RT Journal Article SR Electronic T1 The Influence of Family Physicians Within the South African District Health System: A Cross-Sectional Study JF The Annals of Family Medicine JO Ann Fam Med FD American Academy of Family Physicians SP 28 OP 36 DO 10.1370/afm.2133 VO 16 IS 1 A1 Klaus B. von Pressentin A1 Robert J. Mash A1 Laurel Baldwin-Ragaven A1 Roelf Petrus Gerhardus Botha A1 Indiran Govender A1 Wilhelm Johannes Steinberg A1 Tonya M. Esterhuizen YR 2018 UL http://www.annfammed.org/content/16/1/28.abstract AB PURPOSE Evidence of the influence of family physicians on health care is required to assist managers and policy makers with human resource planning in Africa. The international argument for family physicians derives mainly from research in high-income countries, so this study aimed to evaluate the influence of family physicians on the South African district health system.METHODS We conducted a cross-sectional observational study in 7 South African provinces, comparing 15 district hospitals and 15 community health centers (primary care facilities) with family physicians and the same numbers without family physicians. Facilities with and without family physicians were matched on factors such as province, setting, and size.RESULTS Among district hospitals, those with family physicians generally scored better on indicators of health system performance and clinical processes, and they had significantly fewer modifiable factors associated with pediatric mortality (mean, 2.2 vs 4.7, P =.049). In contrast, among community health centers, those with family physicians generally scored more poorly on indicators of health system performance and clinical processes, with significantly poorer mean scores for continuity of care (2.79 vs 3.03; P =.03) and coordination of care (3.05 vs 3.51; P =.02).CONCLUSIONS In this study, having family physicians on staff was associated with better indicators of performance and processes in district hospitals but not in community health centers. The latter was surprising and is inconsistent with the global literature, suggesting that further research is needed on the influence of family physicians at the primary care level.