Open research questions in Primary Care and Health Outcomes
265 gap statements mined from Primary Care and Health Outcomes papers in our 7.9M-paper local library, which holds 2,237 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.
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What the literature leaves open
There is a lack of understanding of the factors contributing to patients bypassing primary healthcare facilities. The study aims to address this gap by investigating the reasons for non-referred patients seeking care directly at public hospitals.
Factors Contributing to Patients Bypassing Primary Healthcare Facilities: Evidence from Mpumalanga Province, South Africa · 2026 · DOIFuture research should explore potential underlying mechanisms and establish whether the same relationship exists between objectively measured relational continuity and patient complaints.
Less continuity with more complaints: a repeated cross-sectional study of the association between relational continuity of care and patient complaints in English general practice · 2025 · DOIThere is a gap between aspiration and implementation in academic family medicine. Advanced topics such as research methodology and dissemination strategies are only briefly introduced in existing resources.
New Faculty Guide to Academic Family Medicine: A Collaboration of STFM Collaboratives: Faculty Development and New Faculty · 2026 · DOIThere is a need to evaluate whether SRFCs are located in objectively defined areas of need. There is a lack of research on the geographic alignment of SRFCs with medically underserved and underinsured areas.
A Cross-Sectional Study on Geographic Alignment of Student-Run Free Clinics with Medically Underserved and Underinsured Areas in the United States. · 2026 · DOIThere are no existing globally informed guidelines on how to prepare family medicine faculty. The current regional variations in training pathways, certification, and recognition create a need for a global framework.
A global ‘Common Core’ framework for family medicine faculty development: Getting the right person, doing the right thing, right! · 2026 · DOIThe need to evaluate the possibility of transforming PHC centers into family health centers. The lack of specialized family physicians and limited staff training.
POSSIBILITY OF TRANSFORMATION OF PRIMARY HEALTH CARE CENTERS INTO FAMILY HEALTH CENTERS · 2026 · DOIThe challenge of sustaining a workforce capable of delivering high-quality care is not adequately addressed. The future of healthcare depends on creating workplace environments where individuals choose to remain, develop and flourish.
The lack of access to diagnostic tools and treatments for respiratory conditions in Africa. The limited familiarity of primary care providers with COPD and other respiratory conditions. The impact of climate change on respiratory health in Africa.
This study aims to describe and analyze the co-development and work of the PC-QI PAC to identify factors that shape meaningful patient engagement in the design and implementation of research in primary care, contributing to the limited evidence on this topic.
Building meaningful partnerships: engaging and co-developing a patient advisory council to inform the implementation of person-centred quality indicators in Alberta primary care · 2026 · DOIWithin the Veterans Health Administration (VHA), 14 sites have implemented HiH programs, yet limited research has examined implementation within a large integrated system.
Identifying Contextual Factors affecting Hospital In Home Program Implementation within the Veterans Health Administration · 2026 · DOIChallenges with health care access in long-term care facilities, including lack of administrative, financial and governance integration between the health and social welfare sectors. Financial incentives, workforce shortages, and increasingly greater demands on the primary care sector. The study had to account for the complex health care needs and functional and cognitive impairment of long-term care residents.
The impact of primary health care services, continuity of care and patterns of care on mortality and hospitalisation-related outcomes in residents of long-term care facilities: a comprehensive national evaluation · 2026 · DOIVoluntary empanelment is widely adopted as a primary care strategy across diverse health systems to promote continuity of care and early disease detection, yet its equity implications remain underexplored, particularly in Asian multi-ethnic settings.
Beyond financial access: socioeconomic and ethnic disparities in preventive care engagement under Singapore’s Healthier SG programme · 2026 · DOIThe Patient Centered Medical Home (PCMH) model of care is intended to provide accessible and comprehensive care, but little is known about how practicing in a PCMH is associated with rural family physicians’ scope of practice.
Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice · 2026 · DOIStudent-run free clinics are crucial in providing healthcare to underserved populations; however, few studies have evaluated common reasons patients seek care, particularly those in recovery from substance use.
In some form, team-based care is an essential element of family medicine practice; however, the composition, roles, and definitions of team members vary widely.
To Team or Not to Team: A Foundational Debate for the Future of Family Medicine—Insights from the Family Medicine Leadership Council · 2026 · DOIAdvocacy and community mobilisation efforts should be through Ward-Based Outreach Teams, strengthened community health workers, traditional leaders, and civil society organisations.
Healthcare workers’ perspectives on patient bypassing of Primary Health Care facilities in Mpumalanga province, South Africa · 2026 · DOIThe current system of recruitment and retention in academic family medicine leadership is flawed. Diversity efforts are often reliant on individual resilience rather than systemic change.
