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[Impact of the Healthcare Triad Model on Primary Care accessibility: a quasi-experimental before-and-after study]
Fátima Cañas Tornero1, Manuel Ignacio Monge García2, Lourdes González Soria3
1Área de Gestión Sanitaria Jerez, Hospital Universitario Jerez de la Frontera, Servicio Andaluz de Salud Costa Noroeste y Sierra de Cádiz, Andalucía, España.
Objective:
To assess the impact of the Healthcare Triad Model (HTM) on Primary Care accessibility by analyzing changes in Average Response Time (ART).
Design:
Multicenter, retrospective, quasi-experimental before-and-after study.
Setting:
Three primary care centers within the Jerez, Costa Noroeste and Sierra de Cádiz Health Management Area (Andalusia, Spain).
Participants:
Thirty physicians with continuous clinical activity throughout the study period. Data from the two months before and two months after implementation were analyzed, excluding the rollout phase and summer months.
Interventions:
Implementation of the Healthcare Triad Model, which integrates family physicians, nurses, and citizen care units to reorganize care demand management.
Main Outcome Measure:
Average Response Time (ART), defined as the number of days until a scheduled medical appointment.
Results:
Median ART decreased from 8.93 to 4.61 days, representing a median relative reduction of 39.5% (interquartile range [IQR]: 31.1-55.3; p <0.0001). Improvement was observed in 28 of 30 physicians. Multivariable analysis showed no significant associations between ART reduction and individual professional or workload characteristics.
Conclusions:
The Healthcare Triad Model significantly improves Primary Care accessibility through organizational redesign, independently of individual professional factors.
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