Supporting Integration Through Primary Health Care Teams: A Comparative Policy Analysis Across Five Canadian Provinces

BC, AB, ON, QC: Nelly Oelke, Darlene Arsenault, Shannon M Berg, Phil Graham, Brenda Jagroop, Genevieve Landry, Shana Ooms, Mylaine Breton, Sharon E Johnston, Stephanie R Montesanti

Please describe your research project and how it contributes to improving primary care.

This cross-jurisdictional patient-oriented project aims to conduct a comparative policy analysis across BC, Alberta, Ontario, and Quebec to examine the policies and structures that support service integration for complex patients through primary health care teams. Case study methods will be used to conduct policy analysis across three phases. Currently, individual case studies are being done for each of the participating provinces, and then a cross case analysis will be completed. We are in the process of writing up the individual case studies. The second phase is focused on patient, family, and caregiver involvement in policy development, implementation and evaluation.

What are the key messages from this project to share with stakeholder groups (i.e. clinicians, policy makers, patients)?

Some of the biggest learnings so far for BC include:

  • BC policies on primary health care do for the most part promote the use of primary health care teams to provide improved services for patients with complex conditions; however, policies do not clearly address the operationalization of primary health care teams;
  • Remuneration models for team members continues to be an issue;
  • Primary health care teams are not directly linked to integration;
  • We are seeing more focus on patient-oriented care;
  • We are seeing more focus on Indigenous peoples, due to the First Nations Health Authority.

Some key findings emerging from cross-jurisdictional discussions:

  • Policymakers and researchers are looking for different things in the analysis, but all want to get out of this what will be most helpful to provinces to move primary health care reform forward;
  • There is a lack of common definitions for integration and patients with complex needs;
  • What is a team? Are they only those that work directly together? Or do they include a second layer of providers as well?