{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:08:20Z","timestamp":1788977300633,"version":"build-2803163510"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fragmented outpatient care, and disrupted patient\u2013provider 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\u2019 perspectives on implementing a Family Practice Model to strengthen primary care and advance UHC at a University Hospital in Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two major themes emerged: \u201cTherapeutic Disconnection\u201d and \u201cA Doctor to Call My Own.\u201d 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\u2013patient connections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0327277","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:33:31Z","timestamp":1788975211000},"page":"e0327277","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring patient and provider perspectives on outpatient care and the family practice model at a university hospital in Ghana"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4591-4215","authenticated-orcid":true,"given":"Abigail Kusi-Amponsah","family":"Diji","sequence":"first","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"],"department":["School of Nursing and Midwifery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana Kwame","family":"Ayisi-Boateng","sequence":"additional","affiliation":[{"name":"University Hospital, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"]},{"name":"Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"],"department":["School of Medical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayford","family":"Asare","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"],"department":["School of Nursing and Midwifery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godwin","family":"Antwi","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"],"department":["School of Nursing and Midwifery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2321-387X","authenticated-orcid":true,"given":"Douglas Aninng","family":"Opoku","sequence":"additional","affiliation":[{"name":"University Hospital, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"]},{"name":"Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"],"department":["School of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric Kojo Nsa","family":"Oduro","sequence":"additional","affiliation":[{"name":"University Hospital, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Konadu","sequence":"additional","affiliation":[{"name":"University Hospital, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana Akua","family":"Abruquah","sequence":"additional","affiliation":[{"name":"University Hospital, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Oppong-Kyekyeku","sequence":"additional","affiliation":[{"name":"University Hospital, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercy","family":"Addae","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"],"department":["School of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Mfum-Mensah","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"],"department":["University Information and Technological Services"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita Asiwome","family":"Baku","sequence":"additional","affiliation":[{"name":"University of Ghana Business School, University of Ghana","place":["Legon, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"pone.0327277.ref001","article-title":"Primary healthcare is cornerstone of universal health coverage","volume":"365","author":"A Binagwaho","year":"2019","journal-title":"BMJ"},{"issue":"15","key":"pone.0327277.ref002","doi-asserted-by":"crossref","DOI":"10.1503\/cmaj.170784","article-title":"Why strengthening primary health care is essential to achieving universal health coverage","volume":"190","author":"C van Weel","year":"2018","journal-title":"CMAJ"},{"issue":"15","key":"pone.0327277.ref003","doi-asserted-by":"crossref","DOI":"10.1503\/cmaj.180186","article-title":"Quality primary health care will drive the realization of universal health coverage","volume":"190","author":"S Dugani","year":"2018","journal-title":"CMAJ"},{"key":"pone.0327277.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001244","article-title":"Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review","volume":"9","author":"S Basu","year":"2012","journal-title":"PLoS Med"},{"issue":"1","key":"pone.0327277.ref005","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1177\/20534345211068300","article-title":"The case for continuity of care for people with chronic obstructive pulmonary disease","volume":"25","author":"J Medves","year":"2021","journal-title":"International J Care Coordination"},{"key":"pone.0327277.ref006","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-14-S2-S3","article-title":"Chronic non-communicable diseases and the challenge of universal health coverage: insights from community-based cardiovascular disease research in urban poor communities in Accra, Ghana","volume":"14","author":"A de-Graft Aikins","year":"2014","journal-title":"BMC Public Health"},{"key":"pone.0327277.ref007","first-page":"2350","article-title":"Perception of Patients About Medical Care at Medical OPD in I.T.H.S: Observational Study","volume":"15","author":"Y Sadiq","year":"2021","journal-title":"PJMHS"},{"key":"pone.0327277.ref008","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1001\/jama.288.15.1909","article-title":"Improving primary care for patients with chronic illness","volume":"288","author":"T