| dc.description.abstract | Community Oriented Primary Care (COPC) is a method that aims to enhance community health by 1) defining and characterizing communities and subcommunities within the community; 2) identifying (sub-)community health problems; 3) developing and implementing intervention(s) to improve found health problems; 4) monitoring and evaluating implemented intervention(s); 5) involving the community in community oriented projects. COPC is practiced predominantly by general practitioners (GPs).
Research questions
This paper examines GPs community oriented vision - ‘community orientation’ -, by 1) analyzing how GPs community orientation is distributed over 34 (mostly European) countries; 2) analyzing how country-, practice- and GP level characteristics relate to GPs community orientation and 3) producing evidence-based policy advice regarding the international promotion of GPs community orientation.
Methods
QUALICOPC survey data on ~7500 GPs in 34 (mostly European) countries is analysed, using hierarchical multilevel analysis. The dependent variable, GP community orientation, is measured using a scale of three questions on whether or not GPs answered they would report to an authority if they were confronted with the following situations: repeated accidents in an industrial setting, frequent respiratory problems in patients living near a certain industry and repeated cases of food poisoning. Independent variables are at the system-, practice- and individual GP level.
Results
Findings are that at the country level, having a patient list system is positively related to GPs community orientation and transitional health care systems are negatively related to GPs community orientation. At the practice level, practicing preventive care, interdisciplinary collaboration and practicing in rural areas are positively related to GPs community orientation and GPs perception of a below average ethnic minority proportion of patient population is negatively related to GPs community orientation. At the GP level, having other paid activities next to working as a GP is positively related to GP community orientation.
Conclusion and policy advice
Reasons for the significant relationships of practising in rural areas, GPs perception of proportion of ethnic minority patients and having other paid activities with GPs community orientation are unclear. Therefore, policy advice is formulated regarding the implementation of nationally enforced patient list systems, preventive care and interdisciplinary collaboration. | |