From Pipeline to System Design: Reframing Diversity in Academic Family Medicine Leadership · 2026 · DOIA central tenet of our findings is the imperative to invest in robust digital infrastructure and establish interoperable systems, echoing the priorities outlined in the NHS plan, so that health systems are better equipped to implement and sustain transformative improvements.
In parallel, many countries throughout the OECD have expanded the scope of nurses, often in advanced or nurse practitioners roles, alongside creating new roles such as physician assistants to improve access, continuity and quality of care while reducing pressure on GPs.
Deficient referral systems, - Fragmented PHC delivery, - Limited engagement with the private sector, - Weak tracking and preference for private providers contributed to attrition, - Low screening uptake and poor follow-up due to weak record…
Integration of Cardiovascular Disease Services within Primary Health Care Systems: Insights from South Asia · 2026 · DOIPrioritise robust evaluation of the impacts on CVD morbidity and mortality, - Investigate novel approaches to integrate service provider networks and referral pathways, - Examine the effects of digital and home support innovations on CVD…
Integration of Cardiovascular Disease Services within Primary Health Care Systems: Insights from South Asia · 2026 · DOIFamily medicine–specific; rooted in continuity clinic, resident education, and community partnerships Modular “Know/Do” framework with basics, timelines, barriers, and resources Collection of concise pearls, reflections, and practical advice Early career family medicine faculty; program directors and mentors Early career faculty in academic medicine across disciplines Actionable checklists, barrier-mitigation tips…
New Faculty Guide to Academic Family Medicine: A Collaboration of STFM Collaboratives: Faculty Development and New Faculty · 2026 · DOIExpanding the FMSTP to produce more graduates. Improving rural training and retaining health workers through mentorship and community engagement.
Researchers should look to implementation research methodologies to assist with this in grant applications, - Key issues to consider might be how to improve diagnostic accuracy with appropriate technology, - We need to look at how community-orientated primary care can help address issues such as heat and air…
Linking them to hard outcomes such as patient safety indicators, mortality, readmissions, length of stay, and workforce turnover and retention would connect perceived quality to measurable organizational performance, as planned in the wider FlaQuM research programme.18–21 Third, the next cycles will be a direct test of the ceiling idea proposed here: if the final gap really is harder to close, FIS values should fall…
The impact of the Flanders Quality Model (FlaQuM) on staff and patient/kin perceptions of quality: a multi-centre longitudinal study · 2026 · DOI
Most-cited papers in Primary Care and Health Outcomes
- Contribution of Primary Care to Health Systems and Health · Milbank Quarterly · 2005 · 3,468 citations
- Improving Primary Care for Patients With Chronic Illness · JAMA · 2002 · 2,081 citations
- Organizing Care for Patients with Chronic Illness · Milbank Quarterly · 1996 · 2,069 citations
- Developing and evaluating complex interventions: The new Medical Research Council guidance · International Journal of Nursing Studies · 2012 · 1,242 citations
- The Medical Home · PEDIATRICS · 2002 · 723 citations
- The key informant technique · Family Practice · 1996 · 489 citations
- Qualitative Methods in Health Care Research · International Journal of Preventive Medicine · 2021 · 461 citations
- Patient Self-Management: A Key to Effectiveness and Efficiency in Care of Chronic Disease · Public Health Reports · 2004 · 438 citations
- Effects of pay for performance in health care: A systematic review of systematic reviews · Health Policy · 2013 · 430 citations
- Patients with multiple unexplained symptoms. Their characteristics, functional health, and health care utilization · Archives of Internal Medicine · 1986 · 388 citations
Most recent work
- Experiences of access to general practice in England: qualitative study and implications for the NHS 10 year plan · BMJ · 2026
- Patient-reported outcome and experience measures in primary care: a scoping review of systematic collection and use · BMC Health Services Research · 2026
- Primary Care Clinicians Available for New Patient Visits · JAMA Internal Medicine · 2026
- Strengthening Primary Health Care in Europe: A Delphi study towards accessibility, equity and continuity of care · European Journal of General Practice · 2026
- Practice Variability in the SHARING Choices Pragmatic Trial of Primary Care Advance Care Planning · Journal of the American Geriatrics Society · 2026
- The impact of primary health care services, continuity of care and patterns of care on mortality and hospitalisation-related outcomes in residents of long-term care facilities: a comprehensive national evaluation · Age and Ageing · 2026
- Evaluating the Consequences of a Hypertension Management Incentive · JAMA Internal Medicine · 2026
- Development of a novel GP continuity measurement for practices without personal lists: a two-practice pilot of the modified SLICC · British Journal of General Practice · 2026
- Values-Based Healthcare and the Quintuple Aim: Connection, Compassion, Equity, & Stewardship · The Journal of Allergy and Clinical Immunology In Practice · 2026
- Why Are Family Physicians Leaving Comprehensive Care? A Qualitative Study on Retention in Ontario · The Annals of Family Medicine · 2026
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