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Characteristics of patient enrolment policies in primary care

A qualitative analysis of 15 schemes from 12 high-income countries
Tara Kiran, Michael Kidd, Luke Allen
Journal
Evidence-based practice Policy analysis General practice Primary health care Health services planning Health services administration Patients Australia
Description

Patient enrolment with a general practice is one element of recent health care reforms in Australia. In this review, patient enrolment refers to the formal attachment of a patient to a specific primary care physician, either directly with a physician (e.g. family physician or general practitioner) or indirectly through a primary care practice (e.g. surgery, clinic or general practice), as well as registration with the overall health-care system.

A previous review on primary care enrolment schemes found substantial variations in their characteristics, each with the potential to affect their ability to ensure people have access to primary care and continuity in their care. This study developed a typology informed by the qualitative analysis of 15 schemes in 12 high-income countries for effective comparisons and informed policymaking. The schemes are classified and grouped according to their core characteristics. 

Two distinctive features emerged: 

  1. whether patients could attend other practices (i.e. restricted or unrestricted)
  2. whether there were different types of financial or non-financial incentives to enrol or attend enrolled practices, resulting in eight clusters of enrolment types. 

The identified typologies can assist researchers and policymakers in comparing and interpreting outcomes on patient enrolment schemes, including their impact on continuity of care. This study is particularly relevant to primary care reforms considering patient enrolment.

Publication Details
Peer Reviewed:
Yes
DOI:
10.1016/j.lanprc.2025.100023
License type:
CC BY
Access Rights Type:
open
Volume:
1
Issue:
2