linear multivariable regression models were employed to examine the association between the number of disciplines working within the practice, and the capacity of the practice to offer specialized and preventive care for patients with chronic conditions.ResultsWe found that as the number of non-physicians increased, so did the availability of special sessions/clinics for patients with diabetes (odds ratio 1.43, 1.25–1.65), hypertension (1.20, 1.03–1.39), and the elderly (1.22, 1.05–1.42). Co-location was also associated with the provision of disease management programs for chronic obstructive pulmonary disease, diabetes, and asthma; the equipment available in the centre; and the extent of nursing services.ConclusionsThe care of people with chronic disease is the ‘challenge of the century’. Co-location of practitioners may improve access to services and equipment that aid chronic disease management.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2296-15-149) contains supplementary material, which is available to authorized users.
Highlights
International and national bodies promote interdisciplinary care in the management of people with chronic conditions
A different approach was taken for the NZ sample: practices listed on registers held by the Royal New Zealand College of General Practitioners and the University of Auckland, plus additional practices identified from telephone books, were sent survey packs (n = 1373)
Ontario General Practitioner (GP) reported on average lower roster sizes than that of NZ
Summary
International and national bodies promote interdisciplinary care in the management of people with chronic conditions. Governments of low- and high-income nations alike are focused on how best to provide systematic and comprehensive care for patients with chronic conditions, within their primary healthcare systems [1]. NZ provides a partially tax-funded primary healthcare system, wherein Primary Health Organisations (PHOs) are responsible for the delivery of primary care and preventive services for a defined population. PHOs in turn contract with a network of general practitioners (GPs) and other service providers, with most patients contributing co-payments for GP consultations [2]. Ontario is the largest province with primary care provided by a number of different organizational primary care models, including enhanced fee-for-service and capitation-based payment practices [2]
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