Evolution of Experience of Care of Patients with and without Chronic Diseases following a Québec Primary Healthcare ReformReportar como inadecuado

Evolution of Experience of Care of Patients with and without Chronic Diseases following a Québec Primary Healthcare Reform - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

International Journal of Chronic Diseases - Volume 2016 2016, Article ID 2497637, 13 pages -

Research Article

Direction de Santé Publique de l’Agence de la Santé et des Services Sociaux de Montréal, 1301 Rue Sherbrooke Est, Montréal, QC, Canada H2L 1M3

Institut National de Santé Publique du Québec, 190 Boulevard Crémazie Est, Montréal, QC, Canada H2P 1E2

Centre de Recherche du Centre Hospitalier de l’Université de Montréal, 900 Rue Saint-Denis, Montréal, QC, Canada H2X 0A9

Institut de Recherche en Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC, Canada H3N 1X9

Faculté des Sciences Infirmières de l’Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montréal, QC, Canada H3T 1A8

Centre de Recherche de l’Hôpital Charles LeMoyne, 150 Place Charles-LeMoyne, Bureau 200, Longueuil, QC, Canada J5C 2B6

Département des Sciences de la Santé Communautaire, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC, Canada J1H 5H3

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Avenue des Pins Ouest, Montréal, QC, Canada H3A 1A2

Centre for Primary Health Care and Equity, University of New South Wales, Level 3, AGSM Building, Sydney, NSW 2033, Australia

Bureau of Health Information, 67 Albert Avenue, Chatswood, NSW 2067, Australia

Received 2 December 2015; Revised 16 February 2016; Accepted 22 February 2016

Academic Editor: Jens Klotsche

Copyright © 2016 Raynald Pineault et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To assess the extent to which new primary healthcare PHC models implemented in two regions of Quebec have improved patient experience of care, unmet needs, and use of services for individuals with and without chronic diseases, compared with other forms of PHC practices. Methods. In 2005 and 2010, we carried out population and organization surveys. We divided PHC organizations into new model practices and other practices and followed the evolution over time of patient experience of care. Results. Patients with chronic diseases had better accessibility but worse continuity of care in the new model practices than in the other practices at both time periods. Through the reform, accessibility decreased evenly in both groups, but continuity and perceived outcomes improved more in the other practices. Use of primary care services decreased more in the new model practices. Among patients without chronic disease, accessibility decreased much less in the new models and responsiveness increased more. There was no significant change in ER attendance and hospitalization. Conclusion. The evolution of patient experience of care has been more favorable for patients without chronic diseases. These findings raise concerns about equity since the aim of the PHC reform was targeting in priority individuals with the greatest needs.

Autor: Raynald Pineault, Roxane Borgès Da Silva, Sylvie Provost, Mylaine Breton, Pierre Tousignant, Michel Fournier, Alexandre Pru

Fuente: https://www.hindawi.com/


Documentos relacionados