Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2002-5-6
pubmed:abstractText
There are frequent calls to improve integration of health services, within and between primary and secondary care sectors. In Australia, general medical practitioners (GPs) are central to these endeavours. This paper aims to better conceptualise GP integration and to develop a model and index based on this. A conceptualisation of integration is proposed based on integration fundamentally as an activity or process not structure. Integration process is the frequency and quality of episodes of information exchange involving the GP and another practitioner or patient and aimed at fulfilling the objectives of the health care system with regard to patient care. These are both direct responses to structural forces and emergent GP capacities and dispositions. The content of this typology was studied using Concept Mapping in 11 groups of GPs, consumers and other practitioners. Clusters of related statements within thematic domains were used as the basis for a provisional model. This was tested using confirmatory factor analysis in a data set derived from a national probability sample of 501 GPs. Some re-specification of the model was necessary, with three integration process factors needing to be subdivided. One factor congeneric model assumptions were used to identify the constituent items for these factors. The result was a model in which 50 items measured nine integration process factors and 20 items measured five enabling factors. Two distinct but correlated higher order factors, relating to individual patient care and public (or community) health--in contrast to a single higher order factor for integration--were identified. The re-specified model was tested with a new sample of 151 GPs and exhibited strong psychometric properties. Reliability and validity were acceptable to this stage of the indices' development. Further testing of the index is necessary to demonstrate factor invariance of the indices in other contexts as well as their utility in cross-structural analysis. That said, the indices have immediate uses.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0277-9536
pubmed:author
pubmed:issnType
Print
pubmed:volume
54
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1225-41
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:11989959-Attitude of Health Personnel, pubmed-meshheading:11989959-Australia, pubmed-meshheading:11989959-Cluster Analysis, pubmed-meshheading:11989959-Community Health Planning, pubmed-meshheading:11989959-Continuity of Patient Care, pubmed-meshheading:11989959-Delivery of Health Care, Integrated, pubmed-meshheading:11989959-Factor Analysis, Statistical, pubmed-meshheading:11989959-Family Practice, pubmed-meshheading:11989959-Humans, pubmed-meshheading:11989959-Interviews as Topic, pubmed-meshheading:11989959-Models, Theoretical, pubmed-meshheading:11989959-Physician-Patient Relations, pubmed-meshheading:11989959-Primary Health Care, pubmed-meshheading:11989959-Psychometrics, pubmed-meshheading:11989959-Public Health, pubmed-meshheading:11989959-Reproducibility of Results, pubmed-meshheading:11989959-Systems Theory
pubmed:year
2002
pubmed:articleTitle
Construction of a GP integration model.
pubmed:affiliation
Centre for Health Program Evaluation, Department of General Practice & Public Health, The University of Melbourne, West Heidelberg, VIC, Australia.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't