Table of Contents
International Journal of Family Medicine
Volume 2016 (2016), Article ID 8938420, 13 pages
http://dx.doi.org/10.1155/2016/8938420
Research Article

Impacts of Québec Primary Healthcare Reforms on Patients’ Experience of Care, Unmet Needs, and Use of Services

1Direction de Santé Publique du Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Est-de-l’Île-de-Montréal, 1301 rue Sherbrooke Est, Montréal, QC, Canada H2L 1M3
2Institut National de Santé Publique du Québec, 190 boulevard Crémazie Est, Montréal, QC, Canada H2P 1E2
3Centre de Recherche du Centre hospitalier de l’Université de Montréal, 900 rue St-Denis, Montréal, QC, Canada H2X 0A9
4Institut de Recherche en Santé Publique de l’Université de Montréal, 7101 avenue du Parc, Montréal, QC, Canada H3N 1X9
5Faculté des Sciences Infirmières de l’Université de Montréal, 2375 chemin de la Côte-Ste-Catherine, Montréal, QC, Canada H3T 1A8
6Centre de Recherche de l’Hôpital Charles-Lemoyne, 150 place Charles-Lemoyne, Bureau 200, Longueuil, QC, Canada J5C 2B6
7Département des Sciences de la Santé Communautaire de l’Université de Sherbrooke, 3001 12e avenue Nord, Sherbrooke, QC, Canada J1H 5H3
8Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 avenue des Pins Ouest, Montréal, QC, Canada H3A 1A2
9Centre for Primary Health Care and Equity, University of New South Wales, Kensington, NSW 2033, Australia
10Bureau of Health Information, 67 Albert Avenue, Chatswood, NSW 2067, Australia

Received 9 October 2015; Accepted 11 January 2016

Academic Editor: Hakan Yaman

Copyright © 2016 Raynald Pineault et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. K. Davis, K. Stremikis, D. Squires, and C. Schoen, Mirror, Mirror on the Wall: How the Performance of The U.S. Healthcare System Compares Internationally, vol. 1755, The Commonwealth Fund, 2014.
  2. The College of Family Physicians of Canada, A vision for Canada: Family practice—The Patient's Medical Home, 2011.
  3. V. J. Barr, S. Robinson, B. Marin-Link et al., “The expanded chronic care model: an integration of concept and strategies from population health promotion and the chronic care model,” Hospital Quarterly, vol. 7, no. 1, pp. 73–82, 2003. View at Google Scholar · View at Scopus
  4. B. Starfield, L. Shi, and J. Macinko, “Contribution of primary care to health systems and health,” Milbank Quarterly, vol. 83, no. 3, pp. 457–502, 2005. View at Publisher · View at Google Scholar · View at Scopus
  5. J. L. Haggerty, J.-F. Lévesque, W. Hogg, and S. Wong, “The strength of primary care systems,” British Medical Journal, vol. 346, no. 7914, Article ID f3777, 2013. View at Publisher · View at Google Scholar · View at Scopus
  6. D. McCarthy and S. Klein, “The triple aim journey: improving population health and patients' experience of care, while reducing costs,” The Commonwealth Fund, vol. 48, no. 1421, pp. 1–11, 2010. View at Google Scholar
