Purpose

Due to the evolution of the health-care scenario and the growing role of the primary care setting, the distribution processes of health technologies will be more and more in demand in the near future. This paper aims to investigate this theme, analyzing the performance, strengths and weaknesses of the current distribution practices, with the ultimate overarching aim to improve the provision of the primary care services.

Design/methodology/approach

The research framework is twofold. First, a tool to monitor the economic/quantitative performance of the distribution models was designed; second, the tool was applied to measure the performance of distribution models of absorbent devices for incontinence adopted by Local Health Authorities (LHA) in Lombardy Region (Italy). Quantitative data were collected by LHAs (from 2012 to 2016) and compared through data-benchmarking. Qualitative data from interviews and focus groups complemented the outcomes.

Findings

Two main distribution models were investigated: distribution through pharmacies and home delivery. Results show that there is no winning/preferable model in terms of economic/quantitative performance and service quality level, but a counterbalanced combination of strengths and weaknesses exists. Moving from the highlighted weaknesses and building on the strengths, an alternate distribution model is proposed for testing.

Originality/value

The present study approaches the theme of primary care services with a holistic approach, filling a literature gap. It also provides practitioners with a tool of performance analysis and management and real data, applicable also in international contexts. The collected real-world data also gives insights on the area of the quality of care, with particular reference to the patients’ experience. As a lesson learned, policymakers and the National Healthcare Service should re-think their current distribution models/practices in the light of the highlighted criticisms and opportunities for improvement.

中文翻译：

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分析初级保健服务中卫生技术分配模型的性能

目的

由于医疗保健场景的演变和初级保健环境的作用越来越大，在不久的将来，对医疗技术的分配过程的需求将越来越大。本文旨在调查这一主题，分析当前分配实践的表现、优势和劣势，最终的总体目标是改善初级保健服务的提供。

设计/方法/方法

研究框架是双重的。首先，设计了一种监控分配模型经济/定量性能的工具；其次，该工具用于测量伦巴第地区（意大利）地方卫生当局 (LHA) 采用的失禁吸收装置分布模型的性能。定量数据由 LHA 收集（从 2012 年到 2016 年），并通过数据基准进行比较。来自访谈和焦点小组的定性数据补充了结果。

发现

研究了两种主要的分销模式：通过药店分销和送货上门。结果表明，就经济/数量表现和服务质量水平而言，没有获胜/优选模型，但存在优势和劣势的平衡组合。从突出的弱点出发，在优势的基础上再接再厉，提出了一种替代分布模型进行测试。

原创性/价值

本研究以整体方法接近初级保健服务的主题，填补了文献空白。它还为从业者提供了一种绩效分析和管理工具以及真实数据，也适用于国际环境。收集到的真实世界数据还提供了有关护理质量领域的见解，特别是参考了患者的经验。作为吸取的教训，政策制定者和国家医疗保健服务应根据突出的批评和改进机会重新考虑他们当前的分配模式/做法。