Pantelidis, Pantelis and Vozikis, Athanassios and Meggouli, Eirini (2019): Strategies to prioritize prevention in the Greek primary healthcare system.
PDF
MPRA_paper_92103.pdf Download (182kB) |
Abstract
The present study presents financial incentives for General Practitioners(GPs) to engage in specific preventive care services and describes new roles for nurses to provide recommendations regarding brief nutrition counseling. To calculate the total number of personnel required to provide nutrition counseling, we considered 4 elements: (1) published and estimated time required to deliver nutrition counseling (2) the number of the maximum patients seen per day (3) the annual workload of the provider and (4) the number of people requiring those services. We annualize the frequency of performing specific preventive care services by GPs based on the official recommendations by the American Cancer Society. One exclusive nurse could provide a plan of care, designed to help almost 20.000 individuals either maintain the assessed status or attain a healthier status. Screening tests for cervical, colon and breast cancer should be performed by GPs to at least 3.537.810 individuals of the total Greek population for the year 2018.
Item Type: | MPRA Paper |
---|---|
Original Title: | Strategies to prioritize prevention in the Greek primary healthcare system |
English Title: | Strategies to prioritize prevention in the Greek primary healthcare system |
Language: | English |
Keywords: | Health Workforce Requirements, preventive services, primary healthcare, Greece. |
Subjects: | I - Health, Education, and Welfare > I1 - Health > I10 - General I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health J - Labor and Demographic Economics > J2 - Demand and Supply of Labor > J22 - Time Allocation and Labor Supply |
Item ID: | 92103 |
Depositing User: | Eirini Meggouli |
Date Deposited: | 04 Mar 2019 17:39 |
Last Modified: | 29 Sep 2019 21:08 |
References: | American Cancer Society Guidelines for the Early Detection of Cancer. Available at:https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html. Artinian NT, Fletcher GF, Mozaffarian D, Kris-Etherton P, Van Horn L, Lichenstein AH, Kumanyika S, Kraus WE, Fleg JL, Burke LE. Interventions to Promote Physical Activity and Dietary Lifestyle Changes for Cardiovascular Risk Factor Reduction in Adults: A Scientific Statement from the American Heart Association. Circulation. 2010;122:406–441. doi:10.1161/CIR.0b013e3181e8edf1. Barton M. Screening for obesity in children and adolescents: US preventive services task force recommendation statement. Pediatrics. 2010;125(2):361–367. doi:10.1542/peds.2009-2037. Bodenheimer T, MacGregor K, Stothart N. Nurses as leaders in chronic care: Their role is pivotal in improving care for chronic diseases. British Medical Journal. 2005;330(7492):612-613. Chen LM, Farwell WR, Jha AK. Primary care visit duration and quality: does good care take longer? Arch Intern Med. 2009;169(20):1866–1872. Constantinou P, Sicsic J, Franc C. Effect of pay-for-performance on cervical cancer screening participation in France. International Journal of Health Economics and Management. 2016. doi:10.1007/s10754-016-9207-3. Dahrouge S, Hogg WE, Russell G, Tuna M, Geneau R, Muldoon LK, Kristjansson E, Fletcher J. Impact of remuneration and organizational factors on completing preventive manoeuvres in primary care practices. Can Med Assoc J. 2012;184:2. Dierick-van Daele AT, Steuten LM, Metsemakers JF, Derckx EW, Spreeunwenberg C, Vrijhoef HJ. Economic evaluation of nurse practitioners versus GPs in treating common conditions. British Journal for General Practice. 2010;60(570):28-35. doi:10.3399/bjgp10X482077. Elia M, Zellipour L, Stratton RJ. To screen or not to screen for adult malnutrition?. Clinical Nutrition. 