Skip to main content


Service organization, utilization, and delivery of care

Section edited by Mark Harris and Cindy Lam

This section covers, though is not limited to, service policy and evaluation, health systems research, professional boundaries, access, referral and consultations, screening and early detection, within the context of primary care.

Page 1 of 9

  1. Content type: Research article

    Community pharmacy represents an important setting to identify patients who may benefit from an adherence intervention, however it remains unclear whether it would be feasible to monitor antihypertensive adher...

    Authors: Paul Dillon, Ronald McDowell, Susan M. Smith, Paul Gallagher and Gráinne Cousins

    Citation: BMC Family Practice 2019 20:131

    Published on:

  2. Content type: Research article

    The United Kingdom (UK) is experiencing a general practitioner (GP) workforce retention crisis. Research has focused on investigating why GPs intend to quit, but less is known about the acceptability and effec...

    Authors: Rupa Chilvers, Suzanne H. Richards, Emily Fletcher, Alex Aylward, Sarah Dean, Chris Salisbury and John Campbell

    Citation: BMC Family Practice 2019 20:130

    Published on:

  3. Content type: Research article

    In the UK, there is ongoing integration of pharmacists into general practice as a new healthcare service in primary care. Evaluation of the service involves national measures that require pharmacists to record...

    Authors: Georgios Dimitrios Karampatakis, Kath Ryan, Nilesh Patel and Graham Stretch

    Citation: BMC Family Practice 2019 20:126

    Published on:

  4. Content type: Research article

    Team-based models of care are efficacious in improving outcomes for patients with mental and physical illnesses. However, primary care clinics have been slow to adopt these models. We used iterative stakeholde...

    Authors: Danielle F. Loeb, Danielle M. Kline, Kurt Kroenke, Cynthia Boyd, Elizabeth A. Bayliss, Evette Ludman, L. Miriam Dickinson, Ingrid A. Binswanger and Samantha P. Monson

    Citation: BMC Family Practice 2019 20:124

    Published on:

  5. Content type: Research article

    Depression is the second leading cause of death among young adults and a major cause of disability worldwide. Some studies suggest a disparity between rural and urban outcomes for depression. Collaborative Car...

    Authors: Hailon Wong, Kyle Moore, Kurt B. Angstman and Gregory M. Garrison

    Citation: BMC Family Practice 2019 20:123

    Published on:

  6. Content type: Research article

    Working with patients and health care providers to co-design health interventions is gaining global prominence. While co-design of interventions is important for all patients, it is particularly important for ...

    Authors: Ruta Valaitis, Jennifer Longaphy, Jenny Ploeg, Gina Agarwal, Doug Oliver, Kalpana Nair, Monika Kastner, Ernie Avilla and Lisa Dolovich

    Citation: BMC Family Practice 2019 20:122

    Published on:

  7. Content type: Research article

    In France, with the growing scarcity of gynecologists and a globally low and socially differentiated coverage of cervical cancer screening (CCS), general practitioners (GPs) are valuable resources to improve s...

    Authors: Chiara Maj, Lorraine Poncet, Henri Panjo, Arnaud Gautier, Pierre Chauvin, Gwenn Menvielle, Emmanuelle Cadot, Virginie Ringa and Laurent Rigal

    Citation: BMC Family Practice 2019 20:114

    Published on:

  8. Content type: Research article

    A perennial challenge of primary care quality improvement is to establish why interventions work in some circumstances, but not others. This study aimed to identify factors explaining variations in the impact ...

    Authors: Grant Russell, Riki Lane, Sharon Parker, John Litt, Danielle Mazza, Jane Lloyd, Nicholas Zwar, Mieke van Driel, Chris Del Mar, Jane Smith and Mark F. Harris

    Citation: BMC Family Practice 2019 20:113

    Published on:

  9. Content type: Research article

    The PaTz-method (acronym for Palliatieve Thuiszorg, palliative care at home) is perceived to improve coordination, continuity and communication in palliative care in the Netherlands. Although important for fur...

    Authors: Ian Koper, H. Roeline W. Pasman, Annicka G. M. Van der Plas, Bart P. M. Schweitzer and Bregje D. Onwuteaka-Philipsen

    Citation: BMC Family Practice 2019 20:112

    Published on:

  10. Content type: Research article

    The collaborative care model with a care manager has previously generated beneficial results for patients with depression in terms of decreased burden of depression symptoms. A care manager function has been t...

    Authors: I. Svenningsson, E-L Petersson, C. Udo, J. Westman, C. Björkelund and L. Wallin

    Citation: BMC Family Practice 2019 20:108

    Published on:

  11. Content type: Research article

    Healthy Hearts Northwest (H2N) is a study of external support strategies to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors: appropriate aspirin use, blood p...

