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Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review

BACKGROUND: Fragmented delivery of health and social services can impact access to high-quality, person-centred care. The goal of system navigation is to reduce barriers to healthcare access and improve the quality of care. However, the effectiveness of system navigation remains largely unknown. Thi...

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Autores principales: Teggart, Kylie, Neil-Sztramko, Sarah E., Nadarajah, Abbira, Wang, Amy, Moore, Caroline, Carter, Nancy, Adams, Janet, Jain, Kamal, Petrie, Penelope, Alshaikhahmed, Aref, Yugendranag, Shreya, Ganann, Rebecca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165767/
https://www.ncbi.nlm.nih.gov/pubmed/37158878
http://dx.doi.org/10.1186/s12913-023-09424-5
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author Teggart, Kylie
Neil-Sztramko, Sarah E.
Nadarajah, Abbira
Wang, Amy
Moore, Caroline
Carter, Nancy
Adams, Janet
Jain, Kamal
Petrie, Penelope
Alshaikhahmed, Aref
Yugendranag, Shreya
Ganann, Rebecca
author_facet Teggart, Kylie
Neil-Sztramko, Sarah E.
Nadarajah, Abbira
Wang, Amy
Moore, Caroline
Carter, Nancy
Adams, Janet
Jain, Kamal
Petrie, Penelope
Alshaikhahmed, Aref
Yugendranag, Shreya
Ganann, Rebecca
author_sort Teggart, Kylie
collection PubMed
description BACKGROUND: Fragmented delivery of health and social services can impact access to high-quality, person-centred care. The goal of system navigation is to reduce barriers to healthcare access and improve the quality of care. However, the effectiveness of system navigation remains largely unknown. This systematic review aims to identify the effectiveness of system navigation programs linking primary care with community-based health and social services to improve patient, caregiver, and health system outcomes. METHODS: Building on a previous scoping review, PsychInfo, EMBASE, CINAHL, MEDLINE, and Cochrane Clinical Trials Registry were searched for intervention studies published between January 2013 and August 2020. Eligible studies included system navigation or social prescription programs for adults, based in primary care settings. Two independent reviewers completed study selection, critical appraisal, and data extraction. RESULTS: Twenty-one studies were included; studies had generally low to moderate risk of bias. System navigation models were lay person-led (n = 10), health professional-led (n = 4), team-based (n = 6), or self-navigation with lay support as needed (n = 1). Evidence from three studies (low risk of bias) suggests that team-based system navigation may result in slightly more appropriate health service utilization compared to baseline or usual care. Evidence from four studies (moderate risk of bias) suggests that either lay person-led or health professional-led system navigation models may improve patient experiences with quality of care compared to usual care. It is unclear whether system navigation models may improve patient-related outcomes (e.g., health-related quality of life, health behaviours). The evidence is very uncertain about the effect of system navigation programs on caregiver, cost-related, or social care outcomes. CONCLUSIONS: There is variation in findings across system navigation models linking primary care with community-based health and social services. Team-based system navigation may result in slight improvements in health service utilization. Further research is needed to determine the effects on caregiver and cost-related outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09424-5.
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spelling pubmed-101657672023-05-09 Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review Teggart, Kylie Neil-Sztramko, Sarah E. Nadarajah, Abbira Wang, Amy Moore, Caroline Carter, Nancy Adams, Janet Jain, Kamal Petrie, Penelope Alshaikhahmed, Aref Yugendranag, Shreya Ganann, Rebecca BMC Health Serv Res Research BACKGROUND: Fragmented delivery of health and social services can impact access to high-quality, person-centred care. The goal of system navigation is to reduce barriers to healthcare access and improve the quality of care. However, the effectiveness of system navigation remains largely unknown. This systematic review aims to identify the effectiveness of system navigation programs linking primary care with community-based health and social services to improve patient, caregiver, and health system outcomes. METHODS: Building on a previous scoping review, PsychInfo, EMBASE, CINAHL, MEDLINE, and Cochrane Clinical Trials Registry were searched for intervention studies published between January 2013 and August 2020. Eligible studies included system navigation or social prescription programs for adults, based in primary care settings. Two independent reviewers completed study selection, critical appraisal, and data extraction. RESULTS: Twenty-one studies were included; studies had generally low to moderate risk of bias. System navigation models were lay person-led (n = 10), health professional-led (n = 4), team-based (n = 6), or self-navigation with lay support as needed (n = 1). Evidence from three studies (low risk of bias) suggests that team-based system navigation may result in slightly more appropriate health service utilization compared to baseline or usual care. Evidence from four studies (moderate risk of bias) suggests that either lay person-led or health professional-led system navigation models may improve patient experiences with quality of care compared to usual care. It is unclear whether system navigation models may improve patient-related outcomes (e.g., health-related quality of life, health behaviours). The evidence is very uncertain about the effect of system navigation programs on caregiver, cost-related, or social care outcomes. CONCLUSIONS: There is variation in findings across system navigation models linking primary care with community-based health and social services. Team-based system navigation may result in slight improvements in health service utilization. Further research is needed to determine the effects on caregiver and cost-related outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09424-5. BioMed Central 2023-05-08 /pmc/articles/PMC10165767/ /pubmed/37158878 http://dx.doi.org/10.1186/s12913-023-09424-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Teggart, Kylie
Neil-Sztramko, Sarah E.
Nadarajah, Abbira
Wang, Amy
Moore, Caroline
Carter, Nancy
Adams, Janet
Jain, Kamal
Petrie, Penelope
Alshaikhahmed, Aref
Yugendranag, Shreya
Ganann, Rebecca
Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review
title Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review
title_full Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review
title_fullStr Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review
title_full_unstemmed Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review
title_short Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review
title_sort effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165767/
https://www.ncbi.nlm.nih.gov/pubmed/37158878
http://dx.doi.org/10.1186/s12913-023-09424-5
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