Implementing Community Based Primary Healthcare for Older Adults with Complex Needs in Quebec, Ontario and New-Zealand: Describing Nine Cases

Abstract

The aim of this paper is to set the foundation for subsequent empirical studies of the “Implementing models of primary care for older adults with complex needs” project, by introducing and presenting a brief descriptive comparison of the nine case studies in Quebec, Ontario and New Zealand. Each case is described based on key dimensions of Rainbow model of Valentijn and al (2013) with a focus on “meso level” integration. Meso level integration is represented by organizational and professional elements of the Rainbow Model, which are of particular interest in our nine case studies. Each of the three cases in Ontario and three in New Zealand are different and described separately. In Quebec, a local health services network model is presented across the three cases studied with variations in the way it is implemented. The three cases selected in the three jurisdictions under study were not chosen to be representative of wider practice within each country, but rather represent interesting and unique models of community-based primary healthcare integration. Similarities and variations in the integrated care models, context and dimension of integration offer insights regarding core component of integration of services, offering a foundational understanding of the cases on which future analysis will be based.

Mapping for Conceptual Clarity: Exploring Implementation of Integrated Community-Based Primary Health Care from a Whole Systems Perspective

“…Elsewhere in this special issue Breton et al [19] offer detailed descriptions of case examples from Ontario and Quebec in Canada, and New Zealand. The Ontario case of focus for the analysis presented in this paper is the Integrated Client Care Program, a collaborative model of care based on a partnership between a Family Health Team and Community Care Access Centre located in Toronto with strong partnerships with a local hospital and other community agencies.…”

“…Three theoretical frameworks are brought to bear on this research question including: 1) Ham’s Ten Characteristics of the High-Performing Chronic Care System [15] (which captures key elements of the CCM) to capture patient/carer and provider level perspectives; 2) Organizational Context and Capabilities for Integrating Care (CCIC) framework [16] to capture organizational and provider level perspectives; and 3) the Health Policy Monitor (HPM) [17] survey methodology to capture system and policy level perspectives. See Wodchis et al [18] and Breton et al [19] in this issue for an overview of the research program and case study summaries.…”

Providers’ Perspectives on the Implementation of Mandated Local Health Networks for Older People in Québec

“…In fact, one may consider that the organisation of health services differs depending on the level of the urbanisation of the setting. The three cases differ in terms of population density, geographic settings, and number of healthcare organisations [44]. Table 1 describes some characteristics of the different cases.…”

From pilot project to system solution: innovation, spread and scale for health system leaders

“…Core components are the features of the innovation that are essential to the innovation itself, such that without them, the innovation becomes something substantively different. For example, an interprofessional team is essential to many new models of community-based primary healthcare 15. The adaptable periphery are those features of the innovation that can be built on, changed or discarded as the innovation is adopted in local settings.…”