What Is the Optimal Primary Care Panel Size?: A Systematic Review

Area of Science:

• Health Services Research
• Primary Care Medicine
• Population Health Management

Background:

• Primary care patient panel size is crucial for population health management.
• The optimal panel size for primary care physicians is not well-defined.

Purpose of the Study:

• To systematically review existing evidence on the relationship between primary care panel size and healthcare outcomes.
• To investigate the association between panel size and provider burnout.

Main Methods:

• Searched multiple databases and Google for English-language studies up to October 2019.
• Included studies of any design assessing panel size effects on safety, efficacy, patient-centeredness, timeliness, efficiency, equity, or burnout.
• Utilized independent, dual-reviewer data extraction and consensus for evidence certainty rating.

Main Results:

• Low-certainty evidence suggests increasing panel size may have minimal adverse effects on patient-centered and effective care.
• Low-certainty evidence indicates variable effects of panel size on timely care.
• Moderate-certainty evidence from simulation models shows adjusting panel size for case mix improves access.
• No studies evaluated panel size impact on safety, efficiency, or equity.
• Very-low-certainty evidence links larger panels to provider burnout.

Conclusions:

• Insufficient evidence exists to establish evidence-based recommendations for optimal primary care panel size.
• Further research is needed to determine the ideal panel size for maximizing health outcomes and minimizing provider burnout.