Factors of primary care demand: a case study.
Introduction: Primary care facilities in many parts of Quebec, Canada, are under pressure because of staff shortages, service instability, increasing requests from an aging population, and uncoordinated, fragmented delivery of care. Resource allocation in one facility is often made with an approxima...
| Publicado en: | Rural & Remote Health Vol. 10; no. 4; pp. 1 - 13 |
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| Autores principales: | , |
| Formato: | case study pictorial research tables/charts Journal Article |
| Publicado: |
James Cook University, Rural Health Research Unit
Oct-Dec2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=57827857&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 57827857 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14456354 1D30 jtl: Rural & Remote Health issn: 14456354 maglogo: N pubinfo: dt: Oct-Dec2010 vid: 10 iid: 4 pid: 69464 pub: James Cook University, Rural Health Research Unit artinfo: ui: 57827857 57827857 105005114 57827857 ppf: 1 ppct: 12 formats: tig: atl: Factors of primary care demand: a case study. aug: au: Zubieta, L. Bequet, S. A. F. affil: Bishop's University, Sherbrooke, Quebec, Canada sug: subj: Health Services Needs and Demand Canada Patient Attitudes Primary Health Care Administration Primary Health Care Utilization Quebec Rural Population Health Services Accessibility Health Resource Allocation Rural Health Services Administration Human Male Female Adult Middle Age Age Factors Sex Factors Aged Funding Source Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Introduction: Primary care facilities in many parts of Quebec, Canada, are under pressure because of staff shortages, service instability, increasing requests from an aging population, and uncoordinated, fragmented delivery of care. Resource allocation in one facility is often made with an approximate knowledge of its impact on other facilities nearby. Unanticipated overflows may affect patients' health and staff morale. The main purpose of this study was to use consolidated administrative data in order to find the factors that better explain the choice of patients in Val Saint-Francois, a rural area of Quebec. Methods: Administrative data relating to medical visits were linked to 6 primary care facilities over a period of 4 years. A classification tree algorithm generated users' profiles of facility choice, which was explored for frequency of use and related changes in preference, and for changes in levels of service. The factors used were: age, sex, postal code, and date of visit. Results: Community was the major explanatory factor for patients' choice of facility, probably reflecting a tendency to use the closest facility. Older men and women tended to use appointment-based clinics more regularly than those who were younger. It was noted that younger men selected emergency rooms more often than young women, with the difference cancelling out as they age. The classification tree determined age thresholds for changing behaviours but also found dates when profiles changed within the same age-sex group. Later examination of service levels revealed that profile changes were subsequent to modifications in service operating hours. Conclusions: Evidence was found that predisposing factors (age and sex) with community enabling factors (distance) affected people's choice of healthcare facility. Changes in some patients' profiles corresponded to changes in service levels, proving that a modification of service hours in one facility affects demand in other facilities in a way that can be quantified. It is important to measure the effect of service changes on patients' choices for a more efficient allocation of resources. pubtype: Academic Journal doctype: case study pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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