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Health Expect. 2019 May 10. doi: 10.1111/hex.12902. [Epub ahead of print]

Citizen perspectives on the use of publicly reported primary care performance information: Results from citizen-patient dialogues in three Canadian provinces.

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Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
CT Lamont Primary Health Care Research Centre, Élisabeth Bruyère Research Institute, Ottawa, Ontario, Canada.
Department of Clinical Epidemiology & Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada.
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.



Performance measurement and reporting is proliferating in all sectors of the healthcare system, including primary care, despite a dearth of evidence on how the public uses reports on primary care performance. We explored how the public might use this information, to guide the development of effective reporting systems for primary care.


We conducted six full-day deliberative dialogue sessions with a purposive sample of 56 citizen-patients across three Canadian provinces (British Columbia, Ontario and Nova Scotia). Participants identified how they would use publicly reported performance data. We conducted a thematic analysis of the data by region.


Common uses for primary care performance information emerged across all sessions. Participants most often discussed the utility of this information for community advocacy and participation in health system decision making. Similar barriers for using performance information to choose a primary care provider were identified in each region including the perceived lack of choice of providers and the high value placed on relationships with current providers. Finally, the value of public performance reporting in enhancing trust that people would receive good care was also a common theme.


Citizen-patient perspectives highlight that public reporting on primary care performance could promote the health system's responsiveness by enabling public engagement in decision making at the community level. The role of public reporting in promoting trust rather than empowering patient choice may reflect unique elements of the Canadian health system's context.


accountability; performance reporting; primary care; public participation


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