Factors influencing the match between patient needs and primary care services: Patient and healthcare provider perspectives from two Canadian provinces.

Abstract

ObjectivesThis study aims to combine the perspectives of patients and healthcare providers on the factors that influence the match between patients' needs for and providers' capacity to deliver services.MethodsA qualitative descriptive study design was used to examine perspectives and experiences of patients, family physicians and nurse practitioners in two jurisdictions in Canada: Nova Scotia and Ontario. Data from interviews were analyzed using the concept of comprehensiveness, the extent to which the approach to care and services delivered by providers meets patients' needs, to examine how decisions were made in each province for patients to become members of a providers' panel (the process known as 'empanelment').ResultsInterviews with 33 providers and 25 patients were conducted in Nova Scotia and Ontario. Three areas of tension were identified in patients' decision-making about choosing a regular primary care provider and providers' decision-making about accepting regular patients. Patients and providers discussed the success of such a match as being influenced by personal characteristics, including attitudes, gender and cultural background, scope of practice and panel composition.ConclusionsFindings support the value of team-based care that considers the needs for empanelment of both patients and providers. This study provides healthcare providers with information to improve matching processes by incorporating these considerations (e.g., patient and provider sex, gender and chronic care needs) into decisions about empanelment. Mechanisms that reflect the characteristics and range of skills of the whole team rather than the family physician and nurse practitioner alone are an avenue for optimizing the success of empanelment.