Referral continuity between private and public health care for the patient under 18 in the Montreal metropolitan region.

One of the objectives of the health and social services reform launched in Quebec in the early 70s was to achieve continuity between the public and the private sector. This study focuses on specific aspects of continuity, namely referral continuity as measured by the degree to which physicians refer to public health resources in the care they provide to patients under 18, as well as their perception of these resources. A telephone survey conducted in February, 1984 gathered information on the way Montreal general practitioners and pediatricians use other medical, paramedical and public health resources. The findings indicate that the objective of continuity has not been fully achieved. Among the factors which explain such results are the lack of communication between the two sectors and the perception by physicians that these other resources, especially CLSCs, offer competitive rather than complementary services. Such a view constitutes a major constraint to the effective and efficient coexistence of the private and public sectors in a medical care system.