Grant: Partnerships for Health System Improvement (PHSI)

The Canadian healthcare system is currently experiencing important transformations, particularly in its primary healthcare (PHC) sector. Most of these reforms propose implementing new models of PHC to better meet the expectations and the needs of users of services and the whole population. Evaluation of these experiences is thus needed with regards to the degree of success of such initiatives in order to draw lessons for the future. Leaning on a "natural experiment" situation, we propose to assess the impact of changes introduced around 2005 in the Quebec healthcare system. More specifically, our study aims to: 1.assess the magnitude of change in PHC between 2005 and 2010, as new emergent models have been proposed and implemented (Family Medicine Groups, Network Clinics), and Social and Health Services Centres have been created; 2.to explain organizational and professional factors associated with these changes; 3.to determine the extent to which these changes have had an impact on experience of care, utilization of services, unmet needs at the population level; Our study will consist in three interrelated surveys: (1) a telephone survey of a sample of the two populations; (2) a postal survey of all PHC organizations with nominal link with the population survey through identification of regular source of care; (3) a third survey of key informants at the level of local territories. A fourth source of information will come from administrative datafiles obtained from the Régie de l'Assurance-maladie du Québec. Results of this study are likely to help decision and policy makers in planning future action, as well as making adjustments to ongoing reforms. Knowledge translation activities occupy an important place in the project and will target diverse audiences: policy and decision-makers, professionals, pressure groups and the larger public.