Jeannie Haggerty

McGill University | McGill · Department of Family Medicine

Background: The advanced access model was developed 20 years ago and has been implemented in several countries. We aimed to revise and operationalize the pillars and subpillars of the advanced access model based on its contemporary practice by profes- sionals in primary health care. Methods: This multimethod sequential study was informed by a liter...

Background Current dimensions of the primary health care research (PHC) context, including the need for contextualized research methods to address complex questions, and the co-creation of knowledge through partnerships with stakeholders – require PHC researchers to have a comprehensive set of skills for engaging effectively in high impact research...

Background: The aim of this work was to show the feasibility of providing a comprehensive portrait of regional primary care performance. Methods: The TRANSFORMATION study used a mixed-methods concurrent study design where we analyzed survey data and case studies. Data were collected in British Columbia, Ontario and Nova Scotia. Patient's Medical...

Aim To describe the process by which the 12 community-based primary health care (CBPHC) research teams worked together and fostered cross-jurisdictional collaboration, including collection of common indicators with the goal of using the same measures and data sources. Background A pan-Canadian mechanism for common measurement of the impact of prim...

Objectives To examine: 1) whether patient characteristics predict perceived self-management support (usefulness of information and collaborative care planning) by primary care providers after six months, and 2) the association between perceived self-management support and patient activation at 6 months Methods We conducted a secondary analysis amo...

This chapter focuses on North American (NA) participatory health research (PHR), particularly with organizations. We begin by presenting the definition of PHR put forth by NA leaders in 1995 and, then, sketching the contributions of those who have led the field since, developing, promoting, and advocating for PHR in Canada and the United States. We...

Introduction: Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options...

Background In health, organizational participatory research (OPR) refers to health organization members participating in research decisions, with university researchers, throughout a study. This non-academic partner contribution to the research may take the form of consultation or co-construction. A drawback of OPR is that it requires more time fro...

Background In rural China, patients have free choice of health facilities for outpatient services. Comparison studies exploring the attributes of different health facilities can help identify optimal primary care service models. Using a representative sample of Chinese provinces, this study aimed to compare patients’ rating of three primary care se...

Background: Various data sources may be used to document the presence of chronic medical conditions. This study examined the agreement between self-reported and health administrative data. Methods: A randomly selected cohort of participants aged 25-75 years recruited by telephone from the general population of Quebec reported on the presence of...

Objectives To validate 2 new patient-reported measures of self-management support from health professionals for mood and emotional problems. Methods The sample comprised primary care patients with chronic physical conditions and co-morbid depressive symptoms enrolled in a randomized trial of telephone coaching of a depression self-care interventio...

Introduction: Recruitment and retention of healthcare staff are difficult in rural communities. Poor quality of work life (QWL) may be an underling factor as rural healthcare professionals are often isolated and work with limited resources. However, QWL data on rural emergency (ED) staff is limited. We assessed QWL among nurses and physicians as pa...

Most highly developed economies have embarked on a process of primary health care (PHC) transformation. To provide evidence on how nations vary in terms of accessing PHC, the aim of this study is to describe the extent to which barriers to access were experienced by adults in Australia compared with other countries. Communities participating in an...

Objective Primary care services form the foundation of modern healthcare systems, yet the breadth and complexity of services and diversity of patient populations may present challenges for creating comprehensive primary care information systems. Our objective is to develop regional-level information on the performance of primary care in Canada. Me...

Sources: Main bibliographic databases (Medline, Embase, CINAHL) and team members' personal files. Study selection: One researcher selected relevant abstracts and full text papers. Theory-driven synthesis: The researcher classified included studies using (i) the 'Patient Centered Access to Healthcare' conceptual framework (dimensions and outcomes...

Objective. To analyze the relationship between health system financing and services organization models with costs and health services performance in each of Rosario’s health sub-systems. Materials and methods. The financing and organization models were characterized using secondary data.Costs were calculated using theWHO/SHA methodology.Healthcare...

Background: Evidence-based indicators of quality of care have been developed to improve care and performance in Canadian emergency departments. The feasibility of measuring these indicators has been assessed mainly in urban and academic emergency departments. We sought to assess the feasibility of measuring quality-of-care indicators in rural emerg...

Background: Settings affect estimation of multimorbidity prevalence. Multimorbidity prevalence was reported to be substantially higher among family practice-based patients than in the general population, but prevalence estimates were obtained with different methods and at different time periods. The aim of the present study was to compare estimate...

Objective: A small number of patients frequently using the emergency department (ED) account for a disproportionate amount of the total ED workload and are considered using this service inappropriately. The aim of this study was to identify prospectively personal characteristics and experience of organizational and relational dimensions of primary...

