Observational studyJournal of general internal medicine2025
Impact of Primary Care Team Configuration on Access and Quality of Care.
Observational study in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed.
- Comparing Work Experiences of Internal Medicine Physicians in Veterans Affairs and Non-Federal Hospitals: A National Survey.Journal of general internal medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundTeam-based primary care has become the norm within many large healthcare systems; however, limited guidance exists on how to optimally staff primary care teams in relationship to healthcare.
objectiveThis paper examines the associations between variations in team staffing configurations on primary care access and clinical quality.
designObservational study linking national Veterans Health Administration (VHA) data from February 2020 on primary care team staffing configurations to data on access to and quality of care the teams delivered.
participantsWe examined data from 22,390 primary care personnel assigned to 7050 teams from 1050 VA Medical Centers and Community-Based Outpatient Clinics across the USA. MAIN MEASURES: We used data from VHA's Corporate Data Warehouse. We assessed team-based measures of overall adherence to VHA's national guidelines for front-line clinical team staffing based on achievement of recommended staffing configurations in terms of quantity of staff and diversity of professional roles. To measure staffing sufficiency, we integrated total number of team members (team size) with their full-time equivalents (FTEs). To measure role diversity, we assessed deviation from guidelines using network analysis of staffing data. As outcomes, we used three measures of patient access to primary care and four measures of clinical quality that were prioritized by a prior expert panel. We analyzed associations between predictors and outcomes using random intercept multilevel models, with teams nested within healthcare facility. KEY
resultsVariation in team size and FTE reflected lack of adherence to VHA guidelines rather than normal variation. Overall adherence to VHA guidelines was unrelated to access or quality of care delivered. In most cases, teams with higher FTEs exhibited better outcomes. Increased role diversity was associated with decreased secure messaging communication ratios. Teams with more members exhibited improved 2-day post-hospital discharge contact, but reduced access through third next available appointments.
conclusionsPrimary care teams require a minimum amount of FTE staff capacity to deliver high quality and access to healthcare. Future work should examine how these associations vary by specific job role to further optimize staffing configurations.
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Registered trials
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.