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Objective To conduct a systematic review on the effects of multisectoral interventions for health on health system performance. Methods We conducted a systematic review according to the preferred reporting items for systematic review and meta- analysis protocols. We searched for peer-reviewed journal articles in PubMed[R], Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature, and the Cochrane Database of Systematic Reviews on 31 August 2023 (updating on 28 February 2024). We removed duplicates, screened titles and abstracts, and then conducted a full-text eligibility and quality assessment. Findings We identified an initial 1118 non-duplicate publications, 62 of which met our inclusion and exclusion criteria. The largest proportions of reviewed studies focused on multisectoral interventions directly related to specific health outcomes (66.1%; 41 studies) and/or social determinants of health (48.4%; 30 studies), but without explicit reference to overall health system performance. Most reviewed publications did not address process indicators (83.9%; 52/62) or discuss sustainability for multisectoral interventions in health (72.6%; 45/62). However, we observed that the greatest proportion (66.1%; 41/62) considered health system goals: health equity (68.3%; 28/41) and health outcomes (63.4%; 26/41). Although the greatest proportion (64.5%; 40/62) proposed mechanisms explaining how multisectoral interventions for health could lead to the intended outcomes, none used realistic evaluations to assess these. Conclusion Our review has established that multisectoral interventions influence health system performance through immediate improvements in service delivery efficiency, readiness, acceptability and affordability. The interconnectedness of these effects demonstrates their role in addressing the complexities of modern health care. [phrase omitted] [phrase omitted] Objectif Realiser une revue systematique consacree a l'impact des interventions multisectorielles sur la performance des systemes de sante. Methodes Nous avons procede a une revue systematique en appliquant les elements de rapport privilegies dans les protocoles de revues systematiques et meta-analyses. Nous avons explore PubMed[R], Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature, ainsi que la Base de donnees Cochrane des revues systematiques le 31 aout 2023 (mise a jour le 28 fevrier 2024), a la recherche d'articles de revue evalues par des pairs. Ensuite, nous avons supprime les doublons, passe les titres et resumes au crible, puis determine la qualite et l'admissibilite des articles complets. Resultats Nous avons initialement identifie 1118 publications non dupliquees; 62 d'entre elles repondaient a nos criteres d'inclusion et d'exclusion. Une grande partie des etudes examinees portaient sur des interventions multisectorielles en lien direct avec des resultats de sante specifiques (66,1%; 41 etudes) et/ou des determinants sociaux de la sante (48,4%; 30 etudes), sans toutefois faire explicitement reference a la performance globale des systemes de sante. La majorite des publications ne mentionnaient aucun indicateur de processus (83,9%; 52/62) et n'abordaient pas la durabilite des interventions multisectorielles dans le domaine de la sante (72,6%; 45/62). Nous avons neanmoins constate qu'en general, elles tenaient compte des objectifs relatifs aux systemes de sante (66,1%; 41/62): l'equite en sante (68,3%; 28/41) et les resultats de sante (63,4%; 26/41). Bien que la plupart (64,5%; 40/62) proposent des mecanismes visant a expliquer comment les interventions multisectorielles en matiere de sante pourraient amener aux resultats escomptes, aucune n'avait recours a des evaluations realistes pour les mesurer. Conclusion Notre revue nous a permis d'etablir que les interventions multisectorielles influencaient la performance des systemes de sante a travers des ameliorations immediates en termes d'efficacite, de disponibilite, d'acceptation et d'abordabilite des prestations de services. L'interdependance entre ces effets temoigne de l'importance qu'ils revetent lorsqu'il s'agit d'apprehender les rouages complexes des soins de sante modernes. [phrase omitted] Objetivo Realizar una revision sistematica sobre los efectos de las intervenciones multisectoriales en favor de la salud sobre el rendimiento de los sistemas sanitarios. Metodos Se realizo una revision sistematica de acuerdo con los items de informe preferidos para los protocolos de revision sistematica y metanalisis. Se realizaron busquedas de articulos de revistas con revision por pares en PubMed[R], Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature y la Base de Datos Cochrane de Revisiones Sistematicas el 31 de agosto de 2023 (actualizacion el 28 de febrero de 2024). Se eliminaron los duplicados, se examinaron los titulos y los resumenes y, a continuacion, se realizo una evaluacion de la elegibilidad y la calidad del texto completo. Resultados Se identificaron 1118 publicaciones iniciales no duplicadas, 62 de las cuales cumplian los criterios de inclusion y exclusion. El mayor porcentaje de estudios revisados se centro en intervenciones multisectoriales directamente relacionadas con resultados sanitarios especificos (66,1%; 41 estudios) o determinantes sociales de la salud (48,4%; 30 estudios), pero sin referencia explicita al rendimiento general del sistema sanitario. La mayoria de las publicaciones revisadas no abordaron indicadores de proceso (83,9%; 52/62) ni discutieron la sostenibilidad de las intervenciones multisectoriales en salud (72,6%; 45/62). Sin embargo, se observo que el mayor porcentaje (66,1%; 41/62) tenia en cuenta los objetivos del sistema sanitario: equidad sanitaria (68,3%; 28/41) y resultados sanitarios (63,4%; 26/41). Aunque el mayor porcentaje (64,5%; 40/62) propuso mecanismos que explicaban como las intervenciones multisectoriales para la salud podian conseguir los resultados previstos, ninguno empleo evaluaciones realistas para evaluarlos. Conclusion La revision que se realizo ha demostrado que las intervenciones multisectoriales influyen en el rendimiento de los sistemas sanitarios a traves de mejoras inmediatas en la eficiencia, la disponibilidad, la aceptabilidad y la asequibilidad de la prestacion de servicios. La interconexion de estos efectos demuestra su funcion a la hora de abordar las complejidades de la atencion sanitaria moderna., Introduction There is unequivocal recognition that health and well-being are determined by non-medical factors, including structural, social and commercial determinants of health. (1) Addressing those determinants is a task for [...]

