Health Care Evaluation of Effectiveness

Introduction: The overall aim of this project is to help
develop knowledge about primary care delivery models
likely to improve the accessibility, quality and efficiency
of care. Operationally, this objective will be achieved
through supporting and evaluating 8 primary care team
pilot sites that rely on an expanded nursing role within
a more intensive team-based, interdisciplinary setting.
Methods and analysis: The first research
component is aimed at supporting the development
and implementation of the pilot projects, and is divided
into 2 parts. The first part is a logical analysis based
on interpreting available scientific data to understand
the causal processes by which the objectives of the
intervention being studied may be achieved. The
second part is a developmental evaluation to support
teams in the field in a participatory manner and
thereby learn from experience. Operationally, the
developmental evaluation phase mainly involves
semistructured interviews. The second component of
the project design focuses on evaluating pilot project
results and assessing their costs. This component is in
turn made up of 2 parts. Part 1 is a pre-and-post
survey of patients receiving the intervention care to
analyse their care experience. In part 2, each patient
enrolled in part 1 (around 4000 patients) will be
matched with 2 patients followed within a traditional
primary care model, so that a comparative analysis of
the accessibility, quality and efficiency of the
intervention can be performed. The cohorts formed in
this way will be followed longitudinally for 4 years.
Ethics and dissemination: The project, as well as
all consent forms and research tools, have been
accepted by 2 health sciences research ethics
committees. The procedures used will conform to best
practices regarding the anonymity of patients.