  7. Institute for Healthcare Improvement, “IHI Triple Aim Initiative,” 2015, http://www.ihi.org/.
  8. M.-P. Pomey, E. Martin, and P.-G. Forest, “Québec's family medicine groups: innovation and compromise in the reform of front-line care,” Canadian Political Science Review, vol. 3, no. 4, pp. 31–46, 2009. View at Google Scholar
  9. M. Breton, J. F. Levesque, R. Pineault, and W. Hogg, “Primary care reform: can Québec's family medicine group model benefit from the experience of Ontario's family health teams?” Healthcare Policy, vol. 7, no. 2, pp. e122–e135, 2011. View at Google Scholar
  10. T. Bodenheimer, E. H. Wagner, and K. Grumbach, “Improving primary care for patients with chronic illness,” The Journal of the American Medical Association, vol. 288, no. 14, pp. 1775–1779, 2002. View at Publisher · View at Google Scholar · View at Scopus
  11. B. E. Landon, J. M. Gill, R. C. Antonelli, and E. C. Rich, “Prospects for rebuilding primary care using the patient-centered medical home,” Health Affairs, vol. 29, no. 5, pp. 827–834, 2010. View at Publisher · View at Google Scholar · View at Scopus
  12. M. Breton, R. Pineault, J.-F. Levesque, D. Roberge, R. B. Da Silva, and A. Prud'Homme, “Reforming healthcare systems on a locally integrated basis: is there a potential for increasing collaborations in primary healthcare?” BMC Health Services Research, vol. 13, article 262, 2013. View at Publisher · View at Google Scholar · View at Scopus
  13. B. Hutchison, J.-F. Levesque, E. Strumpf, and N. Coyle, “Primary health care in Canada: systems in motion,” The Milbank Quarterly, vol. 89, no. 2, pp. 256–288, 2011. View at Publisher · View at Google Scholar · View at Scopus
  14. B. Hutchison and R. Glazier, “Ontario's primary care reforms have transformed the local care landscape, but a plan is needed for ongoing improvement,” Health Affairs, vol. 32, no. 4, pp. 695–703, 2013. View at Publisher · View at Google Scholar · View at Scopus
  15. M. W. Friedberg, P. S. Hussey, and E. C. Schneider, “Primary care: a critical review of the evidence on quality and costs of health care,” Health Affairs, vol. 29, no. 5, pp. 766–772, 2010. View at Publisher · View at Google Scholar · View at Scopus
  16. R. Pineault, R. Borgès Da Silva, A. Prud'homme et al., “Impact of Québec's healthcare reforms on the organization of primary healthcare (PHC): a 2003–2010 follow-up,” BMC Health Services Research, vol. 14, article 229, 2014. View at Publisher · View at Google Scholar · View at Scopus
  17. M.-D. Beaulieu, J. Haggerty, P. Tousignant et al., “Characteristics of primary care practices associated with high quality of care,” Canadian Medical Association Journal, vol. 185, no. 12, pp. e590–e596, 2013. View at Publisher · View at Google Scholar · View at Scopus
  18. L. Shi, “The impact of primary care: a focused Review,” Scientifica, vol. 2012, Article ID 432892, 22 pages, 2012. View at Publisher · View at Google Scholar
  19. J. L. Haggerty, R. Pineault, M.-D. Beaulieu et al., “Practice features associated with patient-reported accessibility, continuity, and coordination of primary health care,” Annals of Family Medicine, vol. 6, no. 2, pp. 116–123, 2008. View at Publisher · View at Google Scholar · View at Scopus
  20. M. W. Friedberg, K. L. Coltin, D. G. Safran, M. Dresser, A. M. Zaslavsky, and E. C. Schneider, “Associations between structural capabilities of primary care practices and performance on selected quality measures,” Annals of Internal Medicine, vol. 151, no. 7, pp. 456–463, 2009. View at Publisher · View at Google Scholar · View at Scopus
  21. R. H. Glazier, J. Klein-Geltink, A. Kopp, and L. M. Sibley, “Capitation and enhanced fee-for-service models for primary care reform: a population-based evaluation,” Canadian Medical Association Journal, vol. 180, no. 11, pp. e72–e81, 2009. View at Publisher · View at Google Scholar · View at Scopus
  22. R. Pineault, J. F. Levesque, D. Roberge, M. Hamel, P. Lamarche, and J. Haggerty, Accessibility and Continuity of Care: A Study of Primary Healthcare in Québec, The Canadian Institutes of Health Research and the Canadian Health Services Research Foundation, 2008.