2005;24(6):867-884. doi:10.1016/j.clnu.2005.03.004. Färnkvist L, Olofsson N, Weinehall L. Did a health dialogue matter? Self-reported cardiovascular disease and diabetes 11 years after health screening. Scand J Prim Health Care 2008;26:135–9. Frich LM. Nursing interventions for patients with chronic conditions. Journal of Advanced Nursing.2003;44(2):137-53. Fujisawa R., Lafortune G., (2008), The Remuneration of general practitioners and specialists in 14 OECD countries: what are the factors influencing variations across countries?, Paris, Organization for Economic Co-operation and Development, OECD Health Working Papers, no.41. Garrison GM, Traverse CR, Fish RG. A Case Study of Visit-Driven Preventive Care Screening Using Clinical Decision Support: The Need to Redesign Preventive Care Screening. Health services research and managerial epidemiology. 2016;3:2333392816650344. doi:10.1177/2333392816650344. Glasgow RE, Kaplan RM, Ockene JK, Fisher EB, Emmons KM. Patient-reported measures of psychosocial issues and health behavior should be added to electronic health records. Health Aff (Millwood). 2012;31(3):497–504. Grandes G,Sanchez A, Montoya I, Sanchez-Pinilla R, Torcal J. Two-year longitudinal analysis of a cluster randomized trial of physical activity promotion by general practitioners. PLoS One. 2011;6(3). doi:10.1371/journal.pone.0018363. Green S, Watson R. Nutritional screening and assessment tools for older adults: Literature review. Journal of Advanced Nursing. 2016;54(4):477-490. doi:10.1111/j.1365-2648.2006.03841.x. Greene J. An Examination of Pay-for-Performance in General Practice in Australia. Health Services Research. 2013;48(4):1415-1432. doi:10.1111/1475-6773.12033. Greene SM, James EP. Barriers and facilitators to undertaking nutritional screening of patients: a systematic review. Journal of Human Nutrition and Dietetics. 2013;263):211-21. doi:10.1111/jhn.12011. Groenewegen P, Jurgutis A. A future for primary care for the Greek population. Quality in Primary Care. 2013;21(6):369-78. Hocking J, Temple-Smith M, et al. Can preventive care activities in general practice be sustained when financial incentives and external audit plus feedback are removed? Accept-able: a cluster randomised controlled trial protocol. Implementation Science. 2016;11:122. doi:10.1186/s13012-016-0489-0. Hogg W, Lemelin J, Moroz I, Soto E, Russell G. Improving prevention in primary care: Evaluating the sustainability of outreach facilitation. Canadian Family Physician. 2008;54(5):712-720. Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ. 2002;14:819–823. doi:10.1136/bmj.324.7341.819. Hudon E, Beaulieu MD, Roberge D. Integration of the recommendations of the Canadian Task Force on Preventive Health Care: Obstacles perceived by a group of family physicians. Family Practice. 2004;21(1):11-17. doi: 10.1093/fampra/cmh104. Hurley J, Decicca P, Li J, Buckley G. The response of Ontario primary care physicians to pay-for-performance incentives. Centre for Health Economics and Policy Analysis. Ontario; 2011. Available at: https://macsphere.mcmaster.ca/bitstream/11375/16898/1/229350.pdf. Imperial Cancer Research Fund Oxcheck Study Group. Effectiveness of health checks conducted by nurses in primary care: results of the OXCHECK study after one year. OXCHECK Study Group. British Medical Journal. 1994;308(6924):308-312. Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 12, Assessment of Nutrient Needs. Available at: https://www.ncbi.nlm.nih.gov/books/NBK235239/. International Agency for Research on Cancer. Cancer Screening in the European Union: Report on the implementation of the Council Recommendation on cancer screening. European Commission;2017. Available at: https://ec.europa.eu/health/sites/health/files/major_chronic_diseases/docs/2017_cancerscreening_2ndreportimplementation_en.pdf. Jawad M, Ingram S, Choudhury I, Airebamen A, Christodoulou K, Wilson Sharma A. Television-based health promotion in general practice waiting rooms in London: a cross-sectional study evaluating patients’ knowledge and intentions to access dental services. BMC Oral Health. 