    Authors: Michael L. Parchman, Melissa L. Anderson, Katie Coleman, Le Ann Michaels, Linnaea Schuttner, Cullen Conway, Clarissa Hsu and Lyle J. Fagnan

    Citation: BMC Family Practice 2019 20:103

    Published on:

  12. Content type: Research article

    Shared medical appointments (SMAs), or group visits, are a healthcare delivery method with the potential to improve chronic disease management and preventive care. In this review, we sought to better understan...

    Authors: Kim H. Wadsworth, Trevor G. Archibald, Allison E. Payne, Anita K. Cleary, Byron L. Haney and Adam S. Hoverman

    Citation: BMC Family Practice 2019 20:97

    Published on:

  13. Content type: Research article

    Developed countries have widely implemented a gatekeeping system as a core policy of primary care, also known as the system of first visit in the community. As gatekeepers, general practitioners are responsibl...

    Authors: Cuiying Liang, Jie Mei, Yuan Liang, Ruwei Hu, Li Li and Li Kuang

    Citation: BMC Family Practice 2019 20:93

    Published on:

  14. Content type: Research article

    The benefit of a “diagnosis” of pre-diabetes in very elderly patients is debated. How clinicians manage pre-diabetic blood results in these patients is unknown. This study aims to understand how clinicians are...

    Authors: Patrick Burch, Thomas Blakeman, Peter Bower and Caroline Sanders

    Citation: BMC Family Practice 2019 20:90

    Published on:

  15. Content type: Study protocol

    Strengthening the coordination, continuity and intersectoral cooperation for cancer patients’ during cancer treatment is being underlined by international guidelines and research. General practitioners have as...

    Authors: Theis Bitz Trabjerg, Lars Henrik Jensen, Jens Søndergaard, Jeffrey James Sisler and Dorte Gilså Hansen

    Citation: BMC Family Practice 2019 20:86

    Published on:

  16. Content type: Research article

    Strengthening primary care is considered a global strategy to address non-communicable diseases and their comorbidity. However, empirical evidence of the longer-term benefits of capacity building programmes fo...

    Authors: Paibul Suriyawongpaisal, Wichai Aekplakorn, Borwornsom Leerapan, Fatim Lakha, Samrit Srithamrongsawat and Suparpit von Bormann

    Citation: BMC Family Practice 2019 20:85

    Published on:

  17. Content type: Research article

    Although patients in Germany are generally free to choose their primary healthcare provider, this role should mainly be assumed by general practitioners (GPs). While some predictors of the frequency of use of ...

    Authors: Judith Tillmann, Marie-Therese Puth, Klaus Weckbecker, Manuela Klaschik and Eva Münster

    Citation: BMC Family Practice 2019 20:84

    Published on:

  18. Content type: Research article

    Primary Care Plus (PC+) is an intervention where patients consult specialists in a primary care setting outside the hospital. Two facilities have been founded in the city of Maastricht, the Netherlands. Main a...

    Authors: Paul Smeele, Mariëlle E. A. L. Kroese, Marieke D. Spreeuwenberg and Dirk Ruwaard

    Citation: BMC Family Practice 2019 20:81

    Published on:

  19. Content type: Research article

    Research underpinning the patient experience of people with chronic conditions in Australian general practice is not well developed. We aimed to ascertain the perspectives of key stakeholders on aspects of pat...

    Authors: Hyun Jung Song, Sarah Dennis, Jean-Frédéric Levesque and Mark Fort Harris

    Citation: BMC Family Practice 2019 20:79

    Published on:

  20. Content type: Research article

    Rising healthcare costs due to unnecessary referrals to secondary healthcare services underscore the need for optimizing current referral procedures. This study investigates whether the use of web-based consul...

    Authors: Thomas van der Velden, Bianca W. M. Schalk, Mirjam Harmsen, Guido Adriaansens, Tjard R. Schermer and Marc A. ten Dam

    Citation: BMC Family Practice 2019 20:73

    Published on:

  21. Content type: Research article

    General practitioners (GPs) play a key role in securing and coordinating appropriate use of healthcare services, by providing primary and preventive healthcare and by acting as gatekeepers for secondary health...

    Authors: Ellen Rabben Svedahl, Kristine Pape, Marlen Toch-Marquardt, Lena Janita Skarshaug, Silje-Lill Kaspersen, Johan Håkon Bjørngaard and Bjarne Austad

    Citation: BMC Family Practice 2019 20:68

    Published on:

  22. Content type: Research article

    National guidelines recommend patients with suspected transient ischaemic attack (TIA) should be seen by a specialist within 24 h. However, people with suspected TIA often present to non-specialised services, ...

