Evaluation of the implementation of centralized waiting lists for patients without a family physician and their effects across the province of Quebec

被引：15

作者：

Breton, Mylaine ^{[1
,2
]}

Brousselle, Astrid ^{[1
,2
]}

Boivin, Antoine ^{[1
,2
]}

Loignon, Christine ^{[1
,2
]}

Touati, Nassera ^{[3
]}

Dubois, Carl-Ardy ^{[4
]}

Nour, Kareen ^{[5
]}

Berbiche, Djamal ^{[1
,2
]}

Roberge, Daniele ^{[1
]}

机构：

[1] Charles LeMoyne Hosp Res Ctr, Greenfield Pk, PQ J4K 0A8, Canada

[2] Univ Sherbrooke, Fac Med & Hlth Sci, Longueuil, PQ J4K 0A8, Canada

[3] Ecole Natl Adm Publ, Montreal, PQ G1K 9E5, Canada

[4] Univ Montreal, Fac Nursing, Montreal, PQ H3C 3J7, Canada

[5] Monteregie Reg Dept Publ Hlth, Longueuil, PQ J4K 2M3, Canada

来源：

IMPLEMENTATION SCIENCE | 2014年 / 9卷

关键词：

Primary healthcare; Access; Continuity; Implementation study; PRIMARY-CARE; CHRONIC ILLNESS; ACCESS; CONTINUITY; EMERGENCY; FRAMEWORK; SERVICES; ORGANIZATIONS; INTERVENTIONS; INNOVATIONS;

D O I：

10.1186/s13012-014-0117-9

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: Most national and provincial commissions on healthcare services in Canada over the past decade have recommended that primary care services be strengthened in order to guarantee each citizen access to a family physician. Despite these recommendations, finding a family physician continues to be problematic. The issue of enrolment with a family physician is worrying in Canada, where nearly 21% of the country's population reported not having a family physician in the last Commonwealth Fund survey. To respond to this important need, centralized waiting lists have been implemented in four Canadian provinces to help 'orphan,' or unaffiliated, patients find a family physician. These organizational mechanisms are intended to better coordinate the demand for and supply of family physicians. The objectives of this study are: to assess the effects of centralized waiting lists for orphan patients (GACOs) implemented in the province of Quebec and to explain the variation among their effects by analyzing factors influencing implementation process. Methods: This study is based on two complementary and sequential research strategies. The first (objective 1) is a quantitative longitudinal design to assess the effects of all the GACOs (n = 93) in Quebec using clinical-administrative data. The second (objective 2) involves using four case studies to explain variations in effects through in-depth analysis of the various factors contributing to the observed effects. The primary source of data will be key actors involved in the GACOs. We expect to conduct around 40 semi-structured interviews. Discussion: This will be the first study in Canada to evaluate the implementation of this innovation. It will provide an exhaustive picture of the effects of GACO implementation in Quebec and to assess their potential for generalization elsewhere in Canada. At the theoretical level, this study will produce new knowledge on the factors having the greatest influence on the implementation of primary care innovations in professional environments.

引用

页数：10

共 69 条

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