Exploring future models of primary care for Texas

摘要

Purpose - The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the burden of chronic disease in a population-based approach. Design/methodology/approach - A systematic literature review was conducted and identified 1,880 published records through PubMed using 26 search terms. After abstract and full-text review, 70 articles remained as potential models. Findings - Although there is already a severe shortage of physicians in Texas, emerging practice patterns and choices among physicians are likely to erode access to primary care services in the state. Health-care leaders are encouraged to consider models such as complex adaptive systems for team-based care, pharmacist hypertension care management program and combined nurse-led care management with group visit structure. Research limitations/implications - As with any study, this research has its limitations; for example, models that might work in one state, or under a unique state-funded academic medical center, might not be "do-able" in another state within the nuances of a different funding mechanism. Practical implications - Results of this research provide a model for implementing IPCM for the state of Texas first and will guide IPCM planning and implementation in other states. Originality/value - This study is "land grant-centric" and focused on carrying out the mission of a major, top-tier research university with an emerging college of medicine at an academic medical center.