Keywords: Healthcare access, rural areas, Primary Care Teams, coordinated practice, interprofessional collaboration

Background:

In the Centre Val-de-Loire region, concentrating hospital care in urban centers while reducting services in small towns and rural areas have significantly impeded access to healthcare. An aging population, a shortage of healthcare professionals, and geographic remoteness further exacerbate these disparities.

Aim of the study:

o address these challenges, the region played a pioneering role in the deployment of coordinated practice, facilitating the emergence of Primary Care Teams (PCTs) in 2020. These teams offer a flexible model to streamline coordinated practice, foster interprofessional collaboration, and enhance territorial attractiveness—particularly in rural areas. Running until 2025, the PCT initiative is a key component of the region’s broader healthcare transformation. It complements existing coordinated multiprofessionnal structures and addresses current demographic and health challenges. A comprehensive evaluation assesses its organizational, collaborative, and economic impacts and to determine its long-term integration into formalized coordinated practice. This evaluation aims to optimize resource allocation, tailor care to the specific needs of the region, and questions the effectiveness of PCT in improving healthcare access and quality in Centre Val-de-Loire.

Methodology:

A mixed-method approach combines semi-structured interviews with a diverse panel of PCT professionals and project leaders, along with surveys of healthcare providers, coordinated practice actors, and patients. This methodology enabled the creation of a PCT typology based on territorial location and the unique organizational specificities and constraints.

Results:

Results indicate that the model improves care quality and coordination, strengthens interprofessional collaboration, and enhances caregivers’ sense of belonging. However, issues such as unclear leadership roles, inadequate compensation for certain professions, and limited funding for targeted actions persist, prompting recommendations for further improvements.

Conclusions:

These findings offer valuable guidance for future reforms. The PCT initiative has shown promise in addressing healthcare disparities in rural areas of Centre Val-de-Loire, but further improvements are necessary to ensure its long-term success and integration into coordinated practice.