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

Chuan De Foo, Shilpa Surendran, Geronimo Jimenez, John Pastor Ansah, David Bruce Matchar and Gerald Choon Huat Koh
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Chuan De Foo: Department of Health Systems and Behavioural Sciences, Saw Swee Hock School of Public Health, National University Singapore, Singapore 117549, Singapore
Shilpa Surendran: Department of Health Systems and Behavioural Sciences, Saw Swee Hock School of Public Health, National University Singapore, Singapore 117549, Singapore
Geronimo Jimenez: Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
John Pastor Ansah: Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore
David Bruce Matchar: Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore
Gerald Choon Huat Koh: Department of Health Systems and Behavioural Sciences, Saw Swee Hock School of Public Health, National University Singapore, Singapore 117549, Singapore

IJERPH, 2021, vol. 18, issue 6, 1-13

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.

Keywords: qualitative; Starfield; 4Cs; chronic disease management; primary health care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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