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Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries

AIM: To describe variation in task shifting from GPs to practice assistants/nurses in 34 countries and to explain differences by analysing associations with characteristics of the GPs and their practices and features of the health care systems. BACKGROUND: Redistribution of tasks and responsibilitie...

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Autores principales: Groenewegen, Peter, Boerma, Wienke G.W., Spreeuwenberg, Peter, Seifert, Bohumil, Schäfer, Willemijn, Batenburg, Ronald, van Tuyl, Lilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532851/
https://www.ncbi.nlm.nih.gov/pubmed/36134523
http://dx.doi.org/10.1017/S1463423622000470
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author Groenewegen, Peter
Boerma, Wienke G.W.
Spreeuwenberg, Peter
Seifert, Bohumil
Schäfer, Willemijn
Batenburg, Ronald
van Tuyl, Lilian
author_facet Groenewegen, Peter
Boerma, Wienke G.W.
Spreeuwenberg, Peter
Seifert, Bohumil
Schäfer, Willemijn
Batenburg, Ronald
van Tuyl, Lilian
author_sort Groenewegen, Peter
collection PubMed
description AIM: To describe variation in task shifting from GPs to practice assistants/nurses in 34 countries and to explain differences by analysing associations with characteristics of the GPs and their practices and features of the health care systems. BACKGROUND: Redistribution of tasks and responsibilities in primary care are driven by changes in demand, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill-mix of primary care teams. These developments are hampered by barriers between professional domains. METHODS: Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7,200 general practitioners (GPs) in 34 countries. Task shifting is measured through a composite score of GPs’ self-reported shifting of tasks. Independent variables at GP and practice level are as follows: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are as follows: demand for and supply of care, nurse prescribing, and professionalisation of practice assistants/nurses. Multilevel analysis is used to account for clustering of GPs in countries. FINDINGS: Countries vary in the degree of task shifting. Regarding GP and practice characteristics, use of electronic health records and availability of support staff in the practice are positively associated with task shifting and GPs’ working hours negatively, in line with our hypotheses. Age of the GPs is, contrary to our hypothesis, positively related to task shifting. These variables explain 11% of the variance at GP level. Two country variables are related to task shifting: a lower percentage of practices without support staff in a country and nurse prescribing rights coincide with more task shifting. The percentage of practices without support staff has the strongest relationship, explaining 73% of the country variation.
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spelling pubmed-95328512022-10-17 Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries Groenewegen, Peter Boerma, Wienke G.W. Spreeuwenberg, Peter Seifert, Bohumil Schäfer, Willemijn Batenburg, Ronald van Tuyl, Lilian Prim Health Care Res Dev Research Article AIM: To describe variation in task shifting from GPs to practice assistants/nurses in 34 countries and to explain differences by analysing associations with characteristics of the GPs and their practices and features of the health care systems. BACKGROUND: Redistribution of tasks and responsibilities in primary care are driven by changes in demand, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill-mix of primary care teams. These developments are hampered by barriers between professional domains. METHODS: Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7,200 general practitioners (GPs) in 34 countries. Task shifting is measured through a composite score of GPs’ self-reported shifting of tasks. Independent variables at GP and practice level are as follows: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are as follows: demand for and supply of care, nurse prescribing, and professionalisation of practice assistants/nurses. Multilevel analysis is used to account for clustering of GPs in countries. FINDINGS: Countries vary in the degree of task shifting. Regarding GP and practice characteristics, use of electronic health records and availability of support staff in the practice are positively associated with task shifting and GPs’ working hours negatively, in line with our hypotheses. Age of the GPs is, contrary to our hypothesis, positively related to task shifting. These variables explain 11% of the variance at GP level. Two country variables are related to task shifting: a lower percentage of practices without support staff in a country and nurse prescribing rights coincide with more task shifting. The percentage of practices without support staff has the strongest relationship, explaining 73% of the country variation. Cambridge University Press 2022-09-22 /pmc/articles/PMC9532851/ /pubmed/36134523 http://dx.doi.org/10.1017/S1463423622000470 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Research Article
Groenewegen, Peter
Boerma, Wienke G.W.
Spreeuwenberg, Peter
Seifert, Bohumil
Schäfer, Willemijn
Batenburg, Ronald
van Tuyl, Lilian
Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries
title Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries
title_full Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries
title_fullStr Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries
title_full_unstemmed Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries
title_short Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries
title_sort task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532851/
https://www.ncbi.nlm.nih.gov/pubmed/36134523
http://dx.doi.org/10.1017/S1463423622000470
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