Policies and program innovations that connect primary health care, social services, public health, and community supports in Canada: A comparative policy analysis

Haggerty, JL (NPI); Quesnel-Vallée, A; Currie, L; Scott, CM; Stewart, T; Doucet, S; Dawe, R; Montelpare, WJ; Urquhart, RL; Berg, SM; Junker, AK; Roy, DA; Hébert, R; Tschupruk, C; Couturier, Y; Chan, KJ; Edwards, JM; Stoddard, RE; Mann, J; O’Beirne, M; Barrett, M; Schuckel, VM; Barrett, M; Jones, A; Jones, KL; Anderson, K; Aubrey-Bassler, K; Azar, R; Breton, M; Charlton, PC; Delli-Colli, N; Gaboury, I; Gagnon, D; Hyndman, NE; Lane, J; Law, SK; Maillet, L; Metge, CJ; Morin, P; Newall, NE; Oelke, N; Sutherland, JM

Objectives

Comprehensive management in primary health care for complex patients often requires integration with social services and community supports. This comparative policy and program analysis describes governance and policies in Canadian provinces that condition multi-service integration programs for children and youth with high functional needs and community-dwelling older adults experiencing functional decline.

Approach

We will use Nominal Group Process to identify the most important services that need to be connected for our two patient populations. We will identify the relevant governance structures, formal mandates and regulatory frameworks that influence actions of the workforce to connect these services in each province. We will identify and select 20 publicly funded programs where system alterations were made specifically to connect primary health care services with social and community services for our target populations. We will describe the specific policy instruments that were used to enhance integration. Finally, we will estimate the degree of integration and evaluate the degree of implementation success.

Anticipated Results

A database will identify for each service the institutional authorities, regulatory frameworks and workforce organization. The description will make explicit how service entities and governance structures differ across provinces as well as areas suggesting readiness for spread or scale up of integrated multi-service delivery innovations across jurisdictions. An analysis within and between selected publicly funded programs of health-social-community intervention will capture the most used policy instruments and the characteristics of the program that correlate with better implementation and greater integration. Conclusion: This study will provide a cross-provincial description of the governance policy context for integrating health-social-community services in Canada. The information will accelerate cross-provincial learning and research on integrated care solutions, especially in the context of the SPOR Network in Primary and Integrated Health Care Innovations.