Evaluation of the implementation of centralized waiting lists for patients without a family physician and their effects across the province of Quebec
Date
2014
Authors
Breton, Mylaine
Brousselle, Astrid
Boivin, Antoine
Loignon, Christine
Touati, Nassera
Dubois, Carl-Ardy
Nour, Kareen
Berbiche, Djamal
Roberge, Danièle
Journal Title
Journal ISSN
Volume Title
Publisher
Implementation Science
Abstract
Background: Most national and provincial commissions on healthcare services in Canada over the past decade
have recommended that primary care services be strengthened in order to guarantee each citizen access to a
family physician. Despite these recommendations, finding a family physician continues to be problematic. The issue
of enrolment with a family physician is worrying in Canada, where nearly 21% of the country’s population reported
not having a family physician in the last Commonwealth Fund survey.
To respond to this important need, centralized waiting lists have been implemented in four Canadian provinces to
help ‘orphan,’ or unaffiliated, patients find a family physician. These organizational mechanisms are intended to
better coordinate the demand for and supply of family physicians. The objectives of this study are: to assess the
effects of centralized waiting lists for orphan patients (GACOs) implemented in the province of Quebec and to
explain the variation among their effects by analyzing factors influencing implementation process.
Methods: This study is based on two complementary and sequential research strategies. The first (objective 1) is a
quantitative longitudinal design to assess the effects of all the GACOs (n = 93) in Quebec using clinicaladministrative
data. The second (objective 2) involves using four case studies to explain variations in effects through
in-depth analysis of the various factors contributing to the observed effects. The primary source of data will be key
actors involved in the GACOs. We expect to conduct around 40 semi-structured interviews.
Discussion: This will be the first study in Canada to evaluate the implementation of this innovation. It will provide
an exhaustive picture of the effects of GACO implementation in Quebec and to assess their potential for
generalization elsewhere in Canada. At the theoretical level, this study will produce new knowledge on the factors
having the greatest influence on the implementation of primary care innovations in professional environments.
Keywords: Primary healthcare, Access, Continuity, Implementation study
Description
Keywords
Primary healthcare, Access, Continuity, Implementation study
Citation
Breton, M., Brousselle, A., Boivin, A., Loignon, C., Touati, N., Dubois, C., … Roberge, D. (2014). Evaluation of the implementation of centralized waiting lists for patients without a family physician and their effects across the province of Quebec. Implementation Science, 9(117), 1-10. https://doi.org/10.1186/s13012-014-0117-9.