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Assessing the performance of centralized waiting lists for patients without a regular family physician using clinical-administrative data

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dc.contributor.author Breton, Mylaine
dc.contributor.author Smithman, Mélanie Ann
dc.contributor.author Brousselle, Astrid
dc.contributor.author Loignon, Christine
dc.contributor.author Touati, Nassera
dc.contributor.author Dubois, Carl-Ardy
dc.contributor.author Nour, Kareen
dc.contributor.author Boivin, Antoine
dc.contributor.author Berbiche, Djamal
dc.contributor.author Roberge, Danièle
dc.date.accessioned 2021-02-19T00:17:31Z
dc.date.available 2021-02-19T00:17:31Z
dc.date.copyright 2017 en_US
dc.date.issued 2017
dc.identifier.citation Breton, M., Smithman, M. A., Brousselle, A., Loignon, C., Touati, N., Nour, K., … Roberge, D. (2017). Assessing the performance of centralized waiting lists for patients without a regular family physician using clinical-administrative data. BMC Family Practice, 18, 1-13. https://doi.org/10.1186/s12875-016-0573-1. en_US
dc.identifier.uri https://doi.org/10.1186/s12875-016-0573-1
dc.identifier.uri http://hdl.handle.net/1828/12700
dc.description.abstract Background: With 4.6 million patients who do not have a regular family physician, Canada performs poorly compared to other OECD countries in terms of attachment to a family physician. To address this issue, several provinces have implemented centralized waiting lists to coordinate supply and demand for attachment to a family physician. Although significant resources are invested in these centralized waiting lists, no studies have measured their performance. In this article, we present a performance assessment of centralized waiting lists for unattached patients implemented in Quebec, Canada. Methods: We based our approach on the Balanced Scorecard method. A committee of decision-makers, managers, healthcare professionals, and researchers selected five indicators for the performance assessment of centralized waiting lists, including both process and outcome indicators. We analyzed and compared clinical-administrative data from 86 centralized waiting lists (GACOs) located in 14 regions in Quebec, from April 1, 2013, to March 31, 2014. Results: During the study period, although over 150,000 patients were attached to a family physician, new requests resulted in a 30% median increase in patients on waiting lists. An inverse correlation of average strength was found between the rates of patients attached to a family physician and the proportion of vulnerable patients attached to a family physician meaning that as more patients became attached to an FP through GACOs, the proportion of vulnerable patients became smaller (r = −0.31, p < 0.005). The results showed very large performance variations both among GACOs of different regions and among those of a same region for all performance indicators. Conclusions: Centralized waiting lists for unattached patients in Quebec seem to be achieving their twofold objective of attaching patients to a family physician and giving priority to vulnerable patients. However, the demand for attachment seems to exceed the supply and there appears to be a tension between giving priority to vulnerable patients and attaching of a large number of patients. Results also showed heterogeneity in the performance of centralized waiting lists across Quebec. Finally, our findings suggest it is critical that similar mechanisms should use available data to identify the best strategies for reducing variations and improving performance. en_US
dc.description.sponsorship This study was funded by the Fonds de recherche du Québec–Santé (FRQ-S Grant #28974) for which MB is the principal investigator. en_US
dc.language.iso en en_US
dc.publisher BMC Family Practice en_US
dc.subject Unattached patients en_US
dc.subject Centralized waiting lists en_US
dc.subject Performance en_US
dc.subject Balanced Scorecard en_US
dc.title Assessing the performance of centralized waiting lists for patients without a regular family physician using clinical-administrative data en_US
dc.type Article en_US
dc.description.scholarlevel Faculty en_US
dc.description.reviewstatus Reviewed en_US


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