Coordination, Comprehensiveness and Continuity as the Quality Measures of Remote Primary Healthcare in Poland

Liliana Hawrysz; Renata Walczak; Agnieszka Bitkowska; Piotr Korneta; Wioletta Pomaranik; Magdalena Kludacz-Alessandri

doi:10.15678/krem.17394

Authors

Liliana Hawrysz Wrocław University of Science and Technology, Faculty of Management https://orcid.org/0000-0002-0357-9930
Renata Walczak Warsaw University of Technology, Branch in Płock, Faculty of Civil Engineering, Mechanics and Petrochemistry https://orcid.org/0000-0002-9882-5195
Agnieszka Bitkowska Warsaw University of Technology, Faculty of Management https://orcid.org/0000-0002-2817-8244
Piotr Korneta Warsaw University of Technology, Faculty of Management https://orcid.org/0000-0003-2726-8309
Wioletta Pomaranik Warsaw University of Technology, Branch in Płock, College of Economics and Social Sciences https://orcid.org/0000-0001-9552-2677
Magdalena Kludacz-Alessandri Warsaw University of Technology, Branch in Płock, College of Economics and Social Sciences https://orcid.org/0000-0002-7011-2302

DOI:

https://doi.org/10.15678/krem.17394

Keywords:

comprehensiveness, continuity, coordination, quality of primary healthcare

Abstract

Objective: The purpose of this article is to examine the quality of remote primary healthcare in Poland measured through three dimensions: coordination, comprehensiveness, and continuity (3Cs) and examine the relationship between them.

Research Design & Methods: The 3Cs were measured using a proprietary questionnaire to measure the quality of primary healthcare in a teleconsultation setting. The survey was conducted among 98 patients in primary healthcare facilities nationwide in 2021. Structural equation modelling was used in the data analysis.

Findings: The survey results showed that coordination and continuity are one common dimension of quality of primary healthcare. In Poland, patients distinguish only between continuity of care and comprehensiveness. Coordination can be considered part of continuity because it requires a long-term relationship between the patient and the general practitioners. We found that continuity positively affects the comprehensiveness of primary healthcare.

Implications / Recommendations: This study is the first of its kind in primary healthcare in Poland, and its results may be of particular value to general practitioners and healthcare managers wishing to improve the quality of teleconsultation services.

Contribution: The evidence can help develop appropriate strategies for improving the quality of 3Cs-based care. Validated research tools provide basic metrics that can be used for future research to see to what extent the development of the telehealth system improves the continuity, coordination and comprehensiveness of remote primary healthcare.

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References

Bodenheimer, T., Ghorob, A., Willard-Grace, R., & Grumbach, K. (2014). The 10 Building Blocks of High-performing Primary Care. Annals of Family Medicine, 12(2), 166–171. https://doi.org/10.1370/afm.1616 DOI: https://doi.org/10.1370/afm.1616

Bokolo, A., Jr. (2020). Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic. Journal of Medical Systems, 44, 132. https://doi.org/10.1007/s10916-020-01596-5 DOI: https://doi.org/10.1007/s10916-020-01596-5

Cabana, M. D., & Jee, S. H. (2004). Does Continuity of Care Improve Patient Outcomes? The Journal of Family Practice, 53(12), 974–980. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/15581440/ (accessed: 7.03.2023).

Donelan, K., Barreto, E. A., Sossong, S., Michael, C., Estrada, J. J., Cohen, A. B., Wozniak, J., & Schwamm, L. H. (2019). Patient and Clinician Experiences with Telehealth for Patient Follow-up Care. American Journal of Managed Care, 25(1), 40–44.

Faujdar, D. S., Sahay, S., Singh, T., Kaur, M., & Kumar, R. (2020). Field Testing of a Digital Health Information System for Primary Health Care: A Quasi-experimental Study from India. International Journal of Medical Informatics, 141, 104235. https://doi.org/10.1016/J.IJMEDINF.2020.104235 DOI: https://doi.org/10.1016/j.ijmedinf.2020.104235

Freeman, G., & Hughes, J. (2010). Continuity of Care and the Patient Experience. An Inquiry into the Quality of General Practice in England. The King’s Fund.

Garattini, L., Badinella Martini, M., & Mannucci, P. M. (2021). Improving Primary Care in Europe beyond COVID-19: From Telemedicine to Organizational Reforms. Internal and Emergency Medicine, 16(2), 255–258. https://doi.org/10.1007/s11739-020-02559-x DOI: https://doi.org/10.1007/s11739-020-02559-x

Haggerty, J. L., Reid, R. J., Freeman, G. K., Starfield, B. H., Adair, C. E., & McKendry, R. (2003). Continuity of Care: A Multidisciplinary Review. BMJ, 327(7425), 1219–1221. https://doi.org/10.1136/BMJ.327.7425.1219 DOI: https://doi.org/10.1136/bmj.327.7425.1219

