Zhongguo quanke yixue (Feb 2024)
Patterns and Effects of Collaboration between Primary Care Providers and Medical Specialists in the Delivery of Integrated Health Care Services: a Scoping Review
Abstract
Background Addressing current health challenges requires the integrated and continuous health care services. The collaboration between primary care providers (PCPs) and medical specialists other than general practice is the most common means of achieving this objective. The patterns and effect of collaborative working between different disciplines has a direct impact on the quality of integrated service delivery, which is critical to improving patient health outcomes. Objective To systematically review the characteristics of studies related to collaboration patterns between PCPs and medical specialists, contents of collaboration patterns and effects reported by the authors by using scoping review methods. Methods On September 3 in 2022, PubMed, EmBase, Web of Science, CNKI, and Wanfang Data Knowledge Service Platform were searched for literature related to collaboration between PCPs and medical specialists from inception to the date of search. The characteristics of literature, collaboration patterns and effects were extracted. The elemental decomposition of collaboration patterns was performed based on Mulave 'Gearing Up' model and the contents of collaboration patterns were integrated and demonstrated using content analysis method. Results A total of 420 relevant papers were included, of which 214 (51.0%) were committed to evaluating the effects of collaboration patterns, but specific contents of collaboration patterns could be extracted from 82 (19.5%) papers. The distinctive characteristics revealed by the extraction of limited information on the details of collaboration patterns included clear and formalized collaboration patterns, evidence-based guidelines/norms support for collaborative service contents, information systems and dedicated coordinators support for the collaboration between PCPs and specialists. Among the 82 papers, a total of 54 (65.9%) papers clearly reported indicators of effect, of which 90.7% (49/54) reported positive impact on service delivery and outcomes, ranging from service provision process, service utilization and health-related outcome indicators, however, higher proportion (90.7%, 49/54) of studies reporting positive effects could not exclude the presence of publication bias. Conclusion When collaboration patterns between PCPs and medical specialists other than general practice are implemented in integrated health services, it is necessary to ensure that approaches and contents of collaboration are specified, as well as the focus on the support of information systems and coordinators. Intervention studies related to health system and policy should emphasize describing the details of intervention design and implementation processes. Methodological quality assessment and meta-analysis are necessary to conduct in future studies on this topic.
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