Defining comprehensiveness in primary care: a scoping review.

Area of Science:

• Primary Care Research
• Health Services Research

Background:

• Comprehensiveness is a core attribute of primary care, recognized since the 1960s.
• Despite its importance, a consolidated definition of comprehensiveness in primary care has been lacking.
• Existing research prioritizes patient experience, cost, and health outcomes related to comprehensive care.

Purpose of the Study:

• To unify existing definitions of comprehensiveness in primary care.
• To establish a working, evidence-based definition of primary care comprehensiveness.

Main Methods:

• A scoping review was conducted following the PRISMA extension guidelines.
• MeSH terms and affiliated terms related to 'comprehensiveness' were hierarchically filtered.
• Snowballing methods and systematic review by a three-clinician team were employed.

Main Results:

• Twenty-five articles were included from an initial search of over 679,000.
• Key components identified were whole-person care (WPC), range of services, and referral to specialty care.
• WPC involves considering physical, emotional, and social health aspects, impacting costs, outcomes, and satisfaction.

Conclusions:

• Comprehensiveness in primary care integrates whole-person care, a broad range of services, and appropriate specialist referrals.
• A unified definition emphasizes managing most medical needs, complemented by integrated services aligned with patient values.
• This approach aims to improve patient care, reduce costs, and enhance continuity within primary care settings.