Article

Assessing the evolution of primary healthcare organizations and their performance (2005-2010) in two regions of Québec province: Montréal and Montérégie

Institut national de santé publique du Québec, Québec, Canada.
BMC Family Practice (Impact Factor: 1.74). 12/2010; 11(1):95. DOI: 10.1186/1471-2296-11-95
Source: PubMed

ABSTRACT The Canadian healthcare system is currently experiencing important organizational transformations through the reform of primary healthcare (PHC). These reforms vary in scope but share a common feature of proposing the transformation of PHC organizations by implementing new models of PHC organization. These models vary in their performance with respect to client affiliation, utilization of services, experience of care and perceived outcomes of care.
In early 2005 we conducted a study in the two most populous regions of Quebec province (Montreal and Montérégie) which assessed the association between prevailing models of primary healthcare (PHC) and population-level experience of care. The goal of the present research project is to track the evolution of PHC organizational models and their relative performance through the reform process (from 2005 until 2010) and to assess factors at the organizational and contextual levels that are associated with the transformation of PHC organizations and their performance.
This study will consist of three interrelated surveys, hierarchically nested. The first survey is a population-based survey of randomly-selected adults from two populous regions in the province of Quebec. This survey will assess the current affiliation of people with PHC organizations, their level of utilization of healthcare services, attributes of their experience of care, reception of preventive and curative services and perception of unmet needs for care. The second survey is an organizational survey of PHC organizations assessing aspects related to their vision, organizational structure, level of resources, and clinical practice characteristics. This information will serve to develop a taxonomy of organizations using a mixed methods approach of factorial analysis and principal component analysis. The third survey is an assessment of the organizational context in which PHC organizations are evolving. The five year prospective period will serve as a natural experiment to assess contextual and organizational factors (in 2005) associated with migration of PHC organizational models into new forms or models (in 2010) and assess the impact of this evolution on the performance of PHC.
The results of this study will shed light on changes brought about in the organization of PHC and on factors associated with these changes.

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    • "The structure of the organization questionnaire was based on four core elements of organizations. Vision refers to goals, values, and orientations shared by members of an organization; resources concern availability, quantity, and types of resources that can be mobilized by the organization's members; structure formalizes rules of governance, conventions, and procedures that regulate the behavior of organizational actors, and practices relate to coordination, administrative, and professional mechanisms that underpin service delivery [21] [23] [33]. "
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