Hashemi, G., Wickenden, M., Bright, T., & Kuper, H. (2020). Barriers to Accessing Primary Healthcare Services for People with Disabilities in Low and Middle-income Countries, a Meta-synthesis of Qualitative Studies. Disability and Rehabilitation, 44(8), 1207–1220. https://doi.org/10.1080/09638288.2020.1817984 DOI: https://doi.org/10.1080/09638288.2020.1817984

Hu, P. J., Chau, P. Y. K., Sheng, O. R. L., & Tam, K. Y. (1999). Examining the Technology Acceptance Model Using Physician Acceptance of Telemedicine Technology. Journal of Management Information Systems, 16(2), 91–112. https://doi.org/10.1080/07421222.1999.11518247 DOI: https://doi.org/10.1080/07421222.1999.11518247

Jimenez, G., Matchar, D., Koh, G. C. H., Tyagi, S., van der Kleij, R. M. J. J., Chavannes, N. H., & Car, J. (2021). Revisiting the Four Core Functions (4Cs) of Primary Care: Operational Definitions and Complexities. Primary Health Care Research & Development, 22, e68. https://doi.org/10.1017/S1463423621000669 DOI: https://doi.org/10.1017/S1463423621000669

Kalaivani, K., Anjalipriya, V., Sivakumar, R., & Srimeena, R. (2015). An Efficient Bio-key Management Scheme for Telemedicine Applications. In: Proceedings – 2015 IEEE International Conference on Technological Innovations in ICT for Agriculture and Rural Development, TIAR 2015 (pp. 122–126). https://doi.org/10.1109/TIAR.2015.7358543 DOI: https://doi.org/10.1109/TIAR.2015.7358543

Khairat, S., Liu, S., Zaman, T., Edson, B., & Gianforcaro, R. (2019). Factors Determining Patients’ Choice between Mobile Health and Telemedicine: Predictive Analytics Assessment. JMIR mHealth and uHealth, 7(6), e13772. https://doi.org/10.2196/13772 DOI: https://doi.org/10.2196/13772

Kludacz-Alessandri, M., Walczak, R., Hawrysz, L., & Korneta, P. (2021). The Quality of Medical Care in the Conditions of the COVID-19 Pandemic, with Particular Emphasis on the Access to Primary Healthcare and the Effectiveness of Treatment in Poland. Journal of Clinical Medicine, 10(16), 3502. https://doi.org/10.3390/JCM10163502 DOI: https://doi.org/10.3390/jcm10163502

Kringos, D., Boerma, W., Bourgueil, Y., Cartier, T., Dedeu, T., Hasvold, T., Hutchinson, A., Lember, M., Oleszczyk, M., Rotar Pavlic, D., Svab, I., Tedeschi, P., Wilm, S., Wilson, A., Windak, A., van der Zee, J., & Groenewegen, P. (2013). The Strength of Primary Care in Europe: An International Comparative Study. British Journal of General Practice, 63(616), e742–e750. https://doi.org/10.3399/BJGP13X674422 DOI: https://doi.org/10.3399/bjgp13X674422

Kringos, D. S., Boerma, W. G., Hutchinson, A., van der Zee, J., & Groenewegen, P. P. (2010). The Breadth of Primary Care: A Systematic Literature Review of Its Core Dimensions. BMC Health Services Research, 10(1), 65. https://doi.org/10.1186/1472-6963-10-65 DOI: https://doi.org/10.1186/1472-6963-10-65

Kuang, L., Liang, Y., Mei, J., Zhao, J., Wang, Y., Liang, H., & Shi, L. (2015). Family Practice and the Quality of Primary Care: A Study of Chinese Patients in Guangdong Province. Family Practice, 32(5), 557–563. https://doi.org/10.1093/FAMPRA/CMV064 DOI: https://doi.org/10.1093/fampra/cmv064

Latifi, R., & Doarn, C. R. (2020). Perspective on COVID-19: Finally, Telemedicine at Center Stage. Telemedicine and e-Health, 26(9), 1106–1109. https://doi.org/10.1089/tmj.2020.0132 DOI: https://doi.org/10.1089/tmj.2020.0132

Lionis, C., Papadakis, S., Tatsi, C., Bertsias, A., Duijker, G., Mekouris, P. B., Boerma, W., & Schäfer, W. (2017). Informing Primary Care Reform in Greece: Patient Expectations and Experiences (the QUALICOPC Study). BMC Health Services Research, 17(1), 255. https://doi.org/10.1186/s12913-017-2189-0 DOI: https://doi.org/10.1186/s12913-017-2189-0

Maarsingh, O. R., Henry, Y., van de Ven, P. M., & Deeg, D. J. H. (2016). Continuity of Care in Primary Care and Association with Survival in Older People: A 17-year Prospective Cohort Study. British Journal of General Practice, 66(649), e531–e539. https://doi.org/10.3399/BJGP16X686101 DOI: https://doi.org/10.3399/bjgp16X686101

