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Pineault, Raynald; Lévesque, Jean‐Frédéric; Bréton, Mylaine; Hamel, Márcio Renan; Roberge, Danièle

doi:10.2307/j.ctv69tdx2.25

Cited by 11 publications

(15 citation statements)

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“…This was the case in the implementation of CLSCs (Local Community Services Centres) in Québec. The Government policy aimed to establish a public health and social services organization (coercive pressure) was opposed by professional medical associations which encouraged their members not to practice in CLSCs (normative pressure) and reactively developed a network of privately owned group practice clinics (mimetic pressure) [ 4 , 41 ]. The opposition and reaction of the medical organized medicine to the CLSC project was a major obstacle in making CLSC the point of entry into the system.…”

Section: Introductionmentioning

confidence: 99%

“…Reforms of PHC organizations and local organization of healthcare services have been the subject of various evaluative studies in Canada [ 46 ]. Studies in Québec, Ontario, Manitoba and British Columbia have highlighted the positive impact of new forms of PHC organizations integrating desirable attributes of experience of care [ 7 , 41 , 47 - 52 ]. Studies have focused on understanding the process of organizational changes using a case study approach [ 16 , 53 ], linking experience of care and use of services provided by a limited number of organizations [ 48 , 54 ], using administrative data files or population surveys.…”

Section: Introductionmentioning

confidence: 99%

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Assessing the evolution of primary healthcare organizations and their performance (2005-2010) in two regions of Québec province: Montréal and Montérégie

et al. 2010

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BackgroundThe Canadian healthcare system is currently experiencing important organizational transformations through the reform of primary healthcare (PHC). These reforms vary in scope but share a common feature of proposing the transformation of PHC organizations by implementing new models of PHC organization. These models vary in their performance with respect to client affiliation, utilization of services, experience of care and perceived outcomes of care.ObjectivesIn early 2005 we conducted a study in the two most populous regions of Quebec province (Montreal and Montérégie) which assessed the association between prevailing models of primary healthcare (PHC) and population-level experience of care. The goal of the present research project is to track the evolution of PHC organizational models and their relative performance through the reform process (from 2005 until 2010) and to assess factors at the organizational and contextual levels that are associated with the transformation of PHC organizations and their performance.Methods/DesignThis study will consist of three interrelated surveys, hierarchically nested. The first survey is a population-based survey of randomly-selected adults from two populous regions in the province of Quebec. This survey will assess the current affiliation of people with PHC organizations, their level of utilization of healthcare services, attributes of their experience of care, reception of preventive and curative services and perception of unmet needs for care. The second survey is an organizational survey of PHC organizations assessing aspects related to their vision, organizational structure, level of resources, and clinical practice characteristics. This information will serve to develop a taxonomy of organizations using a mixed methods approach of factorial analysis and principal component analysis. The third survey is an assessment of the organizational context in which PHC organizations are evolving. The five year prospective period will serve as a natural experiment to assess contextual and organizational factors (in 2005) associated with migration of PHC organizational models into new forms or models (in 2010) and assess the impact of this evolution on the performance of PHC.DiscussionThe results of this study will shed light on changes brought about in the organization of PHC and on factors associated with these changes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing the evolution of primary healthcare organizations and their performance (2005-2010) in two regions of Québec province: Montréal and Montérégie

et al. 2010

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“…Par conséquent, toutes les analyses ont été effectuées à partir de données pondérées afin de tenir compte de cette caractéristique du plan d'échantillonnage. L'enquête a permis de documenter l'affiliation des répondants aux organisations de SSP, leur degré d'utilisation des services de santé, les attributs de leur expérience de soins et leur perception des besoins non comblés de soins de santé 22,23 .…”

Section: Devis De Rechercheunclassified

L’influence des modèles d’organisation de soins de santé primaires sur l’expérience de soins de patients atteints de différentes maladies chroniques