Integrating primary care with the health response is key to managing pandemics and other health emergencies. In recognition of this, the Australian Government established a network of respiratory clinics led by general practitioners in response to the coronavirus disease 2019 (COVID-19) pandemic as part of broader measures aimed at supporting primary care. General practitioner (GP) respiratory clinics provide holistic face-to-face assessment and treatment to those with respiratory symptoms in an environment with strict protocols for infection prevention and control. This ensures that these patients are able to access high quality primary care while protecting the general practice workforce and other patients. The GP respiratory clinic model was developed and operationalized 10 days after the policy was announced, with the first 2 respiratory clinics opening on March 21, 2020. Subsequently a total of 150 respiratory clinics were opened and served over 800,000 patients within more than 99% of Australia's postcodes. These clinics used a standardized data collection tool that has provided the largest and most complete primary care surveillance database of respiratory illness in Australia. The success of the GP respiratory clinic model was made possible due to strong partnerships with Primary Health Networks and individual general practices that rapidly shifted operations to embrace this new approach. This article describes the development and early implementation of this model. Key words: primary care; general practitioners; pandemic; COVID-19 Ann Fam Med 2022;20:273-276. https://doi.org/10.1370/afm.2808, INTRODUCTION Primary care is the frontline of the health system and has a critical role in responding to pandemics and other health emergencies. (1,2) Experience in previous pandemics, however, has [...]

Background: The COVID-19 pandemic has resulted in the diversion of health resources away from routine primary care delivery. This disruption of health services has necessitated new approaches to providing care to ensure continuity.Objectives: To summarize changes to the provision of routine primary care services during the pandemic.Methods: Rapid literature review using PubMed/MEDLINE, SCOPUS, and Cochrane. Eligible studies were based in primary care and described practice-level changes in the provision of routine care in response to COVID-19. Relevant data addressing changes to routine primary care delivery, impact on primary care functions and challenges experienced in adjusting to new approaches to providing care, were obtained from included studies. A narrative summary was guided by Burns et al.'s framework for primary care provision in disasters.Results: Seventeen of 1,699 identified papers were included. Studies reported on telehealth use and public health measures to maintain safe access to routine primary care, including providing COVID-19 screening, and establishing dedicated care pathways for non-COVID and COVID-related issues. Acute and urgent care were prioritized, causing disruptions to chronic disease management and preventive care. Challenges included telehealth use including disparities in access and practical difficulties in assessing patients, personal protective equipment shortages, and financial solvency of medical practices.Conclusions: Substantial disruptions to routine primary care occurred due to the COVID-19 pandemic. Primary care practices' rapid adaptation, often with limited resources and support, demonstrates agility and innovative capacity. Findings underscore the need for timely guidance and support from authorities to optimize the provision of comprehensive routine care during pandemics. [ABSTRACT FROM AUTHOR]

The urgency of the COVID-19 pandemic in Australia has seen the implementation of digital health technologies to support continuity of high-quality primary care provision. Digital health innovation has been used to operationalise the nation's pandemic preparedness principles by reducing risk of infection to both healthcare workers and at-risk patients, sustaining care for chronic and acute health conditions, and supporting the mental health of the population. In this perspective piece, we document the Australian Federal government's digital health response to ensure the ongoing delivery of high-quality primary care. This includes the implementation of telehealth, point-of-care testing, electronic records and e-prescriptions, national primary care data collection and analysis, and digital communication. Digital health has been a critical element of the pandemic response and paves the way for future primary care provision during disasters and emergencies. Further research is needed to capture the effectiveness, feasibility and acceptability of these innovations for both patients and primary care practitioners. [ABSTRACT FROM AUTHOR]