Primary Care Productivity: Findings from the Literature and Perspectives from a Stakeholder Panel

• Published in: Policy File 2021
• Main Authors: Hempel, Susanne, Curtis, Idamay, Fihn, Stephan D, Brothers, Annie, Danz, Marjorie, Nelson, Karin M, Motala, Aneesa, Rubenstein, Lisa V
• Format: Report
• Language: English
• Subjects: RAND Corporation

At present, there is a lack of consensus on how to define and assess primary care clinic productivity. To address this need, the authors reviewed relevant literature and convened a diverse set of stakeholders to explore definitions and assessment of productivity, input, and output in primary care; identify tools relevant to primary care productivity; and establish consensus on key aspects of primary care productivity. The authors built on a systematic review of patient panel size, conducted a rapid review exploring the operationalization of input and output in biomedical research (as well as a rapid review to identify tools for health care delivery organizations), and performed additional scoping searches. The research evidence informed a structured panel process that brought together subject-matter experts and key stakeholders. In pre- and post-panel surveys, panelists provided valuable insights into the concept of productivity in primary care and identified key elements of primary care productivity from system, provider, and patient points of view. Structured panel discussions focused on the challenges of assessing productivity with feasible, reliable, and valid methods. The authors found that approaches to assessing and improving primary care productivity would benefit from methods for measuring productivity at the primary care practice level, tools to assess both individual providers and primary care teams, and the integration of practice context and quality of care into productivity assessments. These findings highlight the need for meaningful conceptual, analytic, management, and improvement approaches to primary care productivity.