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The Interaction of Public Health and Primary Care: Functional Roles and Organizational Models that Bridge Individual and Population Perspectives

Public Health Reviews volume 35, Article number: 14 (2013) Cite this article

Abstract

Introduction: Public health and primary care are often conceived as two entities providing complementary services within the health system. This scoping review aims to better understand how the two sectors interact by identifying their shared functions, and by identifying organizational models that could facilitate the interaction between the two domains.

Methodology: We conducted a review of published literature using PubMed and CINAHL journal indices. Our search yielded 179 articles. We reviewed abstracts and retained 55 relevant articles. We developed an extraction grid, based on a conceptual framework of functions of public health and primary care, in order to evaluate the relevance of selected articles, classify the information according to their functional connection, and identify interactions between them.

Results: Our search identified various activities through which public health can contribute to more effective primary care, and functions usually performed by primary care that seemed to support a population health approach. Most authors identified screening and immunization as actions that are carried out in primary care, but that can benefit from the support of public health. Health promotion and lifestyle modification are also shared responsibilities that can take the form of collective or individual intervention. The surveillance and protection function of public health, which actually takes place in primary care, consists of case identification for prevention or early treatment. Primary care is the setting where patients present, whereas public health has the role of investigation and of providing advice to clinical settings. Planning and evaluation are also emerging activities that concern both public health and primary care. Many authors recognized that public health provides tools that enhance the planning of primary care activities and are more aligned with the actual needs of populations. Others noted that public health is able to assess primary care in light of the changing health of populations, which may lead to better results for groups of patients.

Conclusion: One of the routes to a better understanding of how public health and primary care organizations can better interact is to identify the different contexts in which they collaborate successfully. Our scoping review of the scientific and gray literature identified various ways by which public health and primary care either reinforce each other through their respective functions, or increasingly act in a collaborative manner to increase population health and improve health systems performance.

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Authors and Affiliations

  1. Institut national de santé publique du Québec, Québec, Canada

    Jean-Frédéric Levesque MD, PhD, FRCPC, Pascale Levesque MSc, Pierre Bergeron MD, PhD, FRCPC & Denis A. Roy MD, MPH, MSc, FRCPC

  2. Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia

    Jean-Frédéric Levesque MD, PhD, FRCPC

  3. Bureau of Health Information, 15th Floor, Tower A, Zenith Centre, 821 Pacific Highway, Chatswood, New South Wales, 2067, Australia

    Jean-Frédéric Levesque MD, PhD, FRCPC

  4. Centre de recherche Hôpital Charles-Lemoyne, Longueuil, Québec, Canada

    Mylaine Breton PhD & Denis A. Roy MD, MPH, MSc, FRCPC

  5. Université de Sherbrooke, Sherbrooke, Québec, Canada

    Mylaine Breton PhD & Denis A. Roy MD, MPH, MSc, FRCPC

  6. Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland

    Nicolas Senn MD, PhD

  7. Université Laval, Québec, Québec, Canada

    Pierre Bergeron MD, PhD, FRCPC

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  1. Jean-Frédéric Levesque MD, PhD, FRCPC
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  2. Mylaine Breton PhD
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Correspondence to Jean-Frédéric Levesque MD, PhD, FRCPC.

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Levesque, JF., Breton, M., Senn, N. et al. The Interaction of Public Health and Primary Care: Functional Roles and Organizational Models that Bridge Individual and Population Perspectives. Public Health Rev 35, 14 (2013). https://doi.org/10.1007/BF03391699

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Public Health Reviews

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