Table 1 Key drivers and their underpinning components identified by the expert panel.
From: Improving primary care management of asthma: do we know what really works?
1. National healthcare policy |
− Appropriately resourced primary care services |
− Actions to support universal health coverage |
− Recognition of importance of non-communicable chronic disease management |
− Balance between public and private insurance: healthcare systems |
− Redistribution of funding from hospitals to primary care |
2. Clinical guidelines |
− Recognition that primary care uses multiple disease guidelines |
− Primary care ownership and succinct evidence-based guidelines |
− Accessible guidelines produced in a standard recognised format |
− Consider shifting to symptom-based guidelines |
3. Reward for performance |
− Recognition and rewards for high-quality respiratory practice |
− Clearly defined financial incentive schemes |
− Reward for the practice not individual practitioners |
− Reimbursement policies aligned to guidelines, including prescribing |
4. Practice resources and organisation |
− Registered patient lists and fully integrated computer systems |
− Clinical care pathways |
− Access to high-quality lung function and other diagnostic tests |
− Access literacy and culturally sensitive patient education |
5. Workforce |
− Specialist asthma training programmes in primary care |
− Dedicated and appropriately asthma-trained personnel |
− Collaborative working across the wider primary healthcare team, with defined roles |
− Excellent interdisciplinary communication processes |
