SIIReN - System Integration & Innovation Research Network

Primary Health Care System

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"Characteristics of Primary Care Settings That Succeed in Achieving High Quality of Care for Chronic and Acute Conditions "
Presenters:  Marie-Dominique Beaulieu Université de Montréal and Bill Hogg, University of Ottawa
February 16, 2012


An effective primary care (PC) system must provide high quality care for both acute and chronic problems along with disease prevention. However, research has shown that it is difficult to reconcile these missions on the ground.

We undertook to identify organizational characteristics of PC settings associated with high-quality care for patients with chronic conditions or acute illnesses. Using medical charts from approximately 1,500 patients in 37 PC settings recruited in three regions of the province of Québec, Canada, we assessed the quality of care provided. Based on practice-guidelines we looked at overall quality of care as well as quality of care specific to chronic or acute conditions. We also assessed: the integration of preventive care into management of chronic conditions. Factors associated with overall quality of care were:

  • physician remuneration
  • number of physicians
  • presence of allied health professionals or specialist physicians
  • organisational accessibility

Average organisational accessibility and interdisciplinary care was also associated with the quality of chronic disease care and preventive care Interdisciplinary care was associated with quality of chronic care and the incorporation of preventive activities. Factors relating to team functioning were associated with the acute and overall quality of care.This study identified characteristics of PC settings associated with the provision of quality health care in Quebec.

Our findings provide valuable lessons that can be applied in a broader context highlighting areas that can directly be targeted by policy interventions to improve the quality of patient care in a PC setting.

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