Primary Care Networks and Starfield's 4Cs: A Case for Enhanced Chronic Disease Management.

dc.contributor.author

Foo, Chuan De

dc.contributor.author

Surendran, Shilpa

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Jimenez, Geronimo

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Ansah, John Pastor

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Matchar, David Bruce

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Koh, Gerald Choon Huat

dc.date.accessioned

2021-05-03T02:59:50Z

dc.date.available

2021-05-03T02:59:50Z

dc.date.issued

2021-03-12

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2021-05-03T02:59:49Z

dc.description.abstract

The primary care network (PCN) was implemented as a healthcare delivery model which organises private general practitioners (GPs) into groups and furnished with a certain level of resources for chronic disease management. A secondary qualitative analysis was conducted with data from an earlier study exploring facilitators and barriers GPs enrolled in PCN's face in chronic disease management. The objective of this study is to map features of PCN to Starfield's "4Cs" framework. The "4Cs" of primary care-comprehensiveness, first contact access, coordination and continuity-offer high-quality design options for chronic disease management. Interview transcripts of GPs (n = 30) from the original study were purposefully selected. Provision of ancillary services, manpower, a chronic disease registry and extended operating hours of GP practices demonstrated PCN's empowering features that fulfil the "4Cs". On the contrary, operational challenges such as the lack of an integrated electronic medical record and disproportionate GP payment structures limit PCNs from maximising the "4Cs". However, the enabling features mentioned above outweighs the shortfalls in all important aspects of delivering optimal chronic disease care. Therefore, even though PCN is in its early stage of development, it has shown to be well poised to steer GPs towards enhanced chronic disease management.

dc.identifier

ijerph18062926

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1661-7827

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1660-4601

dc.identifier.uri

https://hdl.handle.net/10161/22733

dc.language

eng

dc.publisher

MDPI AG

dc.relation.ispartof

International journal of environmental research and public health

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10.3390/ijerph18062926

dc.subject

Humans

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Chronic Disease

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Long-Term Care

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Qualitative Research

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Primary Health Care

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Disease Management

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General Practitioners

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Primary Care Networks and Starfield's 4Cs: A Case for Enhanced Chronic Disease Management.

dc.type

Journal article

duke.contributor.orcid

Matchar, David Bruce|0000-0003-3020-2108

pubs.begin-page

1

pubs.end-page

14

pubs.issue

6

pubs.organisational-group

School of Medicine

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Duke Clinical Research Institute

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Duke Global Health Institute

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Pathology

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Medicine, General Internal Medicine

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Duke

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Institutes and Centers

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University Institutes and Centers

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Institutes and Provost's Academic Units

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Clinical Science Departments

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Medicine

pubs.publication-status

Published

pubs.volume

18

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