Le renforcement de linterface entre les services de santé publique et de première ligne : enjeux et pistes de solution

摘要

The development of close relationships between public health and clinic services, particularly those provided by primary care family physicians, is supported in all western healthcare systems. Collaborations leading to such interface are supposed to have positive impacts on the quality of care, the burden of diseases and the equity in the healthcare system. If players in both fields accept the relevance of the interface and support in principle its development, there are still many barriers that impede the collaborations in reality. That said, little is known about the barriers in the Quebec healthcare system. The purpose of this study is to answer to this lack of information by studying the interface from an organizational perspective. Two conceptual frameworks have been used: the and the .The analysis highlights two of the six forms of collaboration proposed by the typology used: the coordination of services provided to individuals and the use of clinic visits for the purpose of public health. Activities associated to these forms of collaboration, which are important with regard to the public health mandate, are of interest essentially for public health and are practically unilaterally determined by public health. Moreover, the lack of coordination in activities involving a collaboration with physicians is an obstacle for the development of such activities and generates irritants for the physicians. Thus, in the Quebec healthcare system there are opportunities for the development of the interface where the collaboration occurs also at the benefit of the clinic practice and where it takes into account the constraints of the clinic sector.