Harnagea Hermina, Couturier Yves, Lamothe Lise, Emami Elham
Sante Publique. 2019 November-December;31(6):809-816. doi: 10.3917/spub.196.0809.
Although integrated care is drawing considerable attention from health care policy makers, little is known about integration of oral health care services into primary care in Quebec. Therefore, the objective of this study was to compile information and compare the aspects of primary oral health care in two public health care organizations.
An environmental scan was carried out in one rural and one urban primary health care organizations in Quebec. Data were collected from organizations' websites, operational documents, observational notes on facility visits, primary care meeting minutes, online pages of professional orders and face to face interviews (N = 74) and focus groups (N = 5), between November 2016 and October 2018. Thematic and Prior's documentation analyses were used to analyse the data.
Three themes were identified: normative aspects of integrated care delivery, integration trajectories, and integration initiatives. In both organizations, the integration of oral health into primary care rooted in public health sectors and dental teams were the key players. While urban center showed informal linkages between dental and non-dental primary care providers, the rural organization succeeded in coordination processes, even though these were also informal.
The majority of primary oral health care services are delivered in the public health sectors and the sustainability of integration initiatives in other primary health care sectors remains to be demonstrated. A better management of resources, as well as partnerships between public health care organizations and universities, could contribute to this integration.
尽管综合医疗服务受到了医疗保健政策制定者的广泛关注,但对于魁北克省将口腔保健服务纳入初级医疗服务的情况却知之甚少。因此,本研究的目的是收集信息并比较两个公共医疗保健组织中初级口腔保健的各个方面。
对魁北克省的一个农村和一个城市初级医疗保健组织进行了环境扫描。在2016年11月至2018年10月期间,从组织网站、运营文件、设施访问观察记录、初级医疗保健会议记录、专业协会在线页面以及面对面访谈(N = 74)和焦点小组(N = 5)中收集数据。采用主题分析和普赖尔文献分析法对数据进行分析。
确定了三个主题:综合医疗服务提供的规范性方面、整合轨迹和整合举措。在这两个组织中,口腔保健纳入初级医疗保健均源于公共卫生部门,牙科团队是关键参与者。虽然城市中心的牙科和非牙科初级医疗保健提供者之间存在非正式联系,但农村组织在协调过程中取得了成功,尽管这些协调也是非正式的。
大多数初级口腔保健服务在公共卫生部门提供,其他初级医疗保健部门整合举措的可持续性仍有待证明。更好地管理资源以及公共医疗保健组织与大学之间的合作,可能有助于这种整合。