Cooper Ian R, Lindsay Cameron, Fraser Keaton, Hill Tiffany T, Siu Andrew, Fletcher Sarah, Klimas Jan, Hamilton Michee-Ana, Frazer Amanda D, Humphrys Elka, Koepke Kira, Hedden Lindsay, Price Morgan, McCracken Rita K
Innovation Support Unit, Department of Family Practice, University of British Columbia, Vancouver, BC, Canada.
British Columbia Centre on Substance Use, Vancouver, BC, Canada.
JMIR Form Res. 2022 Jun 22;6(6):e34141. doi: 10.2196/34141.
Some Canadians have limited access to longitudinal primary care, despite its known advantages for population health. Current initiatives to transform primary care aim to increase access to team-based primary care clinics. However, many regions lack a reliable method to enumerate clinics, limiting estimates of clinical capacity and ongoing access gaps. A region-based complete clinic list is needed to effectively describe clinic characteristics and to compare primary care outcomes at the clinic level.
The objective of this study is to show how publicly available data sources, including the provincial physician license registry, can be used to generate a verifiable, region-wide list of primary care clinics in British Columbia, Canada, using a process named the Clinic List Algorithm (CLA).
The CLA has 10 steps: (1) collect data sets, (2) develop clinic inclusion and exclusion criteria, (3) process data sets, (4) consolidate data sets, (5) transform from list of physicians to initial list of clinics, (6) add additional metadata, (7) create working lists, (8) verify working lists, (9) consolidate working lists, and (10) adjust processing steps based on learnings.
The College of Physicians and Surgeons of British Columbia Registry contained 13,726 physicians, at 2915 unique addresses, 6942 (50.58%) of whom were family physicians (FPs) licensed to practice in British Columbia. The CLA identified 1239 addresses where primary care was delivered by 4262 (61.39%) FPs. Of the included addresses, 84.50% (n=1047) were in urban locations, and there was a median of 2 (IQR 2-4, range 1-23) FPs at each unique address.
The CLA provides a region-wide description of primary care clinics that improves on simple counts of primary care providers or self-report lists. It identifies the number and location of primary care clinics and excludes primary care providers who are likely not providing community-based primary care. Such information may be useful for estimates of capacity of primary care, as well as for policy planning and research in regions engaged in primary care evaluation or transformation.
尽管纵向初级保健对人群健康具有已知的优势，但一些加拿大人获得纵向初级保健的机会有限。当前旨在转变初级保健的举措旨在增加获得基于团队的初级保健诊所的机会。然而，许多地区缺乏可靠的方法来枚举诊所，这限制了对临床能力和持续存在的获取差距的估计。需要一份基于地区的完整诊所清单，以有效地描述诊所特征并在诊所层面比较初级保健结果。
本研究的目的是展示如何使用包括省级医师执照登记处在内的公开可用数据源，通过一种名为诊所清单算法（CLA）的过程，生成一份可验证的、覆盖加拿大不列颠哥伦比亚省的初级保健诊所清单。
CLA有10个步骤：（1）收集数据集，（2）制定诊所纳入和排除标准，（3）处理数据集，（4）合并数据集，（5）从医师名单转换为诊所初始名单，（6）添加其他元数据，（7）创建工作清单，（8）验证工作清单，（9）合并工作清单，以及（10）根据经验调整处理步骤。
不列颠哥伦比亚省医师和外科医生学院登记处包含13726名医师，分布在2915个不同地址，其中6942名（50.58%）是在不列颠哥伦比亚省获得执业许可的家庭医生（FP）。CLA识别出1239个地址，4262名（61.39%）FP在这些地址提供初级保健。在纳入的地址中，84.50%（n = 1047）位于城市地区，每个不同地址的FP中位数为2（四分位间距2 - 4，范围1 - 23）。
CLA提供了一份覆盖全地区的初级保健诊所描述，比简单计算初级保健提供者数量或自我报告清单有所改进。它确定了初级保健诊所的数量和位置，并排除了可能不提供基于社区的初级保健的初级保健提供者。此类信息可能有助于估计初级保健能力，以及用于参与初级保健评估或转型地区的政策规划和研究。
