Do new and traditional models of primary care differ with regard to access?: Canadian QUALICOPC study
- PMID: 27331231
- PMCID: PMC4721842
Do new and traditional models of primary care differ with regard to access?: Canadian QUALICOPC study
Abstract
Objective: To examine access to primary care in new and traditional models using 2 dimensions of the concept of patient-centred access.
Design: An international survey examining the quality and costs of primary health care (the QUALICOPC study) was conducted in 2013 in Canada. This study adopted a descriptive cross-sectional survey method using data from practices across Canada. Each participating practice filled out the Family Physician Survey and the Practice Survey, and patients in each participating practice were asked to complete the Patient Experiences Survey.
Setting: All 10 Canadian provinces.
Participants: A total of 759 practices and 7172 patients.
Main outcome measures: Independent t tests were conducted to examine differences between new and traditional models of care in terms of availability and accommodation, and affordability of care.
Results: Of the 759 practices, 407 were identified as having new models of care and 352 were identified as traditional. New models of care were distinct with respect to payment structure, opening hours, and having an interdisciplinary work force. Most participating practices were from large cities or suburban areas. There were few differences between new and traditional models of care regarding accessibility and accommodation in primary care. Patients under new models of care reported easier access to other physicians in the same practice, while patients from traditional models reported seeing their regular family physicians more frequently. There was no difference between the new and traditional models of care with regard to affordability of primary care. Patients attending clinics with new models of care reported that their physicians were more involved with them as a whole person than patients attending clinics based on traditional models did.
Conclusion: Primary care access issues do not differ strongly between traditional and new models of care; however, patients in the new models of care believed that their physicians were more involved with them as people.
Objectif: Vérifier l’accessibilité et le coût des soins de santé primaires prodigués dans des modèles de pratique nouveaux et traditionnels, et ce, en se servant de deux aspects du concept d’accessibilité, centrée sur le patient.
Type d’étude: En 2013, une enquête internationale sur la qualité et le coût des soins de santé primaires, l’étude QUALICOPC, a été effectuée au Canada. Il s’agissait d’une étude descriptive transversale à partir de données provenant de cliniques d’un peu partout au Canada. Chaque clinique participante devait répondre à la Family Physician Survey et à la Practice Survey; on demandait également aux clients de chacune des cliniques de répondre à la Patient Experiences Survey.
Contexte: Les 10 provinces canadiennes.
Participants: Un total de 759 cliniques et de 7172 patients.
Principaux paramètre à l’étude: On s’est servi de tests de t pour échantillons indépendants pour déterminer si les modèles de pratique traditionnels et nouveaux différaient en termes d’accessibilité, de réponse aux besoins et de coût des soins.
Résultats: On a jugé que 407 des 759 cliniques utilisaient un nouveau modèle de pratique contre 352 pour un modèle traditionnel. Les nouveaux modèles se distinguaient en raison de leur structure de paiement, de leurs heures d’ouverture et de la présence d’une équipe multidisciplinaire. La plupart des cliniques participantes desservaient des grandes villes ou des banlieues. On notait très peu de différences entre les modèles de pratique nouveaux et traditionnels pour ce qui est de l’accessibilité et de la réponse aux besoins primaires. Les clients des nouveaux modèles mentionnaient avoir plus facilement accès aux autres médecins de la clinique tandis que ceux des modèles traditionnels disaient voir leur médecin habituel plus souvent. Il n’y avait pas de différence entre les 2 modèles pour ce qui est du coût des soins primaires. Par rapport aux clients des modèles traditionnels de pratique, ceux des modèles nouveaux mentionnaient que leur médecin utilisait davantage l’approche holistique.
Conclusion: Pour ce qui est de l’accessibilité aux soins primaires, il y avait peu de différence entre les modèles de pratique nouveaux et traditionnels; toutefois, les clients des nouveaux modèles de pratique estimaient que leur médecin les traitait de façon plus globale.
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