Grant: Catalyst Grant: Quadruple Aim and Equity - IMHA

Musculoskeletal (MSK) disorders affect 11M people in Canada and generate the highest health costs in the country and a significant demand for care in relation to the complex nature of the needs over a long period of time. In 2016, the Quebec Ministry of Health and Social Services (QMHSS) implemented the APSS-CRDS, regional access points for centralizing requests for a first consultation in specialized care for patients referred by primary care physicians (PCPs), including orthopaedics, neurosurgery, physiatry and rheumatology. Early findings for the evaluation of the APSS-CRDS showed that availability of the resource in these specialties caring for MSK disorders may be problematic and that PCPs may not have all the resource to manage patients with MSK disorders, both challenges that the APSS-CRDS does not address. In complement to the APSS-CRDS, the QMHSS aims to innovate by developing the CRSM, a showcase project of regional MSK health centers that will bring together teams of professionals with an expertise in MSK health. They will perform complete clinical assessment, provide care and services, and even manage certain patients autonomously. Patients targeted for such services are profiles which are associated with large volumes of requests to specialized care, mostly acute and sub-acute problems, at risk of becoming chronic, such as neck pain, low back pain and pain in the lower limbs (hip and knee). The overall objective of the proposed study is to assess the effects of these new modalities for accessing regionally centralized MSK health services. More specifically, we aim to study: -the effects on health, quality of life, pain, and satisfaction with care in patients using CRMS; -the effects on services used by the patients and care pathway costs; - the perceptions of professionals on the clinical utility, appropriateness and general satisfaction regarding the CRMS.