Jamart Hubert, Kringos Dionne, Tare Dajana, Chokshi Aishwarya, Tans Anouk, Heymans Isabelle, Van den Bruel Ann, Belche Jean-Luc
Department of General Practice, Research Unit Primary Care & Health, University of Liège, 13 Avenue Hippocrate, Quartier de L'Hôpital B23, Liège, 4000, Belgium.
Department of Public and Occupational Health, Associate Professor in Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
BMC Prim Care. 2025 Mar 27;26(1):84. doi: 10.1186/s12875-025-02783-4.
Belgian primary care is facing significant challenges due to increasing healthcare demands and an overall decline in the workforce. Most general practitioners (GPs) work solo or in mono-disciplinary practices, leading to suboptimal outcomes in areas such as preventive care and health promotion. In response, the Ministry of Health introduced a "New-Deal" for GPs, which includes additional funding to support innovative practice organisation models. A think tank of GP representatives was established to guide the initiative, with input from practising GPs gathered for further insight. This study aims to identify the professionals needed to support GPs in daily practice, define their roles, and explore the conditions necessary for integrating them into the GP-centred model of care.
Eleven focus groups were conducted with 122 GPs, ensuring geographical and linguistic diversity across Belgium. Participants were selected through purposive sampling to ensure a diverse range of organisational models across the country. A structured focus group guide was designed, incorporating three scenarios to examine tasks commonly encountered in GP practices. Data analysis was conducted using a codebook developed through an inductive approach.
GPs expressed a preference for relatively small-scale teams, generally consisting of nurses and receptionists. The role of a practice assistant was more ambiguously defined, positioned between clinical and administrative responsibilities. Key tools for effective team integration included co-location, well-defined protocols, a shared electronic health record, care coordination, and unified logistical management, all of which are critical to fostering multidisciplinary collaboration.
This study explores Belgian GPs' preferences for integrating healthcare professionals into their practices, with team composition adjusted to workload and patient needs. However, the traditional autonomy of practice design may hinder change. Future research is needed to refine financial models and integration tools for collaborative care.
由于医疗保健需求不断增加以及劳动力总体下降，比利时的初级医疗保健面临重大挑战。大多数全科医生（GP）独自工作或在单一学科诊所工作，导致在预防保健和健康促进等领域的效果欠佳。作为回应，卫生部为全科医生推出了一项“新政”，其中包括额外资金以支持创新的实践组织模式。成立了一个由全科医生代表组成的智囊团来指导该倡议，并收集执业全科医生的意见以获得更深入的见解。本研究旨在确定在日常实践中支持全科医生所需的专业人员，定义他们的角色，并探索将他们融入以全科医生为中心的护理模式所需的条件。
与122名全科医生进行了11个焦点小组讨论，确保比利时各地的地理和语言多样性。通过目的抽样选择参与者，以确保全国各地有各种各样的组织模式。设计了一个结构化的焦点小组指南，纳入三种情景以检查全科医生诊所中常见的任务。使用通过归纳法开发的编码手册进行数据分析。
全科医生表示倾向于规模相对较小的团队，通常由护士和接待员组成。实践助理的角色定义较为模糊，介于临床和行政职责之间。有效团队整合的关键工具包括同地办公、明确的协议、共享的电子健康记录、护理协调和统一的后勤管理，所有这些对于促进多学科协作至关重要。
本研究探讨了比利时全科医生在将医疗保健专业人员融入其诊所方面的偏好，团队组成根据工作量和患者需求进行调整。然而，传统的实践设计自主权可能会阻碍变革。未来需要进行研究以完善协作护理的财务模式和整合工具。
