or over 20 years, the composition, delivery and importance of primary care have been the subject F of quickening international reform. In 1993, the United Kingdom government announced a “primary care-led” National Health Service, underpinned by primary care commissioning and general practitioner fundholding, both vehicles to allow local primary care clinicians to influence government purchasing...

BACKGROUND AND OBJECTIVES Children with special health care needs (CSHCN) face unique challenges in accessing affordable health care. Massachusetts implemented major health reform in 2006; little is known about the impact of this state's health reform on uninsurance, access to care, and financial protection for privately and publicly insured CSHCN. METHODS We used a difference-in-differences ...

BACKGROUND British Columbia's primary care reform (initiated in 2002) aims to promote "full-service family practice" through incentive payments and other practice support programs. Despite attention to policy, no longitudinal analysis has been conducted of the activities of BC primary care physicians. METHODS This study employed linked administrative health data from 1991/92 through 2009/10 t...

In contemplating this column on primary care reform, many things came to mind. First was an anecdote from a friend of mine who comes from a small town where people frequently greet each other with the salutation,“What do you know for sure?” The standard response is, “Pretty quiet.” I think that anecdote probably best sums up how the public generally responds to primary care reform at the presen...

in their 2016 article, saltman and duran provide a thoughtful examination of the governance challenges involved in different care delivery models adopted in primary care and hospitals in two european countries. this commentary examines the limited potential of structural changes to achieve real reform and considers that, unless governance arrangements actually succeed in penetrating organizatio...

BACKGROUND In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China. METHODS The study selected a total of six representative provinces of China, generating a s...

BACKGROUND The primary care sector represents the linchpin of many health systems. However, the translation of evidence-based practices into patient care can be difficult, particularly during healthcare reform. This can have significant implications for patients, their communities, and the public purse. This is aptly demonstrated in the area of sexual health. The aim of this paper is to determi...

BACKGROUND The concept of organizational culture is important in understanding the behaviour of individuals in organizations as they manage external demands and internal social changes. Cyprus healthcare system is under restructuring and soon a new healthcare scheme will be implemented starting at the Primary Healthcare (PHC) level. The aim of the study was to investigate the underlying culture...

PURPOSE A qualitative study was conducted to understand the current and potential role of the community obstetrician/gynecologist (OBGYN) in risk factor screening and prevention of cardiovascular disease. METHODS A total of four focus group discussions were conducted among 46 OBGYN residents and practicing physicians in the mid-Atlantic region. MAIN FINDINGS Five main thematic areas were id...

IMPORTANCE Current measures of access to care have intrinsic limitations and may not accurately reflect the capacity of the primary care system to absorb new patients. OBJECTIVE To assess primary care appointment availability by state and insurance status. DESIGN, SETTING, AND PARTICIPANTS We conducted a simulated patient study. Trained field staff, randomly assigned to private insurance, M...