Borgès Da Silva Roxane, Pineault Raynald, Hamel Marjolaine, Levesque Jean-Frédéric, Roberge Danièle, Lamarche Paul
Direction de santé publique de l'agence de la santé et des services sociaux de Montréal, 1301 Sherbrooke Est, Montréal, QC, Canada H2L 1M3 ; Institut national de santé publique du Québec, QC, Canada ; Département d'administration de la santé et institut de recherche en santé publique de l'université de Montréal, QC, Canada.
Direction de santé publique de l'agence de la santé et des services sociaux de Montréal, 1301 Sherbrooke Est, Montréal, QC, Canada H2L 1M3 ; Institut national de santé publique du Québec, QC, Canada ; Centre de recherche du centre hospitalier de l'université de Montréal, Montréal, QC, Canada.
ISRN Family Med. 2013 Apr 15;2013:798347. doi: 10.5402/2013/798347. eCollection 2013.
Background. Primary healthcare (PHC) renewal gives rise to important challenges for policy makers, managers, and researchers in most countries. Evaluating new emerging forms of organizations is therefore of prime importance in assessing the impact of these policies. This paper presents a set of methods related to the configurational approach and an organizational taxonomy derived from our analysis. Methods. In 2005, we carried out a study on PHC in two health and social services regions of Quebec that included urban, suburban, and rural areas. An organizational survey was conducted in 473 PHC practices. We used multidimensional nonparametric statistical methods, namely, multiple correspondence and principal component analyses, and an ascending hierarchical classification method to construct a taxonomy of organizations. Results. PHC organizations were classified into five distinct models: four professional and one community. Study findings indicate that the professional integrated coordination and the community model have great potential for organizational development since they are closest to the ideal type promoted by current reforms. Conclusion. Results showed that the configurational approach is useful to assess complex phenomena such as the organization of PHC. The analysis highlights the most promising organizational models. Our study enhances our understanding of organizational change in health services organizations.
背景。在大多数国家，初级卫生保健（PHC）的革新给政策制定者、管理者和研究人员带来了重大挑战。因此，评估新兴的组织形式对于评估这些政策的影响至关重要。本文介绍了一套与构型方法相关的方法以及基于我们的分析得出的组织分类法。方法。2005年，我们在魁北克的两个卫生和社会服务地区开展了一项关于初级卫生保健的研究，这些地区包括城市、郊区和农村地区。对473家初级卫生保健机构进行了组织调查。我们使用多维非参数统计方法，即多重对应分析和主成分分析，以及一种升序层次分类方法来构建组织分类法。结果。初级卫生保健组织被分为五种不同模式：四种专业模式和一种社区模式。研究结果表明，专业综合协调模式和社区模式具有很大的组织发展潜力，因为它们最接近当前改革所倡导的理想类型。结论。结果表明，构型方法有助于评估诸如初级卫生保健组织这样的复杂现象。该分析突出了最有前景的组织模式。我们的研究增进了我们对卫生服务组织中组织变革的理解。
