Having or losing a family physician: a protocol for a survey-based study of patient’s continuity of primary care experience in Quebec, Canada
Maude Laberge, Micaël Carrier, Mylaine Breton, Élise Boulanger, Amédé Gogovor, Géraldine Layani, Paolo Landa, Marie-Eve Poitras, Nadia Sourial, Erin StrumpfIntroduction
Continuity of care with a family physician (FP) is a core attribute of effective primary care and is associated with improved health outcomes, reduced service use and lower healthcare costs. In Canada, an ageing FP workforce has led to an increasing number of patients losing their FP, raising concerns about access to care and disruptions in care trajectories. While the benefits of continuity are well documented, evidence on the consequences of discontinuity in primary care, particularly from the patient perspective, remains limited. Relational discontinuity occurs when there is a disruption in the relationship between an FP and a patient, which may be related to the FP’s retirement or relocation or to the closure of a clinic.
Objective
This study aims to assess the effects of a disruption in the relational continuity with an FP on patient’s experience and their patterns of healthcare service use.
Methods and analysis
A descriptive cross-sectional survey will be administered to adults residing in Quebec, Canada’s second most populous province. A total sample of 1000 respondents will be recruited, including approximately 500 individuals who have lost their FP within the past 3 years, and 500 individuals currently registered with an FP. The questionnaire covers sociodemographic characteristics, health status, access to care, use of healthcare services, out-of-pocket costs and perceived impacts of discontinuity. Descriptive and regression analyses will be used to compare experiences and perceived effects between groups and to explore equity-related differences.
Ethics and dissemination
The study has received ethical approval from the Research Ethics Board involving human participants at Université Laval. Findings will be shared with policymakers and healthcare stakeholders to inform them on the patient-reported consequences of primary care discontinuity and support the development of strategies to mitigate its impacts.