    Authors: Duncan Edwards, Grace M. Turner, Satnam K. Virdee and Jonathan Mant

    Citation: BMC Family Practice 2019 20:67

    Published on:

  23. Content type: Research article

    Changning District of Shanghai pioneered in implementing Family Doctor and Medical Insurance Payment Coordination Reform. The survey aimed to assess the effect of the reform to provide a decision-making basis ...

    Authors: Jiaoling Huang, Wei Lu, Luan Wang, Tao Zhang, Chengjun Liu, Shanshan Liu, Hong Liang, Yimin Zhang and Dongfeng Guo

    Citation: BMC Family Practice 2019 20:60

    Published on:

  24. Content type: Research article

    Patient portal secure messaging (asynchronous electronic communication between physicians and their established patients) allows patients to manage their care through asynchronous, direct communication with th...

    Authors: Jennifer L. Hefner, Sarah R. MacEwan, Alison Biltz and Cynthia J. Sieck

    Citation: BMC Family Practice 2019 20:57

    Published on:

  25. Content type: Research article

    Heterogeneity of population health needs and the resultant difficulty in health care resources planning are challenges faced by primary care systems globally. To address this challenge in population health man...

    Authors: Shi Yan, Benjamin Jun Jie Seng, Yu Heng Kwan, Chuen Seng Tan, Joanne Hui Min Quah, Julian Thumboo and Lian Leng Low

    Citation: BMC Family Practice 2019 20:54

    Published on:

  26. Content type: Research article

    Limited studies exist on successful interventions for patients with multimorbidity. Even more limited is the knowledge on how socioeconomic factors have an impact on these interventions. The objective of this ...

    Authors: Éric Contant, Christine Loignon, Tarek Bouhali, José Almirall and Martin Fortin

    Citation: BMC Family Practice 2019 20:53

    Published on:

  27. Content type: Research article

    Greater continuity and access to primary care results in improved patient health, satisfaction, and reduced healthcare costs. Although patient rostering is considered to be a cornerstone of a high performing p...

    Authors: Jatinderpreet Singh, Simone Dahrouge and Michael E. Green

    Citation: BMC Family Practice 2019 20:52

    Published on:

  28. Content type: Research article

    Since 2008 mental health practice nurses have been gradually introduced in general practices in the Netherlands as part of health policy aiming to improve early identification and treatment of mental health pr...

    Authors: L. Abidi, A. Oenema, P. Verhaak, F. E. S. Tan and D. van de Mheen

    Citation: BMC Family Practice 2019 20:48

    Published on:

  29. Content type: Research article

    In Canada, most patients with type 2 diabetes mellitus (T2DM) are cared for in the primary care setting in the practices of family physicians. This care is delivered through a variety of practice models rangin...

    Authors: Olga Szafran, Sandra L. Kennett, Neil R. Bell and Jacqueline M. I. Torti

    Citation: BMC Family Practice 2019 20:44

    Published on:

  30. Content type: Research article

    The general health check, which includes the periodic health visit and annual physical exam, is not recommended to maintain the health of asymptomatic adults with no risk factors. Different funding mechanisms ...

    Authors: Natasha Ruth Saunders, Jun Guan, Longdi Fu, Helen Guo, Xuesong Wang and Astrid Guttmann

    Citation: BMC Family Practice 2019 20:42

    Published on:

  31. Content type: Research article

    Due to the increasing number of non-urgent visits to emergency departments, it is becoming increasingly important to also investigate emergency care in out-of-hours (OOH) primary care. The aim of this study wa...

    Authors: Insa Seeger, Laura Kreienmeyer, Falk Hoffmann and Michael H. Freitag

    Citation: BMC Family Practice 2019 20:41

    Published on:

  32. Content type: Research article

    Hospital admissions for Ambulatory Care Sensitive Conditions (ACSC) are those that could potentially be prevented by timely and effective disease management within primary care. ACSC admissions are increasingl...

    Authors: Marjon van der Pol, Damilola Olajide, Mark Dusheiko, Robert Elliott, Bruce Guthrie, Louisa Jorm and Alastair H. Leyland

    Citation: BMC Family Practice 2019 20:32

    Published on:

  33. Content type: Debate

    Low back pain affects about 80% of all adults, many of whom consult general practice. Providing management can be challenging, in part due to the scarcity of effective treatment methods. There is broad consens...

    Authors: Allan Riis, Emma L. Karran, Jonathan C. Hill, Martin B. Jensen and Janus L. Thomsen

    Citation: BMC Family Practice 2019 20:30

    Published on:

  34. Content type: Research article

    The ageing population and increasing prevalence of multimorbidity place greater resource demands on the health systems internationally. Accurate prediction of general practice (GP) services is important for he...

