Multiprofessional Primary Care Units: What Affects the Clinical Performance of Italian General Practitioners?

Med Care Res Rev. 2014 Aug;71(4):315-36. doi: 10.1177/1077558714536618.

Abstract

Multiprofessional primary care models promise to deliver better care and reduce waste. This study evaluates the impact of such a model, the primary care unit (PCU), on three outcomes. A multilevel analysis within a "pre- and post-PCU" study design and a cross-sectional analysis were conducted on 215 PCUs located in the Emilia-Romagna region in Italy. Seven dimensions captured a set of processes and services characterizing a well-functioning PCU, or its degree of vitality. The impact of each dimension on outcomes was evaluated. The analyses show that certain dimensions of PCU vitality (i.e., the possibility for general practitioners to meet and share patients) can lead to better outcomes. However, dimensions related to the interaction and the joint works of general practitioners with other professionals tend not to have a significant or positive impact. This suggests that more effort needs to be invested to realize all the potential benefits of the PCU's multiprofessional approach to care.

Keywords: chronic care management; emergency room utilization; multiprofessional primary care.

MeSH terms

  • Cross-Sectional Studies
  • Efficiency, Organizational
  • General Practitioners / organization & administration*
  • General Practitioners / standards
  • Guideline Adherence / organization & administration
  • Humans
  • Interprofessional Relations
  • Italy
  • Outcome and Process Assessment, Health Care
  • Practice Patterns, Physicians'
  • Primary Health Care / organization & administration*
  • Primary Health Care / standards