Plausibility of the assumption that the relationship between predictor and ED use was similar for both years. (DOCX)

Background Most Latin American health systems are comprised of public (PubS), social security (SSS) and private (PrS) subsystems. These subsystems coexist, causing health care fragmentation and population segmentation. Objective To estimate the extent of subsystem cross-coverage in a geographically bounded population (Rosario city) and to compare...

Context: Patients are the most valid source for evaluating the accessibility of services, but a previous study observed differential psychometric performance of instruments in rural and urban respondents. Objective: To validate a measure of organizational accessibility free of differential rural-urban performance that predicts consequences of di...

Background Improving access to primary healthcare (PHC) for vulnerable populations is important for achieving health equity, yet this remains challenging. Evidence of effective interventions is rather limited and fragmented. We need to identify innovative ways to improve access to PHC for vulnerable populations, and to clarify which elements of hea...

Introduction: Since 2000, primary care (PC) reforms have been implemented in various Canadian provinces. Emerging organizational models and policies are at various levels of implementation across jurisdictions. Few cross-provincial analyses of these reforms have been realized. The aim of this study is to identify the factors that have facilitated...

. Multimorbidity adversely affects health-related quality of life. Methodological factors may impact the magnitude of this relationship. Objective . To evaluate how physical health-related quality of life varies in individuals with multimorbidity depending on the length of the list of candidate conditions considered. Methods . Secondary analysis fr...

Background: Rural emergency departments (EDs) constitute crucial safety nets for the 20 % of Canadians who live in rural areas. Pilot data suggests that the province of Québec appears to provide more comprehensive access to services than do other provinces. A difference that may be attributable to provincial policy/guidelines "the provincial ED ma...

Communication barriers between persons living in poverty and healthcare professionals reduce care effectiveness. Little is known about the strategies general practitioners (GPs) use to enhance the effectiveness of care for their patients living in poverty. The aim of this study was to identify strategies adopted by GPs to deliver appropriate care t...

Direct measures of health care affordability from the user perspective are needed to monitor equitable access to publicly funded health care in Canada. The objective of our study was to develop a survey-based measure of healthcare affordability applicable to the Canadian context. We developed items after focus group exploration of access and cost b...

Background For mothers who have just given birth, the postpartum hospital stay is meant to promote an environment where resting, healing and bonding can take place. New mothers, however, face many interruptions throughout the day including multiple visitors and noise caused by medical equipment, corridor conversations and intercom announcements. Th...

Context: Participatory Research with Health Organizations (PRO) blends research and action to produce knowledge that can improve organization practices. Organization members may be consulted by researchers (passive participation) or work with researchers making decisions (active participation) throughout the research process. The differences in the...

Purpose: In a primary care context favoring group practices, we assessed the validity of 2 new continuity measures (both versions of known provider continuity, KPC) that capture the concentration of care over time from multiple physicians (multiple provider continuity, KPC-MP) or from the physician seen most often (personal provider continuity, KP...

Background Lifestyle factors have been associated mostly with individual chronic diseases. We investigated the relationship between lifestyle factors (individual and combined) and the co-occurrence of multiple chronic diseases. Methods Cross-sectional analysis of results from the Program of Research on the Evolution of a Cohort Investigating Healt...

The Royal College of General Practitioners (RCGP) has recently released the Continuity of Care Toolkit1 that gives practical advice about how to diagnose and protect the capacity of patients and practitioners to ‘retain contact with each other’ (a nice succinct definition of relational continuity). The toolkit recommends an initial diagnosis of the...

To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. Three regions of Quebec. Health care professionals and staff of 5 PC practices. Five cases showing above-average re...

Comparing accessibility between urban and rural areas requires measurement instruments that are equally discriminating in each context. Through focus groups we explored and compared care-seeking trajectories to understand context-specific accessibility barriers and facilitators. Rural care-seekers rely more on telephone access and experience more o...

Purpose: Evaluate the psychometric properties of the French version of the short 19-item Team Climate Inventory (TCI) and explore the contributions of individual and organizational characteristics to perceived team effectiveness. Method: The TCI was completed by 471 of the 618 (76.2%) healthcare professionals and administrative staff working in...

To examine whether confidence in primary healthcare (PHC) differs among ethnic-linguistic groups and which PHC experiences are associated with confidence. A cross-sectional study where patient surveys were administered using random digit dialling. Regression models identify whether ethnic-linguistic group remains significantly associated with confi...

Introduction: Overweight in children is a serious public health problem. The use of different weight classification systems in research and clinical practice results in variable the estimate of prevalences of overweight, which complicates follow-up of this health problem in the population. The study compared three child body weight classification...