  23. J.-F. Levesque, R. Pineault, S. Provost et al., “Assessing the evolution of primary healthcare organizations and their performance (2005–2010) in two regions of Québec province: montréal and Montérégie,” BMC Family Practice, vol. 11, article 95, 2010. View at Publisher · View at Google Scholar · View at Scopus
  24. L. Shi, B. Starfield, and J. Xu, “Validating the adult primary care assessment tool,” Journal of Family Practice, vol. 50, no. 2, pp. 161–175, 2001. View at Google Scholar
  25. D. G. Safran, M. Kosinski, A. R. Tarlov et al., “The primary care assessment survey: tests of data quality and measurement performance,” Medical Care, vol. 36, no. 5, pp. 728–739, 1998. View at Publisher · View at Google Scholar · View at Scopus
  26. J. Haggerty, R. Pineault, M. D. Beaulieu et al., Accessibility and Continuity of Primary Care in Québec, The Canadian Health Services Research Foundation, 2004.
  27. D. G. Safran, “Defining the future of primary care: what can we learn from patients?” Annals of Internal Medicine, vol. 138, no. 3, pp. 248–255, 2003. View at Publisher · View at Google Scholar · View at Scopus
  28. K. A. Bollen and S. Bauldry, “Three Cs in measurement models: causal indicators, composite indicators, and covariates,” Psychological Methods, vol. 16, no. 3, pp. 265–284, 2011. View at Publisher · View at Google Scholar · View at Scopus
  29. A. Diamantopoulos and H. M. Winklhofer, “Index construction with formative indicators: an alternative to scale development,” Journal of Marketing Research, vol. 38, no. 2, pp. 269–277, 2001. View at Publisher · View at Google Scholar · View at Scopus
  30. J. D. Angrist and J. S. Pischke, “Parallel words: fixed effects, difference-in-differences, and panel date,” in Mostly Harmless Econometric, pp. 221–246, Princeton University Press, Princeton, NJ, USA, 2009. View at Google Scholar
  31. B. D. Meyer, “Natural and quasi-experiments in economics,” Journal of Business & Economic Statistics, vol. 13, no. 2, pp. 151–161, 1995. View at Google Scholar
  32. P. J. Gertler, S. Martinez, P. Premand, L. B. Rawlings, and C. M. J. Vermeersch, “Difference-in-differences,” in Impact Evaluation in Practice, P. J. Gertler, S. Martinez, P. Premand, L. B. Rawlings, and C. M. J. Vermeersch, Eds., pp. 95–105, International Bank for Reconstruction and Development, The World Bank, Washington, DC, USA, 2011. View at Google Scholar
  33. B. A. Griffin and D. F. McCaffrey, “Nonparametric matching and propensity scores,” in Encyclopedia of Health Economics, pp. 370–374, Elsevier, Oxford, UK, 1st edition, 2014. View at Google Scholar
  34. J. B. Dimick and A. M. Ryan, “Methods for evaluating changes in health care policy: the difference-in-differences approach,” The Journal of the American Medical Association, vol. 312, no. 22, pp. 2401–2402, 2014. View at Publisher · View at Google Scholar · View at Scopus
  35. E. A. Stuart, “Matching methods for causal inference: a review and a look forward,” Statistical Science, vol. 25, no. 1, pp. 1–21, 2010. View at Publisher · View at Google Scholar · View at MathSciNet · View at Scopus
  36. P. C. Austin, “An introduction to propensity score methods for reducing the effects of confounding in observational studies,” Multivariate Behavioral Research, vol. 46, no. 3, pp. 399–424, 2011. View at Publisher · View at Google Scholar · View at Scopus
  37. Régie de L'assurance-Maladie du Québec, “Services de médecine de famille de prise en charge et de suivi de la clientèle Inscription générale de la clientèle et autres changements. Communiqué aux professionnels de la santé et aux dispensateurs de soins assurés,” 2008, http://www.ramq.gouv.qc.ca/sitecollectiondocuments/professionnels/infolettres/2008/com145-8.pdf.
