title: Strengthening Integrated Care Through Population-Focused Primary Care Services: International Experiences Outside the United States.
abstract: Many high- and middle-income countries (HMICs) are experiencing a burden of comorbidity and chronic diseases. Together with increasing patient expectations, this burden is raising demand for population health-oriented innovation in health care. Using desk review and country case studies, we examine strategies applied in HMICs outside the United States to address these challenges, with a focus on and use of a new framework for analyzing primary care (PC). The article outlines how a population health approach has been supported by focusing assessment on and clustering services around social groups and multimorbidity, with support for community roles. It presents ways in which early first contact and continuity of PC, PC coordination of referral, multidisciplinary team approaches, investment in PC competencies, and specific payment and incentive models have all supported comprehensive approaches. These experiences locate PC as a site of innovation, where information technology and peer-to-peer learning networks support learning from practice.
authors.affiliation: Training and Research Support Centre, United Kingdom; email: admin@tarsc.org EquiACT, France; email: sarah.simpson@equiact.net.
authors.forename: Rene
authors.initials: R
authors.lastname: Loewenson
authors.affiliation: Training and Research Support Centre, United Kingdom; email: admin@tarsc.org EquiACT, France; email: sarah.simpson@equiact.net.
authors.forename: Sarah
authors.initials: S
authors.lastname: Simpson
mesh_terms: D002908:Chronic Disease; D003695:Delivery of Health Care; D054625:Healthcare Disparities; D006801:Humans; D007391:International Cooperation; D011320:Primary Health Care / Q000379:methods*; D014481:United States
keywords: health service innovation; health system reform; high- and middle-income countries; population health; primary care