Grant: Partnerships for Health System Improvement (PHSI)

Children from low income families are often less healthy than children from wealthier backgrounds. Studies have shown how primary care is important to improve health. Primary care includes visits to a doctor for regular health check ups. When a child receives care from a primary care doctor, they may have fewer visits to the emergency room or hospital. The benefit of primary care may be even greater for children in poverty or children with chronic diseases such as asthma. Since 2002, Quebec introduced new ways for family physicians to practice in groups known as family medicine groups (FMGs) or network clinics. These groups allow doctors to share duties. They provide patients with easier access to more complete medical care. Across Canada, similar changes have taken place, referred to as primary care reform. At the moment, we know little about the primary care of children in Quebec: how many have a doctor, who they are seeing, and if it makes any difference who sees them. We do not know if FMGs or network clinics are providing better care to children in poverty or suffering from asthma compared to other types of primary care providers. In our study, we will use provincial databanks containing all visits to doctors and hospitals for children in Quebec. Using a group representing all children and a group of children with asthma, we will look at where they go for primary care. We will see if children seen by certain primary care providers have fewer visits to the emergency room and hospital stays. We will then see if there are differences between low and high income children. Our study is essential to the health of children and the healthcare system. We will see if primary care reform has reduced the large differences in health between poor and rich children. With our team of policy and decision makers, we will advise the government on what kind of care children need and how to plan future resources.