  38. A. Tourigny, M. Aubin, J. Haggerty et al., “Patients' perceptions of the quality of care after primary care reform: family medicine groups in Quebec,” Canadian Family Physician, vol. 56, no. 7, pp. e273–e282, 2010. View at Google Scholar · View at Scopus
  39. R. Pineault, R. Borgès Da Silva, S. Provost et al., “Primary healthcare solo practices: homogeneous or heterogeneous?” International Journal of Family Medicine, vol. 2014, Article ID 373725, 10 pages, 2014. View at Publisher · View at Google Scholar
  40. P. Tousignant, M. Diop, M. Fournier et al., “Validation of 2 new measures of continuity of care based on year-to-year follow-up with known providers of health care,” Annals of Family Medicine, vol. 12, no. 6, pp. 559–567, 2014. View at Publisher · View at Google Scholar
  41. J. L. Haggerty, D. Roberge, G. K. Freeman, C. Beaulieu, and M. Bréton, “Validation of a generic measure of continuity of care: when patients encounter several clinicians,” Annals of Family Medicine, vol. 10, no. 5, pp. 443–450, 2012. View at Publisher · View at Google Scholar · View at Scopus
  42. C. Dunkley-Hickin, Effects of primary care reform in Quebec on access to primary health care services [M.S. thesis], McGill University, Department of Epidemiology and Biostatistics, 2013.
  43. E. Strumpf, “L'évaluation des groupes de médecine de famille (GMF),” in L'Évaluation Économique et la Recherche sur les Services de Santé, Ministère des Affaires Sociales, de la Santé et des Droits des Femmes, Paris, France, December 2014.
  44. J. Héroux, E. E. Moodie, E. Strumpf, N. Coyle, P. Tousignant, and M. Diop, “Marginal structural models for skewed outcomes: identifying causal relationships in health care utilization,” Statistics in Medicine, vol. 33, no. 7, pp. 1205–1221, 2014. View at Publisher · View at Google Scholar · View at MathSciNet · View at Scopus
  45. S. Dahrouge, W. Hogg, N. Ward et al., “Delivery of primary health care to persons who are socio-economically disadvantaged: does the organizational delivery model matter?” BMC Health Services Research, vol. 13, article 517, 2013. View at Publisher · View at Google Scholar · View at Scopus
  46. A. Sweatman and G. Buckley, “Ontario's experiment with primary care reform,” The School of Public Policy, vol. 7, no. 11, 2014. View at Google Scholar
  47. J. Kantarevic, B. Kralj, and D. Weinkauf, “Enhanced fee-for-service model and access to physician services evidence from family health groups in Ontario,” IZA Discussion Paper 4862, 2010. View at Google Scholar
  48. Commissaire à la Santé et au Bien-Être du Québec, Perceptions et Expériences de Soins de la Population: Le Québec Comparé, Résultats de L'enquête Internationale sur les Politiques de Santé du Commonwealth Fund de 2013, Gouvernement du Québec, 2014.
  49. Vérificateur Général du Québec, Groupe de médecine de famille et Cliniques-réseau, Services de première ligne dans le réseau de la santé et des services sociaux. Rapport du Vérificateur général du Québec à l’Assemblée nationale pour l’année 2015-2016. Vérification de l’optimisation des ressources Services de première ligne dans le réseau de la santé et des services sociaux. Gouvernement du Québec, 2015.
  50. C. Forget, The Case of the Vanishing Quebec Physicians: How Improve Access to Care, vol. 410 of Commentary, C.D. Howe Institute, 2014.
  51. J. Bland and D. Altman, “Statistics notes: Cronbach's alpha,” British Medical Journal, vol. 314, no. 7080, article 572, 1997. View at Publisher · View at Google Scholar
  52. D. Haziza, “Imputation and inference in the presence of missing data,” in Handbook of Statistics, C. R. Rao and D. Pfeffermann, Eds., vol. 29 of Sample Surveys: Theory Methods and Inference, pp. 215–246, Elsevier, 2009. View at Google Scholar
  53. B. Hutchison, “Reforming Canadian primary care—don't stop half-way,” Healthcare Policy, vol. 9, no. 1, pp. 12–25, 2013. View at Google Scholar · View at Scopus
  54. M. W. Friedberg, E. C. Schneider, M. B. Rosenthal, K. G. Volpp, and R. M. Werner, “Association between participation in a multipayer medical home intervention and changes in quality, utilization, and costs of care,” The Journal of the American Medical Association, vol. 311, no. 8, pp. 815–825, 2014. View at Publisher · View at Google Scholar · View at Scopus