2017;17:24. doi:10.1186/s12903-016-0252-6. Kane RL, Johnson PE, Town RJ, et al. Economic Incentives for Preventive Care: Summary. 2004 Aug. In: AHRQ Evidence Report Summaries. Rockville (MD): Agency for Healthcare Research and Quality (US); 1998-2005. 101. Available at: https://www.ncbi.nlm.nih.gov/books/NBK11845. Kiran T, Wilton AS, Moineddin R, Paszat L, Glazier RH. Effect of Payment Incentives on Cancer Screening in Ontario Primary Care. Annals of Family Medicine. 2014;12(4):317-323. doi:10.1370/afm.1664. Kottke TE, Brekke ML, Solberg LI. Making time for preventive services. Mayo Clinic Proceedings. 1993;68(8):785-91. Kris-Etherton PM, Akabas SR, Bales CW, et al. The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness. The American Journal of Clinical Nutrition. 2014;99(5):1153S-1166S. doi:10.3945/ajcn.113.073502. Laurant M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B. Substitution of doctors by nurses in primary care. Cochrane Database Syst Rev. 2005;14:CD001271. doi:10.1002/14651858.CD001271.pub2. Margolius D, Bodenheimer T. Transforming Primary Care: From Past Practice to the Practice of the Future. Health Affairs. 2010;29(5):779-784. doi:10.1377/hlthaff.2010.0045. Markert J, Herget S, Marschke S, Lehnert T, Falkenberg C, Blüher S. Case management via telephone counseling and SMS for weight maintenance in adolescent obesity: study concept of the TeAM program. BMC obesity. 2014;1:8. doi:10.1186/2052-9538-1-8. Markle-Reid M, Browne G, Gafni A. Nurse-led health promotion interventions improve quality of life in frail older home care clients: Lessons learned from three randomized trials in Ontario. Journal of Evaluation in Clinical Practice. 2011; 19(1). doi:10.1111/j.1365-2753.2011.01782. Marks L, Cave S, Wallace A, Mason A, Hunter DJ, Mason JM, Peckham S. Incentivizing preventive services in primary care: perspectives on Local Enhanced Services. J Public Health (Oxf). 2011; 33 (4):556-564. doi:10.1093/pubmed/fdr016. Naylor M, Kurtzman E. The role of Nurse Practitioners in Reinventing Primary Care. Health Affairs. 2010;29(5):893-899. doi:10.1377/hlthaff.2010.0440. Nickolas L, PonD, Roberts D. The effectiveness of nutrition counselling by Australian General Practitioners. European Journal of Clinical Nutrition.2005;59(1):140-146. doi:10.1038/sj.ejcn.1602187. Nicholas L, Roberts D, Pond D. The role of the general practitioner and the dietitian in patient nutrition management. Asia Pacific Journal of Clinical Nutrition. 2003;12(1):3-8. Ockene IS, Hebert JR, Ockene JK, Saperia GM, Stanek E, Nicolosi R, Merriam PA, Hurley TG. Effect of Physician-Delivered Nutrition Counseling Training and an Office-Support Program on Saturated Fat Intake, Weight, and Serum Lipid Measurements in a Hyperlipidemic PopulationWorcester Area Trial for Counseling in Hyperlipidemia (WATCH). Arch Intern Med. 1999;159(7):725-731. doi:10.1001/archinte.159.7.725. O'Connor P, Sperl-Hillen JA, Margolis K, Kottke T. Strategies to Prioritize Clinical Options in Primary Care. Annals of Family Medicine.2017;15:10-13. doi: 10.1370/afm.2027. OECD. Cancer Care: Assuring Quality to Improve Survival. OECD Health Policy Studies , OECD Publishing. doi: 10.1787/9789264181052. OECD. How does Greece compare? OECD Health Statistics 2014. Available at: http://www.oecd.org/els/health-systems/Briefing-Note-GREECE-2014.pdf. OECD, Overweight or obese population (indicator), OECD Publishing 2017. doi:10.1787/86583552-en. OECD. Ratio of nurses to physicians: 2013 or latest available year, in OECD Factbook 2015-2016. OECD Publishing. Paris;2016. doi: 10.1787/factbook-2015-graph199-en. Peckham S, Gousia K. GP Payment schemes review. Policy Research Unit in Commissioning and the Healthcare System. Centre for Health Services Studies, University of kent;2014. doi:10.13140/2.1.4497.4405. Phillips SM, Glasgow RE, Bello G, et al. Frequency and Prioritization of Patient Health Risks from a Structured Health Risk Assessment. Annals of Family Medicine. 