Health and social services organisation

Accessibility and continuity of health services : A study on primary healthcare in Quebec : Research report : Summary

Highlights

  • Overall, individuals’ assessment of their health care experiences with their regular source of primary care is favourable. These observations are similar to the results of international studies on health care user satisfaction. However, the population is clearly less appreciative of geographical and organisational accessibility.
  • Appreciation of care experience varies greatly among territories of the health and social service centres (HSSC) in the two regions under study. The population’s perception of the primary care experience is generally better in Montérégie than in Montréal.
  • The contrasts characterizing the population’s care experience is brought to light when CSSS territories are grouped by context. Urban territories described as affluent commerçant and characterised by the density of their populations and the wide diversity and quantity of health care resources obtain the lowest scores for both aggregate index of care experience a…

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…

Unmet needs for medical services: a reflection of the accessibility of primary care services?

In short,

  • The prevalence of unmet needs seems to have grown over the past decade, and reaches 18% in our study.
  • One out of five people perceive their health problems associated with unmet needs to be urgent, and a large percentage of people who reported unmet needs felt worried and experienced pain, and they needed to limit their activities.
  • This issue affects the population as a whole but is more common among young adults, recent immigrants, people who work or study, individuals with high levels of education and people who report being in poor health.
  • Unmet needs rates are clearly higher among individuals who have no family doctor and people who report an emergency unit as their usual source of primary care.

Evaluation of the performance of designated screening centers of the Programme québécois de dépistage du cancer du sein (PQDCS): description of the methods

The evaluation of the Programme québécois de dépistage du cancer du sein (PQDCS) is based primarily on the analysis of performance indicators as defined in the PQDCS guidelines. Methods were initially developed to measure performance indicators at the provincial level and then in individual regions. The goal of this report is to develop an approach for the measurement and comparison of performance indicators at the screening centre level.

The indicators selected to evaluate the performance of individual centres are: the detection rate, recall rate, and number of false positives per screen detected cancer. These indicators are estimated separately for initial and subsequent screens. The percentage of in situ cancers, the percentage of small invasive cancers, and the percentage of lymph nodenegative invasive cancers were also selected. To evaluate a centre's performance, these indicator measurements were compared to the measurements for Quebec as a whole, as well as w…

Équipe d'évaluation du PQDCS

Accessibility and Continuity of Care: A Study of Primary Healthcare in Québec : research Report

Key Messages

Generally, users of primary care have a favourable opinion of their experience of care. Organisational and geographical accessibility remain the aspect that is the least favourably perceived by the population. We should be concerned with the fact that residents of urban areas in general, and Montréal in particular, have a poorer perception of their healthcare experience.

The adult population is served by primary care medical clinics that have adopted different organisational forms. In the regions studied, we observe five primary care organisational models, four professional and one community. Professional models—single-provider, contact, coordination and integrated coordination—serve 90% of users. These types of organisations are privately governed, and their objective is to respond to the medical needs of who come to clinic, or of people for whom these clinics are the regular source of care.…

Health services utilisation by Montrealers aged 40 and over with chronic obstructive pulmonary disease in 2003–2004

The main objective of this report is to enable decision makers in clinical and administrative health settings in Montréal to be better informed of the utilisation of ambulatory care and institutional services by people in their territories who suffer from chronic obstructive pulmonary disease (COPD). This report on COPD is part of the “Monitorage interprétative” project conducted by the Équipe Santé des populations et services de santé (ESPSS), a joint team of the Montréal Public Health Department and the Institut national de santé publique du Québec. It is one of a series of reports produced by the team on health services utilisation by Montrealers with chronic diseases.

Primary care services organisation - A portrait of primary care medical services in Montréal and Montérégie - Summary

This summary report on primary care services organisation (Hamel, Pineault et al., 2007) is part of a series of publications focusing on the research project results. It presents evidence and unpublished data on primary care medical services organisation. Results are given according to administrative region and Health and Social Services Centre (CSSS) territory.

The data come from a large 2005 study of primary care medical offices and clinics in the regions chosen. This report is intended for clinical and administrative decision makers in Montréal and Montérégie as well as for research groups, clinicians and anyone else interested in primary case services organisation.

Under the current circumstances, at a time when Québec's health system is undergoing significant changes, these data provide very useful information. Moreover, data for this study was collected when the first Family Medicine Groups (FMG) were being implemented and the new CSSS set up. The data precedes…

Hospital Emergency Departments: Substitute for Primary Care? Results of a Survey among the Population of Montréal and Montérégie

Almost one-third (31%) of the adult population in Montréal and Montérégie reported going to emergency departments at least once in the two years preceding the survey. Utilisation of emergency departments varies by health and social services centre (CSSS, Centre de santé et de services sociaux) territory, and tends to be higher in rural areas. This could be related to the specific pattern of organisation of primary care practices in rural areas. Having a regular source of primary care and perceiving to have rapid access to a primary care physician are associated to reduced use of emergency departments. The survey also reveals higher proportions of emergency department utilisation among people reporting poorer health status, young adults, socio-economically disadvantaged individuals, and recent immigrants.

Among people who reported a health problem in the past six months, one out of three identified an emergency department as their primary source of medical advice for this pro…

Unmet health care needs: A reflection of the accessibility of primary services?

In this thematic pamphlet, we present some results of a study entitled Accessibilité et continuité des services de santé - Une étude sur la première ligne au Québec, conducted in 2005 among more than 9000 people in Montréal and Montérégie. Our goal is to provide information concerning unmet health care needs and to analyse the initial implications.

The concept of unmet needs refers to the difference between health services deemed necessary to treat a particular health problem and services actually received. A person who perceived the need to receive medical services—whether information from a health professional or a therapeutic procedure—but who has not obtained these services has unmet health care needs. To a certain extent, this reflects the lack of access to health services.

The hypotheses raised in this document will be the subject of more thorough analyses, the results of which will be published at a later date. The first section gives an overall description of…

Health service utilisation by Montrealers suffering from heart failure in 2003-2004 : summary

The main objective of this report is to enable decision-makers in Montréal clinical and health administration settings be better informed of health service utilisation by people with heart failure who are living in their territories. The report on heart failure is part of the « Monitorage interprétatif » project conducted by the Équipe Santé des populations et services de santé (ESPSS), a joint team of the Direction de santé publique de Montréal and Institut national de santé publique du Québec. This document is one of a series of reports produced by the team on health service utilisation by Montrealers with chronic diseases.