Grant: Travel Awards - Institute Community Support

Objectives: In Canada, there are a growing number of people who have a chronic disease. Compared to the rest of Canada, Newfoundland and Labrador (NL) has above average rates of chronic disease. The aim of this study is to better understand the organization of primary healthcare in NL, in particular chronic disease care. Outcomes from this study will inform future primary healthcare reform. Approach: To do this, a survey of primary healthcare sites across NL was conducted. This survey asked about programs and services offered by these sites. Data collected included location of site, community serviced, disease-specific chronic disease prevention programming, types of routine primary care, allied health prevention and promotion, chronic disease prevention and management services, and whether team-based care was offered. Sites were also asked to identify how services were delivered and types of team-based care offered. Results: Completed surveys were returned by 96% (n=148) of sites. Family physician services were available at 66% of sites and nurse practitioner services at 51%. Less than a third (32%) of sites offered 24/7 primary care services. To deliver services, an on-site staff member was most often used (39-98%) while few used telehealth (<15%). Of services typically offered by allied health providers, healthy eating (77%), tobacco cessation (74%), and blood pressure (67%) were most frequently available. Targeted prevention and management programming was most commonly available for diabetes (46%), autism (27%), and hypertension (25%). Use of team-based care was reported by 41% of sites, most often for diabetes (48%), mental health (24%), and primary care (18%). Conclusion: Primary healthcare services are variable across NL leaving room for improvement. For example, many sites do not offer 24/7 care and telehealth is being underutilized. Future studies should examine how the availability of these programs and services affects those with chronic disease in NL.