TY - JOUR
T1 - Implementation challenges of family physician program: A systematic review on global evidence
AU - Mohammadibakhsh, Roghayeh
AU - Aryankhesal, Aidin
AU - Sohrabi, Rahim
AU - Alihosseini, Samira
AU - Behzadifar, Masoud
N1 - Funding Information:
This study was part of a Ph.D. thesis supported by the School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran (IUMS/SHMIS_97_4_37_13765).
Publisher Copyright:
© Iran University of Medical Sciences
PY - 2023/3/13
Y1 - 2023/3/13
N2 - Background: The family physician program, as one of the core arms of health care systems, has faced various implementation challenges around the world. Experiences in the implementation of family physician program can be helpful for nations that seek to apply for similar programs. The aim of this study is to systematically review the implementation challenges of family physician program across the world. Methods: A systematic search was conducted from January 2000 to February 2022 across scientific databases of Embase, MEDLINE, Web of Science, Scopus, CINAHL, EBSCO, and Google Scholar. The Framework approach was used to analyze the selected studies. The quality of the included studies was evaluated using the McMaster Critical Review Form for qualitative studies. Results: 35 studies upon the study inclusion criteria were included. Based on the Six Building Blocks frame, seven themes and 21 subthemes were developed as the implementation challenges of family physician program. 1) Governance: policy guidance, intelligence, coalition, regulation, system design, and accountability; 2) Financing: financing and payment system; 3) Health workforce: education, research, recruitment and motivation opportunities; 4) Service delivery: management of health services, service package, referral system, continuity of care; 5) Health information systems: production and evaluating the health information system; 6) Availability: provision basic health services, maintenance of facilities; and 7) Cultural considerations: behavior and social determinants of health. Conclusion: Scientific governance, financing, and payment mechanisms, workforce empowerment, designing a strong health information system, and providing access to services with cultural considerations can result in the successful implementation of the family physician program in communities
AB - Background: The family physician program, as one of the core arms of health care systems, has faced various implementation challenges around the world. Experiences in the implementation of family physician program can be helpful for nations that seek to apply for similar programs. The aim of this study is to systematically review the implementation challenges of family physician program across the world. Methods: A systematic search was conducted from January 2000 to February 2022 across scientific databases of Embase, MEDLINE, Web of Science, Scopus, CINAHL, EBSCO, and Google Scholar. The Framework approach was used to analyze the selected studies. The quality of the included studies was evaluated using the McMaster Critical Review Form for qualitative studies. Results: 35 studies upon the study inclusion criteria were included. Based on the Six Building Blocks frame, seven themes and 21 subthemes were developed as the implementation challenges of family physician program. 1) Governance: policy guidance, intelligence, coalition, regulation, system design, and accountability; 2) Financing: financing and payment system; 3) Health workforce: education, research, recruitment and motivation opportunities; 4) Service delivery: management of health services, service package, referral system, continuity of care; 5) Health information systems: production and evaluating the health information system; 6) Availability: provision basic health services, maintenance of facilities; and 7) Cultural considerations: behavior and social determinants of health. Conclusion: Scientific governance, financing, and payment mechanisms, workforce empowerment, designing a strong health information system, and providing access to services with cultural considerations can result in the successful implementation of the family physician program in communities
KW - Family physician program
KW - Health Policy
KW - Health systems
KW - Six Building Blocks
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85150298655&partnerID=8YFLogxK
U2 - 10.47176/mjiri.37.21
DO - 10.47176/mjiri.37.21
M3 - Review article
AN - SCOPUS:85150298655
VL - 37
JO - Medical Journal of the Islamic Republic of Iran
JF - Medical Journal of the Islamic Republic of Iran
SN - 1016-1430
IS - 1
M1 - 21
ER -