An international cross-sectional survey on the Quality and Costs of Primary Care (QUALICO-PC): recruitment and data collection of places delivering primary care across Canada.

Sabrina T Wong,Tim Cooke,Alan Katz,Antoine Boivin,Baukje Miedema,Danièle Francoeur,Leena W Chau,Gary F Teare,Kris Aubrey-Bassler,Mylaine Breton,Fred Burge,William Hogg,Walter P Wodchis

doi:10.1186/s12875-015-0236-7

Abstract

BackgroundPerformance reporting in primary health care in Canada is challenging because of the dearth of concise and synthesized information. The paucity of information occurs, in part, because the majority of primary health care in Canada is delivered through a multitude of privately owned small businesses with no mechanism or incentives to provide information about their performance. The purpose of this paper is to report the methods used to recruit family physicians and their patients across 10 provinces to provide self-reported information about primary care and how this information could be used in recruitment and data collection for future large scale pan-Canadian and other cross-country studies.MethodsCanada participated in an international large scale study-the QUALICO-PC (Quality and Costs of Primary Care) study. A set of four surveys, designed to collect in-depth information regarding primary care activities was collected from: practices, providers, and patients (experiences and values). Invitations (telephone, electronic or mailed) were sent to family physicians. Eligible participants were sent a package of surveys. Provincial teams kept records on the number of: invitation emails/letters sent, physicians who registered, practices that were sent surveys, and practices returning completed surveys. Response and cooperation rates were calculated.ResultsInvitations to participate were sent to approximately 23,000 family physicians across Canada. A total of 792 physicians and 8,332 patients from 772 primary care practices completed the surveys, including 1,160 participants completing a Patient Values survey and 7,172 participants completing a Patient Experience survey. Overall, the response rate was very low ranging from 2% (British Columbia) to 21% (Nova Scotia). However, the participation rate was high, ranging from 72% (Ontario) to 100% (New Brunswick/Prince Edward Island and Newfoundland & Labrador).ConclusionsThe difficulties obtaining acceptable response rates by family physicians for survey participation is a universal challenge. This response rate for the QUALICO-PC arm in Canada was similar to rates found in other countries such as Australia and New Zealand. Even though most family physicians operate as self-employed small businesses, they could be supported to routinely submit data through a collective effort and provincial mandate. The groundwork in setting up pan-Canadian collaboration in primary care has been established through this study.

Highlights

Performance reporting in primary health care in Canada is challenging because of the dearth of concise and synthesized information
The majority of family physicians’ income is derived from billing the government fees for services, which are negotiated between each provincial government and organized medicine in their respective jurisdictions, with some being paid through a blend of payments [3]
Despite primary health care (PHC) being publicly funded in developed countries, providers have not considered it their role to report on their performance or the performance of their practice with the goal of improving the PHC sector or larger health care system

Summary

Introduction

Performance reporting in primary health care in Canada is challenging because of the dearth of concise and synthesized information. The paucity of information occurs, in part, because the majority of primary health care in Canada is delivered through a multitude of privately owned small businesses with no mechanism or incentives to provide information about their performance. In Canada, performance reporting in primary health care (PHC) is challenging because of the dearth of concise and synthesized information [1]. The paucity of information occurs, in part, because the majority of PHC is publicly funded through a single payer (i.e. provincial and federal governments) but delivered through a multitude of privately owned small businesses [2], known as PHC practices. Despite PHC being publicly funded in developed countries, providers have not considered it their role to report on their performance or the performance of their practice with the goal of improving the PHC sector or larger health care system

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