The online version of this article (doi:10.1186/1471-2296-15-149) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
The data were collected by research teams from NZ and Ontario, as part of the multinational QUALICOPC study. JRS and WW had full access to all of the data in the study; JRS takes responsibility for the accuracy of the data analysis. JRS, WW, AK, TK, JB, TA contributed to the interpretation of results. JRS drafted the article and JRS, WW, AK, TK, JB, TA reviewed and edited the article. All authors (JRS, WW, AK, TK, JB, TA) approved the final version of the manuscript and have taken due care to ensure the integrity of this work.
International and national bodies promote interdisciplinary care in the management of people with chronic conditions. We examine one facilitative factor in this team-based approach - the co-location of non-physician disciplines within the primary care practice.
We used survey data from 330 General Practices in Ontario, Canada and New Zealand, as a part of a multinational study using The Quality and Costs of Primary Care in Europe (QUALICOPC) surveys. Logistic and linear multivariable regression models were employed to examine the association between the number of disciplines working within the practice, and the capacity of the practice to offer specialized and preventive care for patients with chronic conditions.
We found that as the number of non-physicians increased, so did the availability of special sessions/clinics for patients with diabetes (odds ratio 1.43, 1.25–1.65), hypertension (1.20, 1.03–1.39), and the elderly (1.22, 1.05–1.42). Co-location was also associated with the provision of disease management programs for chronic obstructive pulmonary disease, diabetes, and asthma; the equipment available in the centre; and the extent of nursing services.
The care of people with chronic disease is the ‘challenge of the century’. Co-location of practitioners may improve access to services and equipment that aid chronic disease management.
Additional file 1: Options able to be selected in response to the item “Indicate the equipment used in your practice by yourself or your staff (mark all that apply)”.(DOCX 15 KB)
Additional file 2: Frequency of co-located disciplines in Ontario and New Zealand samples.(DOCX 15 KB)
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- Under the same roof: co-location of practitioners within primary care is associated with specialized chronic care management
Walter P Wodchis
- BioMed Central
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