Primary Care Services Organisational Models and the Population's Care Experience

Primary care services have undergone significant changes in Québec. It is in this context that a research project entitled “Accessibility and Continuity of Care: A Study of Primary Care Services in Québec” was carried out in two health regions in the province: Montréal and Montérégie (Pineault, Lévesque et al. 2004). The main goal of this project was to study the links between different primary care services organisational models and health care experience reported by the population. The study was conducted by researchers from the Population Health and Health Services team at the Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal (DSP) and Institut national de santé publique du Québec (INSPQ), as well as from the Centre de recherche de l'Hôpital Charles LeMoyne. Numerous partners and other researchers collaborated in this study.

The objective of this summary is to describe the different primary care services organisational models, their principal characteristics and a few of their elements of performance.

The adult population is served by primary care medical clinics that have adopted different organisational profiles. In the two regions studied, professional models, as opposed to the community model, serve 90% of users. Differences in perception of care experience persist among users of the various models. In the current context of primary care transformations, these issues certainly merit consideration. For example, although many people agree that the singleprovider model is not the formula upon which primary care should be based in the future, the general population continues to assess it favourably. In addition, when implementing larger, complex organizations and networks, it is important to remember that the professional/patient relationship is at the core of care provision. Results also show that implementation of walk-in clinics alone is not a solution to accessibility problems. Finally, models that offer patient management and longer hours appear to be the best formula to ensure both accessibility and continuity. Our findings regarding organisational models are discussed in more detail in the research report.