Primary Care Networks and Starfield's 4Cs: A Case for Enhanced Chronic Disease Management.

Journal Article (Journal Article)

The primary care network (PCN) was implemented as a healthcare delivery model which organises private general practitioners (GPs) into groups and furnished with a certain level of resources for chronic disease management. A secondary qualitative analysis was conducted with data from an earlier study exploring facilitators and barriers GPs enrolled in PCN's face in chronic disease management. The objective of this study is to map features of PCN to Starfield's "4Cs" framework. The "4Cs" of primary care-comprehensiveness, first contact access, coordination and continuity-offer high-quality design options for chronic disease management. Interview transcripts of GPs (n = 30) from the original study were purposefully selected. Provision of ancillary services, manpower, a chronic disease registry and extended operating hours of GP practices demonstrated PCN's empowering features that fulfil the "4Cs". On the contrary, operational challenges such as the lack of an integrated electronic medical record and disproportionate GP payment structures limit PCNs from maximising the "4Cs". However, the enabling features mentioned above outweighs the shortfalls in all important aspects of delivering optimal chronic disease care. Therefore, even though PCN is in its early stage of development, it has shown to be well poised to steer GPs towards enhanced chronic disease management.

Full Text

Duke Authors

Cited Authors

  • Foo, CD; Surendran, S; Jimenez, G; Ansah, JP; Matchar, DB; Koh, GCH

Published Date

  • March 12, 2021

Published In

Volume / Issue

  • 18 / 6

PubMed ID

  • 33809295

Pubmed Central ID

  • PMC8001119

Electronic International Standard Serial Number (EISSN)

  • 1660-4601

Digital Object Identifier (DOI)

  • 10.3390/ijerph18062926


  • eng

Conference Location

  • Switzerland