Optimising access to best practice primary health care

1
Optimising access to best practice primary
health care

• Elizabeth Comino, Marion Haas, Yordanka Krastev
• Mark Harris, John Furler, Gawaine Powell Davies,
  Antony Raymont, Jane Hall
• Bettina Christl, Nighat Faruqi

2
Definitions

• Access
• is the relationship between health service need
  and opportunity to use health services
• Population based definition
• Issues in defining access to best practice PHC
• Best practice primary health care
• Inclusion criteria/ examples
• Common conditions
• Largely managed in PHC settings
• Clinical agreement on processes of care
• Examples episodic care, prevention, and chronic
  care

3
Research questions

• What are the facilitators of barriers to access
  to best practice PHC services?
• What are the potential strategies/interventions
  to address these at different levels of the
  health care system?
• Is there any evidence that links policies and
  strategies to address facilitators to and
  barriers of access to best practice PHC to
  improved access?
• Is there any evidence of differential effects of
  facilitators to and barriers of access to best
  practice PHC services for priority groups and
  key domains of practice?
• Is there any evidence about the costs relative to
  the benefits of policies and strategies that
  address access to best practice PHC?

4
Conceptual framework
5
Search strategies

• Black literature
• Search terms
• Access, and related terms
• Primary health care,
• Examples of best practice processes of care
• Limits English, Country, year, adults
• Data bases
• Medline, Embase, CINHAL, Cochrane/DARE
• Grey literature
• Snowballing
• Through reference lists, key informants,
  websites, and major organizations

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Identifying relevant literature
Example- Diabetes
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Reference group / stakeholders

• Reference group
• Comprises representatives from Commonwealth and
  State Health, AGPN, RACGP, Pharmacy, and
  University
• Consumer representative now identified
• Initial meeting on 7th April
• Follow up about to commence
• Stakeholder group for consultation
• Assembling potential interest group
• Consultation documents are being prepared

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Strengths and issues

• Different approach to looking at access
• Not easy because
• Very little literature and not easy to identify
• Needing to look beyond quality and outcomes
• Few evaluated interventions that address the
  relationship between need and opportunity
• Reference stakeholder groups
• Formed and assisting clarify the issues
• Potentially a very broad topic
• Importance of restricting to generalisable
  examples where there is
• Definitive processes of care
• Information on topic and
• Information on evaluated policy/strategies

9
Thank you

• Elizabeth Comino
• E.Comino_at_unsw.edu.au
• Yordanka Karastev
• Y.Krastev_at_unsw.edu.au
• Marion Haas, CHERE
• UNSW Research Centre for Primary Health Care and
  Equity, NSW.
• Phone [phone]
• Mobile [phone]

10
Thank you

• The research reported in this presentation is a
  project of the Australian Primary Health Care
  Research Institute, which is supported by a grant
  from the Australian Government Department of
  Health and Ageing.