2014;12(6):505-513. doi:10.1370/afm.1717. Pignone M, Ammerman A, Fernandez L et al. Counseling to promote a healthy diet in adults: A summary of the evidence for the U.S. Preventive Services Task Force. American Journal of Preventive Medicine. 2003;24(1):75-92. doi:10.1016/S0749-3797(02)00580-9. Ploeg J, Brazil K, Hutchinson B, Kaczorowski J, Dalby D, Goldsmith C, Furlong W. Effect of preventive primary care outreach on health related quality of life among older adults at risk of functional decline: randomized controlled trial. British Medical Journal. 2010;340:1480. doi:10.1136/bmj.c1480. Prevention for a healthier America: investments in disease prevention yield significant savings, stronger communities [Internet]. Washington, D.C.: Trust for America’s Health; 2008. Available at: http://healthyamericans.org/reports/prevention08/. Rasmussen SR, Thomsen JL, Kilsmark J, Hvenegaard A, Engberg M, Lauritzen T, Sogaard J. Preventive health screenings and health consultations in primary care increase life expectancy without increasing costs. Scadinavian Journal of Public Health. 2007;35:365-372. doi:10.1080/14034940701219642. Reginato E, Grosso R. European Hospital Doctor's Salaries. European Federation of Salaried Doctors. Available at: http://www.liganet.hu/news/6205/F11-71_EN_European_Hospital_Doctors_Salaries.pdf. Sargent GM, Forrest LE, Parker RM. Nurse delivered lifestyle interventions in primary health care to treat chronic disease risk factors associated with obesity: a systematic review. Obesity Reviews. 2012;13(12):1148-1171. doi:10.1111/j.1467-789X.2012.01029.x. Scott A, Sivey P, Ait Ouakrim D, Willenberg L, Naccarella L, Furler J, Young D. The effect of financial incentives on the quality of health care provided by primary care physicians. Cochrane Database of Systematic Reviews . 2011;9:CD008451. doi:10.1002/14651858.CD008451.pub2. Steering Committee on Future Health Scenarios: Primary care and home care scenarios 1990-2005. Dodrecht: Kluwer Publishers,1993. U.S. Preventive Services Task Force. Behavioral Counseling in Primary Care to Promote a Healthy Diet in Adults at Increased Risk for Cardiovascular Disease, Topic Page. 2011. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdiet.htm. Van Der Biezen M, Adang E, Van Der Burgt R, Wensing M, Laurant M. The impact of substituting general practitioners with nurse practitioners on resource use, production and health-care costs during out-of-hours: a quasi-experimental study. BMC Family Practice. 2016;17(1):132. doi:10.1186/s12875-016-0528-6. Walter U, Flick U, Neuber A, Fischer C, Hussein R, Schwartz F. Putting prevention into practice: qualitative study of factors that inhibit and promote preventive care by general practitioners, with a focus on elderly patients. BMC Family Practice. 2010;11:68. doi:10.1186/1471-2296-11-68. Wang LY, Crossett LS, Lowery R, Sussman S, Dent CW. Cost-effectiveness of a school-based tobacco-use prevention program. Archives of Pediatrics and Adolescent Medicine 2001;155:1043–1050. World Bank. Population Estimates and Projections. World Bank Group;2016. Available at: http://databank.worldbank.org/data/reports.aspx?source=Health%20Nutrition%20and%20Population%20Statistics:%20Population%20estimates%20and%20projections. World Health Organization. World Health Report 1998, Life in the 21st century: a vision for all. Geneva;1998. Available at: http://www.who.int/whr/1998/en/whr98_en.pdf?ua=1. Wynn K, Trudeau JD, Taunton K, Gowans M, Scott I. Nutrition in primary care: Current practices, attitudes, and barriers. Canadian Family Physician. 2010;56(3):109-116. Yarnall KSH, Pollak KI, Østbye T, Krause KM, Michener JL. Primary Care: Is There Enough Time for Prevention? American Journal of Public Health. 2003;93(4):635-641. |
URI: | https://mpra.ub.uni-muenchen.de/id/eprint/92103 |