Exploring patient and provider perspectives on outpatient care and the family practice model at a university hospital in Ghana.

BACKGROUND

Fragmented outpatient care, and disrupted patient-provider continuity hinder progress towards the achievement of Universal Health Coverage (UHC) in many low- and middle-income countries including Ghana. Despite efforts such as the National Health Insurance Scheme and Community-based Health Planning and Services, continuity of care remains a challenge. This study explored stakeholders' perspectives on implementing a Family Practice Model to strengthen primary care and advance UHC at a University Hospital in Ghana.

METHODS

A descriptive-analytical qualitative study was conducted from September 2023 to May 2024 at the University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi. Twenty-eight participants were purposively selected, comprising nine healthcare providers (physicians and physician assistants) and 19 care recipients (university staffs). Semi-structured interviews, guided by the Consolidated Framework for Implementation Research, explored experiences with the current outpatient system and views on the proposed FPM. Data were audio-recorded, transcribed verbatim, and thematically analyzed using NVivo version 14.

RESULTS

Two major themes emerged: "Therapeutic Disconnection" and "A Doctor to Call My Own." Participants described the existing care system as fragmented, impersonal, and marked by rotating providers, poor documentation, and rushed consultations. These issues weakened trust and care continuity. In contrast, stakeholders supported a dedicated, relationship-based model that would ensure continuity, streamline care processes, and foster long-term provider-patient connections.

CONCLUSION

The Family Practice Model could transform outpatient care at the university hospital and beyond by enhancing continuity, trust, and overall service quality. However, successful implementation depends on tailored strategies encompassing policy support, and pilot testing to assess feasibility and impact on UHC goals in Ghana.