Bodenheimer","year":"2002","journal-title":"JAMA"},{"issue":"7234","key":"pone.0327277.ref009","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1136\/bmj.320.7234.569","article-title":"The role of patient care teams in chronic disease management","volume":"320","author":"EH Wagner","year":"2000","journal-title":"BMJ"},{"key":"pone.0327277.ref010","article-title":"mplementation of The Chronic Disease Care System and Its Association With Health Care Costs and Continuity of Care in Korean Adults With Type 2 Diabetes Mellitus","author":"W Kim","year":"2018","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0327277.ref011","doi-asserted-by":"crossref","DOI":"10.9778\/cmajo.20180152","article-title":"Regional differences in where and how family medicine residents intend to practise: a cross-sectional survey analysis","volume":"7","author":"MR Lavergne","year":"2019","journal-title":"CMAJ Open"},{"issue":"1","key":"pone.0327277.ref012","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1370\/afm.2728","article-title":"Impact of Team-Based Care on Emergency Department Use","volume":"20","author":"T Kiran","year":"2022","journal-title":"Ann Fam Med"},{"issue":"3","key":"pone.0327277.ref013","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.mjafi.2013.06.010","article-title":"Patient satisfaction with services of the outpatient department","volume":"70","author":"A Mohd","year":"2014","journal-title":"Med J Armed Forces India"},{"issue":"1","key":"pone.0327277.ref014","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1186\/s12913-024-11399-w","article-title":"Patient satisfaction with quality of care at out-patient departments in selected health facilities in Kumasi, Ghana","volume":"24","author":"AA Owusu","year":"2024","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0327277.ref015","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1186\/s12913-023-09718-8","article-title":"Continuity and care coordination of primary health care: a scoping review","volume":"23","author":"R Khatri","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"pone.0327277.ref016","doi-asserted-by":"crossref","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"LJ Damschroder","year":"2009","journal-title":"Implementation Science"},{"key":"pone.0327277.ref017","article-title":"The Experienced of Nurses and Family Caregivers towards Family Center Care among Hospitalize Children","author":"E Supriatin","year":"2019","journal-title":"KLS"},{"key":"pone.0327277.ref018","doi-asserted-by":"crossref","first-page":"181","DOI":"10.21608\/asnj.2017.192640","article-title":"Total Quality Management Application Practices at Assuit University Hospitals","volume":"5","author":"K Abdel-Hafez","year":"2017","journal-title":"Assiut Scientific Nursing Journal"},{"issue":"3","key":"pone.0327277.ref019","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.afjem.2023.05.001","article-title":"Emergency preparedness capacity of a university hospital in Ghana: a cross-sectional study","volume":"13","author":"EA Boateng-Osei","year":"2023","journal-title":"Afr J Emerg Med"},{"key":"pone.0327277.ref020","doi-asserted-by":"crossref","DOI":"10.1177\/16094069241296206","article-title":"Sample sizes for 10 types of qualitative data analysis: an integrative review, empirical guidance, and next steps","volume":"23","author":"A Wutich","year":"2024","journal-title":"International Journal of Qualitative Methods"},{"issue":"12","key":"pone.0327277.ref021","doi-asserted-by":"crossref","first-page":"2954","DOI":"10.1111\/jan.13031","article-title":"Systematic methodological review: developing a framework for a qualitative semi-structured interview guide","volume":"72","author":"H Kallio","year":"2016","journal-title":"J Adv Nurs"},{"issue":"1","key":"pone.0327277.ref022","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/26895269.2022.2129597","article-title":"Toward good practice in thematic analysis: Avoiding common problems and be(com)ing a knowing researcher","volume":"24","author":"V Braun","year":"2022","journal-title":"Int J Transgend Health"},{"issue":"4","key":"pone.0327277.ref023","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1108\/QRJ-08-2022-0116","article-title":"Application of Guba and Lincoln\u2019s parallel criteria to assess trustworthiness of qualitative research on indigenous social protection systems","volume":"23","author":"OC Enworo","year":"2023","journal-title":"QRJ"},{"issue":"2","key":"pone.0327277.ref024","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1177\/160940690200100202","article-title":"Verification Strategies for Establishing Reliability and Validity in Qualitative Research","volume":"1","author":"JM Morse","year":"2002","journal-title":"International J Qualitative Methods"},{"key":"pone.0327277.ref025","doi-asserted-by":"crossref","DOI":"10.1177\/16094069231183620","article-title":"From Data Management to Actionable Findings: A Five-Phase Process of Qualitative Data Analysis","volume":"22","author":"AJ Bingham","year":"2023","journal-title":"International J Qualitative Methods"},{"key":"pone.0327277.ref026","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1037\/qup0000215","article-title":"Is member checking the gold standard of quality in qualitative research?","volume":"8","author":"SL Motulsky","year":"2021","journal-title":"Qualitative Psychology"},{"issue":"6","key":"pone.0327277.ref027","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1177\/0020872817695394","article-title":"The experience of social protection in Palestine: An