Table 1 Summary of most common effective strategies used within evaluated intervention studies to enhance access to best practice process of PHC and indicating within each domain the types of strategies that were associated with report of positive or negative (italics) results
Strategy type | Chronic disease: diabetes | Prevention: Pap test | Episodic care |
|---|---|---|---|
Practice/ service reorganisation | |||
Restructure of practice | ·Multidisciplinary team care | ·Greater focus on screening | ·Changed appointment system |
·Disease specific clinic | ·Enhanced risk assessment | ·Same day appointments | |
·Group attendance | ·Nurse facilitated program | ||
Systems to support practice | ·Personalised patient call/recall systems | ·Office systems to identify | ·Telephone triaging |
·Diabetes information and decision support systems | ·compliance | ·Reminders of appointments | |
·Call/ recall/reminder systems | |||
External support for practice | ·Diabetes register | ·Establishment of condition specific registers | ·Doctor-operated after-hours telephone triage system |
·Community awareness programs | |||
·Population based programs | |||
Patient support | |||
|  | ·Patient education /awareness raising | ·Education / awareness programs personalised invitation to attend | ·Telephone follow up of patients |
·Enhanced self-management | ·Culturally appropriate materials and services | ·Increased availability of same day appointments | |
·Personalized invitations | |||
New services | |||
Outreach service | ·Community based culturally specific clinic | ·Outreach clinic, | ·Outreach through home visits or phone |
·Home visit service | |||
New services to improve access | ·Diabetes screening campaign | ·Establishment of screening service | ·Walk-in centres |
·Introduction of women’s health clinic | ·After-hours care e.g. hospital based GP co-op | ||
·Nurse-led telephone triage | |||
Workforce development | |||
|  | ·Education of doctors about guideline-based diabetes care | ·Education of doctors (e.g. use of screening guidelines) |  |
·Enhanced role for other health providers | ·Enhanced role for other health providers Training of lay health educators | ||
·Education of other PHC providers, e.g. Nurses | ·Culturally appropriate workforce | ||
Financial incentives | |||
|  | ·Financial incentives for providers | ·Reduce costs of screening | ·Reduced cost/free service |
·Reduced cost for patients | |||
·Change in funding rules | |||