Primary Care Support Tools for Digestive Health Care: A Mixed Method Study.

Area of Science:

• Health Services Research
• Gastroenterology
• Primary Care

Background:

• Rising demands for gastroenterology care and long wait times necessitate improved referral systems.
• Centralized Access and Triage (CAT) systems, telephone support, and clinical care pathways were implemented to manage low-risk gastrointestinal (GI) conditions in primary care.
• Understanding provider perceptions of these supports is crucial for effective implementation.

Purpose of the Study:

• To assess primary care providers' (PCPs) and gastroenterology (GI) specialists' perceptions of CAT systems and clinical care pathways.
• To identify factors influencing the implementation of these supports.
• To determine barriers and facilitators to implementing these supports from both PCP and GI specialist viewpoints.

Main Methods:

• A mixed-methods study combining online surveys and semistructured qualitative interviews with PCPs and GI specialists.
• Data collected between July and September 2022.
• Thematic analysis for interview transcripts and descriptive/inferential statistics for survey data (SPSS v25).

Main Results:

• PCPs reported satisfaction with CAT and pathways, noting benefits for equitable access but limitations for vulnerable populations.
• GI specialists were generally satisfied, finding CAT and pathways reduced unnecessary resource expenditure.
• Significant differences in perceptions of CAT's effectiveness were found between fee-for-service and alternative relationship plan GI specialists.

Conclusions:

• Both PCPs and GI specialists agree that CAT and primary care pathways enhance referral quality, reduce costs, and ensure equitable access to GI services.
• Improving CAT processes and pathway awareness can further minimize unnecessary referrals.
• Addressing specific process limitations is key to optimizing these systems.