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Int J Family Med. 2014;2014:373725. doi: 10.1155/2014/373725. Epub 2014 Jan 12.

Primary healthcare solo practices: homogeneous or heterogeneous?

Author information

1
Direction de Santé Publique de l'Agence de la Santé et des Services Sociaux de Montréal, 1301 rue Sherbrooke Est, Montréal, QC, Canada H2L 1M3 ; Institut National de Santé Publique du Québec, 945 Avenue Wolfe, Québec, QC, Canada G1V 5B3 ; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 3480 rue Saint-Urbain, Hôtel-Dieu (Pavillon Masson), Montréal, QC, Canada H2W 1T8.
2
Direction de Santé Publique de l'Agence de la Santé et des Services Sociaux de Montréal, 1301 rue Sherbrooke Est, Montréal, QC, Canada H2L 1M3 ; Institut National de Santé Publique du Québec, 945 Avenue Wolfe, Québec, QC, Canada G1V 5B3 ; Faculté des Sciences Infirmières, Université de Montréal (Pavillon Marguerite d'Youville), CP 6128, Succursale Centre-ville, Montréal, QC, Canada H3C 3J7.
3
Département de Médecine Familiale, Université de Montréal (Pavillon Roger-Gaudry), 290 Boulevard Édouard-Montpetit, Bureau S-711, Montréal, QC, Canada H3T 1J4.
4
Centre de Recherche du CSSS Champlain-Charles-Le Moyne, 150 Place Charles-Lemoyne, Bureau 200, Longueuil, Montréal, QC, Canada K4K 0A8.
5
Direction de Santé Publique de l'Agence de la Santé et des Services Sociaux de Montréal, 1301 rue Sherbrooke Est, Montréal, QC, Canada H2L 1M3 ; Institut National de Santé Publique du Québec, 945 Avenue Wolfe, Québec, QC, Canada G1V 5B3.

Abstract

INTRODUCTION:

Solo practices have generally been viewed as forming a homogeneous group. However, they may differ on many characteristics. The objective of this paper is to identify different forms of solo practice and to determine the extent to which they are associated with patient experience of care.

METHODS:

Two surveys were carried out in two regions of Quebec in 2010: a telephone survey of 9180 respondents from the general population and a postal survey of 606 primary healthcare (PHC) practices. Data from the two surveys were linked through the respondent's usual source of care. A taxonomy of solo practices was constructed (n = 213), using cluster analysis techniques. Bivariate and multilevel analyses were used to determine the relationship of the taxonomy with patient experience of care.

RESULTS:

Four models were derived from the taxonomy. Practices in the "resourceful networked" model contrast with those of the "resourceless isolated" model to the extent that the experience of care reported by their patients is more favorable.

CONCLUSION:

Solo practice is not a homogeneous group. The four models identified have different organizational features and their patients' experience of care also differs. Some models seem to offer a better organizational potential in the context of current reforms.

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