exploratory study of beneficiary perspectives","volume":"61","author":"SD Easton","year":"2017","journal-title":"International Social Work"},{"issue":"1","key":"pone.0327277.ref028","doi-asserted-by":"crossref","DOI":"10.1177\/1609406918763214","article-title":"Reflections and Review on the Audit Procedure","volume":"17","author":"R de Kleijn","year":"2018","journal-title":"International J Qualitative Methods"},{"issue":"2","key":"pone.0327277.ref029","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/1053825919892994","article-title":"Community partners\u2019 perspectives and the faculty role in community-based learning","volume":"43","author":"RJ Karasik","year":"2019","journal-title":"J Experiential Education"},{"issue":"3","key":"pone.0327277.ref030","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1177\/160940691201100305","article-title":"Management of a Large Qualitative Data Set: Establishing Trustworthiness of the Data","volume":"11","author":"DE White","year":"2012","journal-title":"Int J Qualitative Methods"},{"issue":"1","key":"pone.0327277.ref031","doi-asserted-by":"crossref","first-page":"4","DOI":"10.5334\/ijic.5508","article-title":"Integrating Primary and Secondary Care to Enhance Chronic Disease Management: A Scoping Review","volume":"21","author":"S Murtagh","year":"2021","journal-title":"Int J Integr Care"},{"issue":"1","key":"pone.0327277.ref032","article-title":"Evaluating the new family medicine internship programmes in the Western Cape, South Africa","volume":"66","author":"LN Hutton","year":"2024","journal-title":"S Afr Fam Pract (2004)"},{"issue":"1","key":"pone.0327277.ref033","doi-asserted-by":"crossref","DOI":"10.4102\/phcfm.v13i1.3218","article-title":"The contribution of family physicians to primary health care: Experiences from southwest Nigeria","volume":"13","author":"T Ilori","year":"2021","journal-title":"Afr J Prim Health Care Fam Med"},{"issue":"1","key":"pone.0327277.ref034","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1186\/s12913-018-3250-3","article-title":"What do you do with success? The science of scaling up a health systems strengthening intervention in Ghana","volume":"18","author":"JF Phillips","year":"2018","journal-title":"BMC Health Serv Res"},{"issue":"7","key":"pone.0327277.ref035","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0158541","article-title":"Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial","volume":"11","author":"RK Alhassan","year":"2016","journal-title":"PLoS One"},{"issue":"1","key":"pone.0327277.ref036","doi-asserted-by":"crossref","first-page":"94","DOI":"10.3390\/ejihpe10010009","article-title":"Ghana\u2019s Journey towards Universal Health Coverage: The Role of the National Health Insurance Scheme","volume":"10","author":"DD Kipo-Sunyehzi","year":"2019","journal-title":"Eur J Investig Health Psychol Educ"},{"key":"pone.0327277.ref037","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0226808","article-title":"Community-Based Health Planning and Services Plus Programme in Ghana: A Qualitative Study With Stakeholders in Two Systems Learning Districts on Improving the Implementation of Primary Health Care","volume":"15","author":"M Kweku","year":"2020","journal-title":"PLoS One"},{"issue":"2","key":"pone.0327277.ref038","doi-asserted-by":"crossref","DOI":"10.9778\/cmajo.20160063","article-title":"Association between interpersonal continuity of care and medication adherence in type 2 diabetes: an observational cohort study","volume":"5","author":"AR Dossa","year":"2017","journal-title":"CMAJ Open"},{"key":"pone.0327277.ref039","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0226808","article-title":"Community-Based Health Planning and Services Plus Programme in Ghana: A Qualitative Study With Stakeholders in Two Systems Learning Districts on Improving the Implementation of Primary Health Care","volume":"15","author":"M Kweku","year":"2020","journal-title":"PLoS One"},{"issue":"3","key":"pone.0327277.ref040","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1108\/JFM-08-2018-0053","article-title":"Modelling the influence of healthcare facilities management service quality on patients satisfaction","volume":"17","author":"O Amankwah","year":"2019","journal-title":"JFM"},{"key":"pone.0327277.ref041","unstructured":"Cesare, Moro, Bert, Olivero, Rossello, Corradi BLGS. 12th European Public Health Conference 2019-01: Parallel Programme 77. European Public Conference. 2019;77."},{"issue":"1","key":"pone.0327277.ref042","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12960-019-0387-z","article-title":"Salaried and voluntary community health workers: exploring how incentives and expectation gaps influence motivation","volume":"17","author":"H Ormel","year":"2019","journal-title":"Hum Resour Health"},{"key":"pone.0327277.ref043","first-page":"298","article-title":"Enhancing the retention of healthcare workers in rural areas: A systematic review","volume":"2","author":"S Rawas","year":"2023","journal-title":"I J S R"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0327277","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:33:39Z","timestamp":1788975219000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0327277"}},"subtitle":[],"editor":[{"given":"Immaculate Sabelile","family":"Tenza","sequence":"first","affiliation":[{"name":"North-West University","place":["SOUTH AFRICA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":43,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0327277","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]}}}