The Influence of Family Physicians Within the South African District Health System: A Cross-Sectional Study.
Ann Fam Med
; 16(1): 28-36, 2018 01.
Article
em En
| MEDLINE
| ID: mdl-29311172
ABSTRACT
PURPOSE:
Evidence of the influence of family physicians on health care is required to assist managers and policy makers with human resource planning in Africa. The international argument for family physicians derives mainly from research in high-income countries, so this study aimed to evaluate the influence of family physicians on the South African district health system.METHODS:
We conducted a cross-sectional observational study in 7 South African provinces, comparing 15 district hospitals and 15 community health centers (primary care facilities) with family physicians and the same numbers without family physicians. Facilities with and without family physicians were matched on factors such as province, setting, and size.RESULTS:
Among district hospitals, those with family physicians generally scored better on indicators of health system performance and clinical processes, and they had significantly fewer modifiable factors associated with pediatric mortality (mean, 2.2 vs 4.7, P =.049). In contrast, among community health centers, those with family physicians generally scored more poorly on indicators of health system performance and clinical processes, with significantly poorer mean scores for continuity of care (2.79 vs 3.03; P =.03) and coordination of care (3.05 vs 3.51; P =.02).CONCLUSIONS:
In this study, having family physicians on staff was associated with better indicators of performance and processes in district hospitals but not in community health centers. The latter was surprising and is inconsistent with the global literature, suggesting that further research is needed on the influence of family physicians at the primary care level.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Médicos de Família
/
Garantia da Qualidade dos Cuidados de Saúde
/
Centros Comunitários de Saúde
/
Hospitais
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
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Observational_studies
/
Prevalence_studies
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Risk_factors_studies
Limite:
Humans
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article