Methods for measuring comprehensiveness in primary care: a narrative review

Author(s)

Baughman, Derek, Nasir, Rafay, and Bazemore, Andrew W

Topic(s)

Role of Primary Care, and Achieving Health System Goals

Keyword(s)

Cost Of Care, Measurement, Medicare, Payment, Quality Of Care, and Visiting Scholar/Fellow

Volume

Journal of Primary Health Care

Comprehensiveness in primary care is defined as managing most medical needs in a population while integrating the context of patient’s values, preferences, and beliefs. This study aims to synthesise validated measures for measuring comprehensiveness in primary care to facilitate its practical application.The objective of this study was to synthesise validated measures for measuring comprehensiveness in primary care, facilitating its practical application.A narrative-style literature review was employed to conduct a hierarchical review of relevant literature. The process involved several stages: initial term filtering, separation of primary care from specialist care using medical subject heading (MeSH) terms, incorporation of non-MeSH terminology, and a manual review of titles, abstracts, and full articles. Articles were included if they discussed the measurement, assessment, or application of comprehensiveness in primary care and were relevant to primary care and methodologically sound. A multistage PubMed search of ‘comprehensiveness’ (MeSH) with hierarchical sub-term filtering and snowball method gleaning of additional articles from literature-described terminology was conducted.Thirteen studies met the inclusion criteria. Methodological strategies varied from claims-based approaches for cost and utilisation to surveys assessing the scope of clinical services and patient experience.Thoroughly measuring comprehensiveness in primary care integrates methods that evaluate the effect of physician ranges of clinical services on the cost and utilisation of health care, and the impact on patient outcomes within the context of the patient experience. Implementing these methods pragmatically can assist communities and health systems in implementing, measuring, and capturing comprehensiveness in primary care.

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