CUP study: protocol for a comparative analysis of centralised waitlist effectiveness, policies and innovations for connecting unattached patients to primary care providers
Frederick Burge,
Lynn Edwards,
Michael Green,
Emily Gard Marshall,
Maria Mathews,
Charmaine McPherson,
Sabrina T Wong,
Imaan Bayoumi,
Caitlyn Ayn,
Rachelle Ashcroft,
David Stock,
Beverley Lawson,
Melissa Andrew,
Mylaine Breton,
Mélanie Ann Smithman,
Shannon Ryan Carson,
Véronique Deslauriers,
Lauren R Moritz,
Sue Nesto
Affiliations
Frederick Burge
Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Lynn Edwards
Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
Michael Green
Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
Emily Gard Marshall
Department of Family Medicine, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
Maria Mathews
Department of Family Medicine, University of Western Ontario, London, Ontario, Canada
Charmaine McPherson
Independent Researcher, Halifax, Nova Scotia, Canada
Sabrina T Wong
14 Centre for Health Services and Policy Research and School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
Imaan Bayoumi
Department of Family Medicine, Queen`s University, Kingston, New York, Canada
Caitlyn Ayn
Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Rachelle Ashcroft
University of Toronto, Toronto, Ontario, Canada
David Stock
Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Beverley Lawson
Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Melissa Andrew
Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Mylaine Breton
Community Health, Université de Sherbrooke, Longueuil, Québec, Canada
Mélanie Ann Smithman
Department of community health sciences, Université de Sherbrooke–Campus de Longueuil, Longueuil, Québec, Canada
Shannon Ryan Carson
Nova Scotia Health, Halifax, Nova Scotia, Canada
Véronique Deslauriers
Department of community health sciences, Université de Sherbrooke–Campus de Longueuil, Longueuil, Québec, Canada
Lauren R Moritz
Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Sue Nesto
Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Introduction Access to a primary care provider is a key component of high-functioning healthcare systems. In Canada, 15% of patients do not have a regular primary care provider and are classified as ‘unattached’. In an effort to link unattached patients with a provider, seven Canadian provinces implemented centralised waitlists (CWLs). The effectiveness of CWLs in attaching patients to regular primary care providers is unknown. Factors influencing CWLs effectiveness, particularly across jurisdictional contexts, have yet to be confirmed.Methods and analysis A mixed methods case study will be conducted across three Canadian provinces: Ontario, Québec and Nova Scotia. Quantitatively, CWL data will be linked to administrative and provider billing data to assess the rates of patient attachment over time and delay of attachment, stratified by demographics and compared with select indicators of health service utilisation. Qualitative interviews will be conducted with policymakers, patients, and primary care providers to elicit narratives regarding the administration, use, and access of CWLs. An analysis of policy documents will be used to identify contextual factors affecting CWL effectiveness. Stakeholder dialogues will be facilitated to uncover causal pathways and identify strategies for improving patient attachment to primary care.Ethics and dissemination Approval to conduct this study has been granted in Ontario (Queens University Health Sciences and Affiliated Teaching Hospitals Research Ethics Board, file number 6028052; Western University Health Sciences Research Ethics Board, project 116591; University of Toronto Health Sciences Research Ethics Board, protocol number 40335), Québec (Centre intégré universitaire de santé et de services sociaux de l'Estrie, project number 2020–3446) and Nova Scotia (Nova Scotia Health Research Ethics Board, file number 1024979).
