Composition of general practices in western countries and associations with their perceived ability to manage patients with chronic conditions

Background Primary care teams (PCTs) are recognized to improve the quality of care. However, few studies have examined which PCT composition best meets patients’ primary care (PC) needs.

Aim The present study aimed to describe the composition of PCTs in eleven Western countries and investigate potential associations with general practitioners’ (GPs) opinions about their practice’s ability to manage patients with chronic conditions and communicate with caregivers.

Design & setting We conducted a secondary analysis of the data from 11 Western countries that participated in the 2019 Commonwealth Fund International Health Policy Survey of Primary Care Physicians (N=13,200).

Method We used a hierarchical clustering algorithm to characterise different types of PCT according to the composition of the health care professionals (HCPs) making them up, in addition to GPs. We subsequently assessed associations between practice types and two GP-reported indicators: their practice’s coordination with social services (SS) and other community providers (CPs) and ability to manage patients with chronic conditions.

Results We characterised five types of PCT (Traditional, Multidisciplinary, Nurse-centred, Psychologist-centred and Physiotherapist-centred). The Traditional type represented 51.6% of all PCTs; they were mainly composed of moderate percentages of all the HCPs: The Multidisciplinary (11.9%) were composed of high percentages of the different HCPs. After controlling for country, the Multidisciplinariy type reported better coordination with SS and CPs than did Traditional ones (OR 0.39, 95%CI [0.29–0.53]).

Conclusion Multidisciplinary PCTs reported better outcomes than Traditional ones regarding their coordination with SS and CPs and perceived ability to manage patients with chronic conditions. These results should encourage governmental efforts to promote PC that uses multidisciplinary PCTs.