Skip to main content

Table 2 Evidence of effects in NSW

From: Improving access to primary health care: a cross-case comparison based on an a priori program theory

Box

Impact

Evidence

Source

10

Consumer ability to perceive need

Not measured.

 

11

Consumer ability to seek

Significant improvement on score on ‘Ability to seek’ (Scale; 1 = Not easy at all to 4 = Very easy) increased from 3.2 to 3.4 p = 0.006.

Patient surveys

12

Consumer ability to reach social/ community services

There were no significant changes in responses to the question:

In the last 6 months, have you used a health or social service in the community for a specific health problem?

Patient surveys

22

GP knowledge, skills, confidence

Significant improvement in scores out of 10 for confidence in providing care to patients with poorly managed diabetes from 7.99 to 9.27 (p = 0.03).

Provider surveys

24

Clinic policies

9 of 10 practices reported the intervention changed the way the practice organizes access or care for patients with poorly managed Type 2 diabetes: a little (10%), quite a lot (50%) or a great deal (20%).

Some clinics had instituted recall systems as part of the study to help with recall of patients for health checks.

Practice surveys

31

Appropriate referrals

GP self-report provided mixed results.

Significant increase in the frequency of someone from the clinic helping patients to make the appointment for a referral; p = 0.046

No significant changes in frequency of:

• providing information on different referral options

• allowing patients to choose which referral option suits them

• referring patients to self-mgt education.

Provider surveys

32

Appropriate primary care

There was no significant improvement in patient reports that the GP provided everything they needed to help them manage their health. However, there was a ceiling effect with a baseline score of 3.8 out of 4 (4 = yes, definitely).

Patient surveys

33

Consumer ability to engage

Significant improvement in patients’ reports of how easy it was to explain their problems to their health professionals. On a scale of 1 to 4 (1 = Not easy at all; 4 = Very easy), patient scores changed from mean = 3.26 to mean = 3.50 p = 0.007.

Patient surveys

  

GPs and patients suggested increased engagement of patients, although not universally.

Interviews

41

Consumer needs addressed at right location

Significantly fewer patients reported spending one or more nights in a hospital after the intervention.

Patient surveys

43

Healthcare is perceived /experienced positively

Responses to question: “Did you have confidence and trust in the person you saw or spoke to?” did not change – very high at baseline and follow-up (3.9/4) i.e. ceiling effect.

Patient follow-up survey