Background In 2004, the Québec government implemented an important reform of the healthcare system. The reform was based on the creation of new organisations called Health Services and Social Centres (HSSC), which were formed by merging several healthcare organisations. Upon their creation, each HSSC received the legal mandate to establish and lead...

Context: Participatory Research with Health Organizations (PRO) blends research and action to produce knowledge that can improve organization practices. It is conducted with organization members (knowledge-users) who participate in the full research process (active participation) or provide information/data for the study (passive participation). No...

Background: No primary practice care model has been shown to be superior in achieving high-quality primary care. We aimed to identify the organizational characteristics of primary care practices that provide high-quality primary care. Methods: We performed a cross-sectional observational study involving a stratified random sample of 37 primary c...

For preschool children aged four-five years, parents play a key role in the adoption of a healthy lifestyle. Social representations is central to understanding the choice of health behaviours promoted by the parent in their child's life. To describe the social representations of parents with respect to the weight and lifestyle of children aged four...

Parent’s social representations of preschool childrens’ weight and lifestyle Background : for preschool children aged four-five years, parents play a key role in the adoption of a healthy lifestyle. Social representations is central to understanding the choice of health behaviours promoted by the parent in their child’s life. Objective : to describ...

Stronger systems improve population health but require higher levels of spending A recent article in Health Affairs by Kringos and colleagues seems destined to take its place alongside other seminal studies that support the importance of investing in a strong system of primary care for a well functioning health system, better population health, an...

Purpose: Continuity of care among different clinicians refers to consistent and coherent care management and good measures are needed. We conducted a metasummary of qualitative studies of patients' experience with care to identify measurable elements that recur over a variety of contexts and health conditions as the basis for a generic measure of...

Introduction Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of speciali...

Background Ensuring access to timely and appropriate primary healthcare for people living in poverty is an issue facing all countries, even those with universal healthcare systems. The transformation of healthcare practices and organization could be improved by involving key stakeholders from the community and the healthcare system in the developme...

Objective: To develop a framework for research and evaluation of collaborative mental health care for depression, which includes attributes or domains of care that are important to consumers. Methods: A literature review on collaborative mental health care for depression was completed and used to guide discussion at an interactive workshop with...

Objective: Evaluate if the Insurance strengthened the primary care role and enhanced healthcare access and comprehensiveness. Materials and methods: Through a household survey (n=2 413; year 2006) we collected data on utilization of health services by under 8 year old beneficiaries from 8 municipalities. We used hypothesis tests to identify sign...

OBJECTIVE: Evaluate if the Insurance strengthened the primary care role and enhanced healthcare access and comprehensiveness. MATERIALS AND METHODS: Through a household survey (n=2 413; year 2006) we collected data on utilization of health services by under 8 year old beneficiaries from 8 municipalities. We used hypothesis tests to identify signifi...

Comparison of three weight classification systems for preschool children in a region of Quebec Introduction: Overweight in children is a serious public health problem. The use of different weight classification systems in research and clinical practice results in variable the estimate of prevalences of overweight, which complicates follow-up of thi...

Building continuity of care takes work but earns trust Estimates of the prevalence of multimorbidity vary according to how it is measured, but studies agree that prevalence is rising and that it increases precipitously with age.1 By middle age, multimorbidity is the new normal. The first article in this editorial series on multimorbidity highligh...

Purpose: Patients who regularly see more than one clinician for health problems risk discontinuity and fragmented care. Our objective was to develop and validate a generic measure of management continuity from the patient perspective. Methods: Themes from 33 qualitative studies of patient experience with care from various clinicians were matched...

Background Childhood obesity is a public health epidemic. In Canada 21.5% of children aged 2–5 are overweight, with psychological and physical consequences for the child and economic consequences for society. Parents often do not view their children as overweight. One way to prevent overweight is to adopt a healthy lifestyle (HL). Nurses with direc...

Patients increasingly receive care from multiple providers in a variety of settings. They expect management continuity that crosses boundaries and bridges gaps in the healthcare system. To our knowledge, little research has been done to assess coordination across organizational and professional boundaries from the patients' perspective. Our objecti...

Primary healthcare in developed countries is undergoing important reforms, and these require evaluation strategies to assess how well the population's expectations are being met. Although numerous instruments are available to evaluate primary healthcare (PHC) from the patient perspective, they do not all measure the same range of constructs. To ana...

The objective was to provide a synthesis of the results of the research and discourse lines on main dimensions of patient-centered care in the context of chronic disease management in family medicine, building on Stewart et al.'s model. We developed search strategies for the Medline, Embase, and Cochrane databases, from 1980 to April 2009. All arti...