Designing centralized waiting lists for attachment to a primary care provider: Considerations from a logic analysis.

Autor: Breton M; Department of Community Health Sciences, Université de Sherbrooke, Canadian Research Chair in Clinical Governance on Primary Health Care, Longueuil, QC, Canada., Smithman MA; Université de Sherbrooke, Longueuil, QC, Canada., Kreindler SA; Department of Community Health Sciences, Manitoba Research Chair in Health System Innovation, University of Manitoba, Winnipeg, MB, Canada., Jbilou J; Centre de formation médicale du Nouveau-Brunswick and École de psychologie, Université de Moncton, Moncton, NB, Canada., Wong ST; School of Nursing and Centre for Health Services and Policy Research, University of British Columbia, BC Primary Care Sentinel Surveillance Network, Vancouver, BC, Canada., Gard Marshall E; Department of Family Medicine, Dalhousie University, Halifax, NS, Canada., Sasseville M; Université de Sherbrooke, Longueuil, QC, Canada., Sutherland JM; Centre for Health Services and Policy Research, University of British Columbia, Michael Smith Foundation for Health Research, Vancouver, BC, Canada., Crooks VA; Department of Geography, Simon Fraser University, Michael Smith Foundation for Health Research, Canada Research Chair in Health Service Geographies, Burnaby, BC, Canada., Shaw J; Institute for Health System Solutions and Virtual Care, Women's College Research Institute, Women's College Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Contandriopoulos D; School of Nursing, University of Victoria, Research Chair Policies, Knowledge and Health (Pocosa/Politiques, Connaissances, Santé), Victoria, BC, Canada., Brousselle A; School of Public Administration, University of Victoria, Victoria, BC, Canada., Green M; Departments of Family Medicine and Public Health Sciences, Queen's University, CTAQ Chair in Applied Health Economics/Health Policy, Centre for Health Services and Policy Research, Centre for Studies in Primary Care, Institute for Clinical Evaluative Sciences, Kingston, ON, Canada.
Jazyk: angličtina
Zdroj: Evaluation and program planning [Eval Program Plann] 2021 Dec; Vol. 89, pp. 101962. Date of Electronic Publication: 2021 May 29.
DOI: 10.1016/j.evalprogplan.2021.101962
Abstrakt: Access to a regular primary care provider is essential to quality care. In Canada, where 15 % of patients are unattached (i.e., without a regular provider), centralized waiting lists (CWLs) help attach patients to a primary care provider (family physician or nurse practitioner). Previous studies reveal mechanisms needed for CWLs to work, but focus mostly on CWLs for specialized health care. We aim to better understand how to design CWLs for unattached patients in primary care. In this study, a logic analysis compares empirical evidence from a qualitative case study of CWLs for unattached patients in seven Canadian provinces to programme theory derived from a realist review on CWLs. Data is analyzed using context-intervention-mechanism-outcome configurations. Results identify mechanisms involved in three components of CWL design: patient registration, patient prioritization, and patient assignment to a provider for attachment. CWL programme theory is revised to integrate mechanisms specific to primary care, where patients, rather than referring providers, are responsible for registering on the CWL, where prioritization must consider a broad range of conditions and characteristics, and where long-term acceptability of attachment is important. The study provides new insight into mechanisms that enable CWLs for unattached patients to work.
(Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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