Grant: Operating Grant

The objective of this study is to document the relationship between access to primary healthcare services available on First Nations reserves in British Columbia, community control and avoidable hospitalizations (that is hospitalization for conditions that could be in a primary healthcare setting if services were available). Communities in which avoidable hospitalization rates are higher than those of other British Columbia rural and remote communities are those in which one would expect additional investment in primary healthcare to be especially necessary. We will examine the rates of avoidable hospitalization by community to determine whether there appears to be any relationship between these rates, and (1) models of community control over the administration and delivery of health services (transfer, integrated, others), and (2) models of service delivery (services limited to public health versus primary care services provided by nurses with an expanded scope of practice). This project will make four broad contributions. (1) It will identify communities with particular needs for primary health care investments. (2) It will build on the methodology developed in the context of the Manitoba study and attempt to replicate findings to ascertain their generalizability nationally. (3) The results of the study will be used as a step forward towards identifying essential primary healthcare services necessary to address existing primary healthcare needs; and inform the development of services provided via telehealth. (4) It will bring evidence to the relationship between community control and outcomes.