Pineault

Provost²,

Hamel³

et al. 2011

Maladies Chroniques Et Blessures Au Canada

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Objectifs Déterminer dans quelle mesure l’expérience de soins varie selon les maladies chroniques et analyser la relation entre les modèles d’organisation de soins de santé primaires (SSP) et l’expérience de soins rapportée par des patients atteints de différentes maladies chroniques. Méthodologie Nous avons jumelé les résultats d’une enquête populationnelle et d’une enquête organisationnelle menées dans deux régions du Québec. Nous avons ciblé cinq groupes de maladies chroniques et les avons comparés à un groupe sans maladie chronique. Résultats L’accessibilité des soins est faible pour tous les groupes de maladies chroniques et présente peu de variation selon les maladies. Les modèles de contact et de coordination intégré sont les plus accessibles, tandis que le modèle à prestataire unique est le moins accessible. Les indices du processus et des résultats de soins sont beaucoup plus élevés que l’indice de l’accessibilité, et ce, pour tous les groupes. De plus, ils varient selon les maladies, les plus élevés se trouvant dans le groupe des facteurs de risque cardiovasculaires, et les plus faibles, dans le groupe des maladies respiratoires (patients âgés de 44 ans et moins). Toutefois, lorsqu’on passe du groupe des facteurs de risque aux groupes de maladies chroniques plus graves, on observe que le modèle de coordination intégré et le modèle communautaire affichent en général une meilleure performance quant au processus de soins, ce qui met en lumière le plus grand potentiel de ces deux modèles pour répondre aux besoins des personnes atteintes des maladies chroniques les plus graves dans le système de soins de santé canadien.

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“…The province of Ontario has adopted the use of various models of interprofessional care, including family health networks and family health teams [13]. Western provinces and Quebec have implemented different organizational reforms, including family medicine groups, local services networks, medical homes, and primary care networks [14-17]. The proportion of clinical payments through capitated and salaried payment models is higher in Ontario, eastern provinces, and the territories, whereas the western provinces and Quebec have a higher proportion of fee-for-service payments [14,15,18].…”

Section: Introductionmentioning

confidence: 99%

Access to Primary Care and Internet Searches for Walk-In Clinics and Emergency Departments in Canada: Observational Study Using Google Trends and Population Health Survey Data

Ssendikaddiwa¹,

Lavergne²

2019

JMIR Public Health Surveill

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BackgroundAccess to primary care is a challenge for many Canadians. Models of primary care vary widely among provinces, including arrangements for same-day and after-hours access. Use of walk-in clinics and emergency departments (EDs) may also vary, but data sources that allow comparison are limited.ObjectiveWe used Google Trends to examine the relative frequency of searches for walk-in clinics and EDs across provinces and over time in Canada. We correlated provincial relative search frequencies from Google Trends with survey responses about primary care access from the Commonwealth Fund’s 2016 International Health Policy Survey of Adults in 11 Countries and the 2016 Canadian Community Health Survey.MethodsWe developed search strategies to capture the range of terms used for walk-in clinics (eg, urgent care clinic and after-hours clinic) and EDs (eg, emergency room) across Canadian provinces. We used Google Trends to determine the frequencies of these terms relative to total search volume within each province from January 2011 to December 2018. We calculated correlation coefficients and 95% CIs between provincial Google Trends relative search frequencies and survey responses.ResultsRelative search frequency of walk-in clinic searches increased steadily, doubling in most provinces between 2011 and 2018. Relative frequency of walk-in clinic searches was highest in the western provinces of British Columbia, Alberta, Saskatchewan, and Manitoba. At the provincial level, higher walk-in clinic relative search frequency was strongly positively correlated with the percentage of survey respondents who reported being able to get same- or next-day appointments to see a doctor or a nurse and inversely correlated with the percentage of respondents who reported going to ED for a condition that they thought could have been treated by providers at usual place of care. Relative search frequency for walk-in clinics was also inversely correlated with the percentage of respondents who reported having a regular medical provider. ED relative search frequencies were more stable over time, and we did not observe statistically significant correlation with survey data.ConclusionsHigher relative search frequency for walk-in clinics was positively correlated with the ability to get a same- or next-day appointment and inversely correlated with ED use for conditions treatable in the patient’s regular place of care and also with having a regular medical provider. Findings suggest that patient use of Web-based tools to search for more convenient or accessible care through walk-in clinics is increasing over time. Further research is needed to validate Google Trends data with administrative information on service use.

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Cited by 11 publications

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Assessing the evolution of primary healthcare organizations and their performance (2005-2010) in two regions of Québec province: Montréal and Montérégie

Assessing the evolution of primary healthcare organizations and their performance (2005-2010) in two regions of Québec province: Montréal and Montérégie

L’influence des modèles d’organisation de soins de santé primaires sur l’expérience de soins de patients atteints de différentes maladies chroniques

Access to Primary Care and Internet Searches for Walk-In Clinics and Emergency Departments in Canada: Observational Study Using Google Trends and Population Health Survey Data

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