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BMC Health Serv Res. 2017 Jan 21;17(1):60. doi: 10.1186/s12913-017-2007-8.

A comparative analysis of centralized waiting lists for patients without a primary care provider implemented in six Canadian provinces: study protocol.

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Charles-LeMoyne Hospital Research Centre, Sherbrooke University, Longueuil Campus, 150 Place Charles-LeMoyne, Office 200, Longueuil, QC, J4K 0A8, Canada.
Family Medicine and Public Health Sciences and CHSPR, Queen's University, Abramsky Hall, 3rd Floor 21 Arch St., Kingston, ON, K7L 3N6, Canada.
Manitoba Research Chair in Health System Innovation and Community Health Sciences, University of Manitoba, 200-1155 Concordia Ave., Winnipeg, MB, R2K 2M9, Canada.
Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
School of psychology, Université de Moncton, Centre de formation médicale du Nouveau-Brunswick, Pavillon Léopold-Taillon Université de Moncton, 18 Ave Antonine-Maillet, Moncton, NB, E1A 3E9, Canada.
School of Nursing and Centre for Health Services and Policy Research in the School of Population and Public Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
Institute for Health System Solutions and Virtual Care, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S1B2, Canada.
Canada Research Chair in Health Service Geographies, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
Faculty of nursing, University of Montréal, 2375, chemin de la Côte-Ste-Catherine, Montréal, Québec, H3T 1A8, Canada.
Charles-LeMoyne Hospital Research Centre, Sherbrooke University, Longueuil Campus, 150 Place Charles-LeMoyne, Office 200, Longueuil, QC, J4K 0A8, Canada.



Having a regular primary care provider (i.e., family physician or nurse practitioner) is widely considered to be a prerequisite for obtaining healthcare that is timely, accessible, continuous, comprehensive, and well-coordinated with other parts of the healthcare system. Yet, 4.6 million Canadians, approximately 15% of Canada's population, are unattached; that is, they do not have a regular primary care provider. To address the critical need for attachment, especially for more vulnerable patients, six Canadian provinces have implemented centralized waiting lists for unattached patients. These waiting lists centralize unattached patients' requests for a primary care provider in a given territory and match patients with providers. From the little information we have on each province's centralized waiting list, we know the way they work varies significantly from province to province. The main objective of this study is to compare the different models of centralized waiting lists for unattached patients implemented in six provinces of Canada to each other and to available scientific knowledge to make recommendations on ways to improve their design in an effort to increase attachment of patients to a primary care provider.


A logic analysis approach developed in three steps will be used. Step 1: build logic models that describe each province's centralized waiting list through interviews with key stakeholders in each province; step 2: develop a conceptual framework, separate from the provincially informed logic models, that identifies key characteristics of centralized waiting lists for unattached patients and factors influencing their implementation through a literature review and interviews with experts; step 3: compare the logic models to the conceptual framework to make recommendations to improve centralized waiting lists in different provinces during a pan Canadian face-to-face exchange with decision-makers, clinicians and researchers.


This study is based on an inter-provincial learning exchange approach where we propose to compare centralized waiting lists and analyze variations in strategies used to increase attachment to a regular primary care provider. Fostering inter-provincial healthcare systems connectivity to improve centralized waiting lists' practices across Canada can lever attachment to a regular provider for timely access to continuous, comprehensive and coordinated healthcare for all Canadians and particular for those who are vulnerable.


Comparative study; General practitioners; Health services accessibility; Physician patient relationship; Physicians; Primary health care; Unattached patients; Waiting lists

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