    Authors: Christopher Harrison, Joan Henderson, Graeme Miller and Helena Britt

    Citation: BMC Family Practice 2019 20:28

    Published on:

  35. Content type: Research article

    This study aimed to use marketing theory to examine the views of patients, pharmacists and general practitioners (GPs) on how community pharmacies are currently used and to identify how community pharmacy serv...

    Authors: Ali M. K. Hindi, Ellen I. Schafheutle and Sally Jacobs

    Citation: BMC Family Practice 2019 20:26

    Published on:

  36. Content type: Research article

    Patient safety research is conducted predominantly in hospital settings, with a dearth of insight from primary care, despite suggestions that 2.2% of primary care consultations result in a patient safety incid...

    Authors: Caoimhe Madden, Sinéad Lydon, Margaret E. Cupples, Nigel D. Hart, Ciara Curran, Andrew W. Murphy and Paul O’Connor

    Citation: BMC Family Practice 2019 20:22

    Published on:

  37. Content type: Research article

    Anxiety and depression often co-exist. These disorders are under-diagnosed and under-treated, specifically among older people, and lead to increased use of health and social care services and raised mortality....

    Authors: Tom Kingstone, Bernadette Bartlam, Heather Burroughs, Peter Bullock, Karina Lovell, Mo Ray, Peter Bower, Waquas Waheed, Simon Gilbody, Elaine Nicholls and Carolyn A. Chew-Graham

    Citation: BMC Family Practice 2019 20:16

    Published on:

  38. Content type: Research article

    Fostering a culture of safety is an essential step in ensuring patient safety and quality in primary care. We aimed to evaluate the effectiveness of an educational intervention to improve the safety culture in...

    Authors: Clara González-Formoso, Ana Clavería, M.J. Fernández-Domínguez, F.L. Lago-Deibe, Luis Hermida-Rial, Antonio Rial, Francisco Gude-Sampedro, Salvador Pita-Fernández and Victoria Martín-Miguel

    Citation: BMC Family Practice 2019 20:15

    Published on:

  39. Content type: Research article

    Sexually transmitted infections (STI) caused by multidrug resistant Neisseria gonorrhoea are an emerging threat to global health. In the Netherlands, the general practitioner (GP) provides the major part of STI c...

    Authors: Roos van Amerongen, Roel P. Gazendam and Jan E. A. M. van Bergen

    Citation: BMC Family Practice 2019 20:12

    Published on:

  40. Content type: Study protocol

    NHS Health Check is a national cardiovascular disease (CVD) risk assessment programme for 40–74 year olds in England, in which practitioners should assess and communicate CVD risk, supported by appropriate ris...

    Authors: Christopher J. Gidlow, Naomi J. Ellis, Lisa Cowap, Victoria Riley, Diane Crone, Elizabeth Cottrell, Sarah Grogan, Ruth Chambers and David Clark-Carter

    Citation: BMC Family Practice 2019 20:11

    Published on:

  41. Content type: Research article

    The increasing number of available point-of-care (POC) tests challenges clinicians regarding decisions on which tests to use, how to efficiently use them, and how to interpret the results. Although POC tests m...

    Authors: Michelle M. A. Kip, J. Marjan Hummel, Elra B. Eppink, Hendrik Koffijberg, Rogier M. Hopstaken, Maarten J. IJzerman and Ron Kusters

    Citation: BMC Family Practice 2019 20:8

    Published on:

  42. Content type: Research article

    In Germany, home visits account for a considerable workload for many family practitioners, substantial rural-urban disparities are assumable with regards to home visit frequency and duration. Considering the o...

    Authors: Maik Pochert, Karen Voigt, Martin Bortz, Alessa Sattler, Jeannine Schübel and Antje Bergmann

    Citation: BMC Family Practice 2019 20:3

    Published on:

  43. Content type: Research article

    Long-term needs of stroke survivors are often not adequately addressed and many patients are dissatisfied with care post-discharge from hospital. Primary care could play an important role in identifying need i...

    Authors: Grace M. Turner, Ricky Mullis, Lisa Lim, Lizzie Kreit and Jonathan Mant

    Citation: BMC Family Practice 2019 20:2

    Published on:

  44. Content type: Research article

    First-contact accessibility remains an important problem in Canada, with this indicator staying the worst of all Organization for Economic Co-operation and Development countries. In the province of Quebec, a n...

    Authors: Andrée-Anne Paré-Plante, Antoine Boivin, Djamal Berbiche, Mylaine Breton and Maryse Guay

    Citation: BMC Family Practice 2018 19:188

    Published on: