Evidence map›Paper›PMID 33624788›Full record

SynthesisEuropean journal of public health2021

The bigger, the better? A systematic review on the impact of mergers on primary care organizations.

Gianfranco Damiani, Domenico Pascucci, Alessandro Sindoni, Rosario Mete, Walter Ricciardi, Paolo Villari, Corrado De Vito

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in European journal of public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. General practice organisational models and heart failure medication adherence: multi-level evidence from a regional cohort in Emilia-Romagna, Italy.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Gianfranco DamianiDipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.
Domenico PascucciDipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.
Alessandro SindoniDipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma, Rome, Italy.
Rosario MeteDistretto 9, ASL Roma 2, Rome, Italy.
Walter RicciardiDipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.
Paolo VillariDipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma, Rome, Italy.
Corrado De VitoDipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma, Rome, Italy.
Sapienza University of Rome · ITUniversità Cattolica del Sacro Cuore · ITASL Roma · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrimary care services are the first point of contact in a healthcare system; in the last years, many mergers and reconfigurations have taken place in this setting. The aim of this study is to summarize the literature evidence on the relationship between the increase in the size of these organizations and their performance.

methodsA systematic review of the literature was carried out querying EMBASE, MEDLINE and Web of Science databases, from their inception to January 2020. Articles which quantitatively assessed outcomes and process indicators of merger/structural reorganization of primary care organizations and qualitative articles that assessed staff perception and satisfaction were included in the review.

resultsA total of 3626 articles was identified and another study was retrieved through snowball search; 11 studies were included in the systematic review. Studies about lipid profile evaluation and emergency admissions for chronic conditions showed moderate evidence in supporting the merging of primary care organizations; conversely, clinical outcome studies did not reach a sufficient level of evidence to support merging actions. A moderate evidence of a negative effect on patient's perspective was found.

conclusionActually, there is no strong evidence in favour or against merging of primary care organizations without equivocation. This review supports the possibility to identify indicators for evaluating a merging process of primary care organizations and for adopting eventual remedies during this process. Further efforts should be made to identify additional indicators to assess merge actions among primary care organizations.

Indexed as

Delivery of Health CarePrimary Health CareHospitalizationHumansOutcome Assessment, Health Care

Identifiers

PMID33624788
PMCPMC8071597
OpenAlexW3131688166

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.