Elsevier

Health Policy

Volume 123, Issue 6, June 2019, Pages 550-563
Health Policy

Implications of interprofessional primary care team characteristics for health services and patient health outcomes: A systematic review with narrative synthesis

https://doi.org/10.1016/j.healthpol.2019.03.015Get rights and content
Under a Creative Commons license
open access

Highlights

  • Shared goals, transparency, role clarity and co-location positively influence team functioning.

  • Studies assessing funding models or provider remuneration in team contexts are lacking.

  • Evidence about the influence of team structures on patient health is insufficient to inform design.

  • Policy makers seek evidence to inform the design of interprofessional teams in primary care.

  • This systematic review of extant evidence on the characteristics of interprofessional primary care teams can inform policy.

Abstract

Interprofessional primary care (IPPC) teams are promoted as an alternative to single profession physician practices in primary care with focus on preventive care and chronic disease management. Characteristics of teams can have an impact on their performance.

We synthesized quantitative, qualitative or mixed-methods evidence addressing the design of IPPC teams. We searched Ovid MEDLINE, Embase, CINAHL, and PAIS using search terms focused on IPPC teams. Studies were included if they discussed the influence of team structure, organization, financial arrangements, or policies and procedures, or either health care processes or outputs, health outcomes, or costs, and were conducted in Australia, Canada, the United Kingdom or New Zealand between 2003 and 2016. We screened 11,707 titles, 5366 abstracts, and selected 77 full text articles (38 qualitative, 31 quantitative and 8 mixed-methods).

Literature focused on the implications of team characteristics on team processes, such as teamwork, collaboration, or satisfaction of patients or providers. Despite heterogeneity of contexts, some trends are observable: shared space, common vision and goals, clear definitions of roles, and leadership as important to good teamwork. The impacts of these on health care outputs or patient health are not clear. To move the state of knowledge beyond perception of what works well for IPPC teams, researchers should focus on quantitative causal inference about the linkages between team characteristics and patient health.

Keywords

Interprofessional primary care teams
Structure
Organization
Funding
Team effectiveness
Systematic review
Narrative synthesis

Cited by (0)