Abstract

BackgroundAcross Canada and internationally we have poor infrastructure to regularly collect survey data from primary care practices to supplement data from chart audits and physician billings. The purpose of this work is to: 1) examine the variable costs for carrying out primary care practice-based surveys and 2) share lessons learned about the level of engagement required for recruitment of practices in primary care.MethodsThis work was part of a larger study, TRANSFORMATION that collected data from three provincial study sites in Canada. We report here on practice-based engagement. Surveys were administered to providers, organizational practice leads, and up to 20 patients from each participating provider. We used the CollaboraKTion framework to report on our recruitment and engagement strategies for the survey work. Data were derived from qualitative sources, including study team meeting minutes, memos/notes from survey administrators regarding their interactions with practice staff, and patients and stakeholder meeting minutes. Quantitative data were derived from spreadsheets tracking numbers for participant eligibility, responses, and completions and from time and cost tracking for patient survey administration.ResultsA total of 87 practices participated in the study (n = 22 in BC; n = 26 in ON; n = 39 in NS). The first three of five CollaboraKTion activities, Contacting and Connecting, Deepening Understandings, and Adapting and Applying the Knowledge Base, and their associated processes were most pertinent to our recruitment and data collection. Practice participation rates were low but similar, averaging 36% across study sites, and completion rates were high (99%). Patient completion rates were similarly high (99%), though participation rates in BC were substantially lower than the other sites. Recruitment and data collection costs varied with the cost per practice ranging from $1503 to $1792.ConclusionsA comprehensive data collection system in primary care is possible to achieve with partnerships that balance researcher, clinical, and policy maker contexts. Engaging practices as valued community members and independent business owners requires significant time, and financial and human resources. An integrated knowledge translation and exchange approach provides a foundation for continued dialogue, exchange of ideas, use of the information produced, and recognises recruitment as part of an ongoing cycle.

Highlights

  • Across Canada and internationally we have poor infrastructure to regularly collect survey data from primary care practices to supplement data from chart audits and physician billings

  • An integrated knowledge translation and exchange approach provides a foundation for continued dialogue, exchange of ideas, use of the information produced, and recognises recruitment as part of an ongoing cycle

  • Future analyses will be conducted using administrative health data to better understand how our sample compares to the larger population studied and how our sample compares to another practice-based survey sample conducted for the Quality and Costs of Primary Care Study [12]

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Summary

Introduction

Across Canada and internationally we have poor infrastructure to regularly collect survey data from primary care practices to supplement data from chart audits and physician billings. High performing primary care is foundational to achieving the triple aim of health reform—better health, improved patient experience, and more affordable costs [1]. Much of what we know about high performing primary care is based on analyses using health administrative data [3,4,5,6] and chart audits, [7, 8] not data from patients, clinicians, or the practices. Across Canada and internationally we have poor infrastructure to regularly collect survey data from primary care practices to supplement the administrative data. The environment for collecting data from multiple sources (e.g. administrative, surveys) across different organizations and regions remains challenging given the diverse custodians of data, multiple ethics review committees and privacy impact assessments

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