Macinko, J., Starfield, B., & Shi, L. (2003). The Contribution of Primary Care Systems to Health Outcomes within Organization for Economic Cooperation and Development (OECD) Countries, 1970–1998. Health Services Research, 38(3), 831–865. https://doi.org/10.1111/1475-6773.00149 DOI: https://doi.org/10.1111/1475-6773.00149

Maria, A. R. J., Serra, H., & Heleno, B. (2022). Teleconsultations and Their Implications for Health Care: A Qualitative Study on Patients’ and Physicians’ Perceptions. International Journal of Medical Informatics, 162, 104751. https://doi.org/10.1016/J.IJMEDINF.2022.104751 DOI: https://doi.org/10.1016/j.ijmedinf.2022.104751

Mold, F., Hendy, J., Lai, Y.-L., & de Lusignan, S. (2019). Electronic Consultation in Primary Care between Providers and Patients: Systematic Review. JMIR Medical Informatics, 7(4), e13042. https://doi.org/10.2196/13042 DOI: https://doi.org/10.2196/13042

O’Malley, A. S., Rich, E. C., Maccarone, A., DesRoches, C. M., & Reid, R. J. (2015). Disentangling the Linkage of Primary Care Features to Patient Outcomes: A Review of Current Literature, Data Sources, and Measurement Needs. Journal of General Internal Medicine, 30(Suppl 3), 576–585. https://doi.org/10.1007/S11606-015-3311-9 DOI: https://doi.org/10.1007/s11606-015-3311-9

Orlandoni, P., Jukic Peladic, N., Spazzafumo, L., Venturini, C., Cola, C., Sparvoli, D., Giorgini, N., Basile, R., & Fagnani, D. (2016). Utility of Video Consultation to Improve the Outcomes of Home Enteral Nutrition in a Population of Frail Older Patients. Geriatrics & Gerontology International, 16(6), 762–767. https://doi.org/10.1111/GGI.12551 DOI: https://doi.org/10.1111/ggi.12551

Pavlič, D. R., Sever, M., Klemenc-Ketiš, Z., & Švab, I. (2015). Process Quality Indicators in Family Medicine: Results of an International Comparison Service Organization, Utilization, and Delivery of Care. BMC Family Practice, 16(1), 172. https://doi.org/10.1186/S12875-015-0386-7 DOI: https://doi.org/10.1186/s12875-015-0386-7

Peckham, S. (2006). The Changing Context of Primary Care. Public Finance and Management, 6(4). DOI: https://doi.org/10.1177/152397210600600404

Rurik, I., Nánási, A., Jancsó, Z., Kalabay, L., Lánczi, L. I., Móczár, C., Semanova, C., Schmidt, P., Torzsa, P., Ungvári, T., & Kolozsvári, L. R. (2021). Evaluation of Primary Care Services in Hungary: A Comprehensive Description of Provision, Professional Competences, Cooperation, Financing, and Infrastructure, Based on the Findings of the Hungarian-arm of the QUALICOPC Study. Primary Health Care Research & Development, 22, e36. https://doi.org/10.1017/S1463423621000438 DOI: https://doi.org/10.1017/S1463423621000438

Schäfer, W. L. A., Boerma, W. G. W., Murante, A. M., Sixma, H. J. M., Schellevis, F. G., & Groenewegen, P. P. (2015). Assessing the Potential for Improvement of Primary Care in 34 Countries: A Cross-sectional Survey. Bulletin of the World Health Organization, 93(3), 161–168. https://doi.org/10.2471/blt.14.140368 DOI: https://doi.org/10.2471/BLT.14.140368

Schäfer, W. L. A., Boerma, W. G. W., Schellevis, F. G., & Groenewegen, P. P. (2018). GP Practices as a One-stop Shop: How Do Patients Perceive the Quality of Care? A Cross-sectional Study in Thirty-four Countries. Health Services Research, 53(4), 2047–2063. https://doi.org/10.1111/1475-6773.12754 DOI: https://doi.org/10.1111/1475-6773.12754

Shin, D. W., Cho, J., Yang, H. K., Park, J. H., Lee, H., Kim, H., Oh, J., Hwang, S., Cho, B., & Guallar, E. (2014). Impact of Continuity of Care on Mortality and Health Care Costs: A Nationwide Cohort Study in Korea. Annals of Family Medicine, 12(6), 534–541. https://doi.org/10.1370/AFM.1685 DOI: https://doi.org/10.1370/afm.1685

Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of Primary Care to Health Systems and Health. The Milbank Quarterly, 83(3), 457–502. https://doi.org/10.1111/J.1468-0009.2005.00409.X DOI: https://doi.org/10.1111/j.1468-0009.2005.00409.x

Worrall, G., & Knight, J. (2006). Continuity of Care for Older Patients in Family Practice: How Important Is It? Canadian Family Physician, 52(6), 754–755. Retrieved from: https://www.cfp.ca/content/52/6/754 (accessed: 7.03.2023).

Coordination, Comprehensiveness and Continuity as the Quality Measures of Remote Primary Healthcare in Poland

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