Transformation of primary care settings implementing a co-located team-based care model: a scoping review

Area of Science:

• Health Services Research
• Primary Care Medicine
• Health Policy and Management

Background:

• Canadian primary care reforms have introduced various team-based care models.
• These models aim to improve patient access and the comprehensiveness of care.
• Challenges persist despite these reforms.

Purpose of the Study:

• To conduct a scoping review of team-based care models in Canadian primary care.
• To explore the functioning, contextual factors, and impact of these models.
• To understand their effects on patients, providers, and healthcare costs.

Main Methods:

• Searched Medline and CINAHL databases.
• Included co-located models with a family physician and specified professionals.
• Analyzed organization, coordination, context, and impact on population, providers, and costs.

Main Results:

• 15 articles were selected from 5952 studies, showing varied terminology and operationalization.
• Models align with the Patient's Medical Home vision, focusing on mental health and chronic diseases.
• Patient and provider expectations are generally met, but economic evaluations are scarce.

Conclusions:

• Lack of overarching views hinders universal guidelines for effective team-based models.
• Implementation complexity requires collaborative stakeholder approaches, including patients.
• Tailoring models to specific populations and professional inclusion is crucial.