Elizabeth Comino|Gawaine Powell Davies|Yordanka Krastev|Marion Haas|Bettina Christl|John Furler|Anthony Raymont|Mark Harris
A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care
UNSW Sydney|UNSW Sydney|UNSW Sydney|University of Technology Sydney|UNSW Sydney|Australian Association for Academic Primary Care|University of Melbourne|Waitemata District Health Board|UNSW Sydney
although primary health care phc key component health care systems services always readily available accessible affordable systematic review examines effective strategies enhance access best practice processes phc three domains chronic disease management prevention episodic care extensive search bibliographic data bases identify peer nonpeer reviewed literature undertaken identified papers screened identify classify intervention studies measured impact strategies singly combination change use reach services defined population groups evaluated interventions search identified 3148 citations 121 intervention studies 75 evaluated interventions evaluated interventions found three domains prevention n 45 episodic care n 19 chronic disease management n 11 undertaken number countries including australia n 25 usa n 25 uk n 15 study quality ranked high 31 studies medium 61 low 8 75 evaluated interventions tested range strategies either singly n 46 studies combination two n 20 strategies n 9 strategies targeted health providers patients categorised five groups practice reorganisation n 43 studies patient support n 29 provision new services n 19 workforce development n 11 financial incentives n 9 strategies varied domain reflecting complexity care needs processes 75 evaluated interventions 55 reported positive findings interventions using combination strategies likely report positive results review suggests multiple linked strategies targeting different levels health care system likely improve access best practice phc proposed changes structure phc australia may provide opportunities investigate factors influence access best practice phc develop implement effective evidence based strategies address